Schizoid Personality Disorder (page 2)

In an article in the American Journal of Psychotherapy, Salman Akhtar, M.D., provides a comprehensive phenomenological profile of Schizoid Personality Disorder in which classic and contemporary descriptive views are synthesized with psychoanalytic observations. This profile is summarized in a table (reproduced below) listing clinical features, involving six areas of psychosocial functioning and designated by "overt" and "covert" manifestations. Dr. Akhtar states that "these designations do not imply conscious or unconscious but denote seemingly contradictory aspects that are phenomenologically more or less easily discernible," and that "this manner of organizing symptomology emphasizes the centrality of splitting and identity confusion in schizoid personality."

CLINICAL FEATURES OF SCHIZOID PERSONALITY DISORDER

	OVERT	COVERT
I. Self-Concept	Compliant; stoic; noncompetitive; self-sufficient; lacking assertiveness; feeling inferior and an outsider in life.	Cynical; inauthentic; depersonalized; alternately feeling empty, robot-like and full of omnipotent, vengeful fantasies; hidden grandiosity.
II. Interpersonal Relations	Withdrawn; aloof; have few close friends; impervious to others' emotions; afraid of intimacy.	Exquisitely sensitive; deeply curious about others; hungry for love; envious of others' spontaneity; intensely needy of involvement with others; capable of excitement with carefully selected intimates.
III. Social Adaptation	Prefer solitary occupational and recreational activities; marginal or eclectically sociable in groups; vulnerable to esoteric movements owing to a strong need to belong; tend to be lazy and indolent.	Lack clarity of goals; weak ethnic affiliation; usually capable of steady work; sometimes quite creative and may make unique and original contributions; capable of passionate endurance in certain spheres of interest.
IV. Love and Sexuality	Asexual, sometimes celibate; free of romantic interests; averse to sexual gossip and innuendo.	Secret vouyeristic and pornographic interests; vulnerable to erotomania; tendency towards compulsive masturbation and perversions.
V. Ethics, Standards, and Ideals	Idiosyncratic moral and political beliefs; tendency towards spiritual, mystical and para-psychological interests.	Moral unevenness; occasionally strikingly amoral and vulnerable to odd crimes, at other times altruistically self sacrificing.
VI. Cognitive Style	Absent-minded; engrossed in fantasy; vague and stilted speech; alternations between eloquence and inarticulateness.	Autistic thinking; fluctuations between sharp contact with external reality and hyperreflectiveness about the self; autocentric use of language.

Akhtar, S. Schizoid Personality Disorder: A Synthesis of Developmental, Dynamic, and Descriptive Features. American Journal of Psychotherapy, 151:499-518, 1987.

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