Understanding Schizotypal Personality Disorder


By: Christine Hammond, LMHC

Pop quiz: what word is similar to “schizotypal”?  If you said “schizophrenia,” then you are right.  Schizotypal is derived from the two words schizophrenia and genotype.  Schizophrenias see, hear and believe things that aren’t really there.  Genotype is the genetic makeup of an individual, think DNA.  So putting the two together a Schizotypal Personality Disorder (SPD) is someone who has may seem schizophrenic but is not a full-blown schizophrenic.  Confused yet?  Good because that is precisely what it feels like to speak to a SPD. 

So what is SPD?  Here is the technical DSM-V definition:

·      Identity:  Confused boundaries between self and others

·      Self-direction:  Incoherent goals, no clear set of standards

·      Empathy:  Difficulty understanding impact of behavior on others

·      Intimacy:  Mistrust and anxiety with close relationships

·      Eccentricity:  Odd, unusual, or bizarre behavior and appearance

·      Cognitive and perceptual dysregulation:  Odd or unusual thought processes, over-elaborate speech

·      Unusual beliefs and experiences:  Unusual experiences of reality

·      Restricted affectivity:  Little reaction to emotional situations, indifference or coldness

·      Withdrawal:  Preference for being alone

·      Suspiciousness:  Expectations of signs of interpersonal harm

The practical definition looks more like this:

·      Loner lacking close friends

·      Feels external events have personal meaning

·      Peculiar, eccentric or unusual thinking, beliefs or behavior

·      Dresses in peculiar ways

·      Belief in special powers

·      Phantom pains

·      Excessive social anxiety

·      Rambling oddly and endlessly during conversations

·      Suspicious or paranoid ideas

·      Doubts the loyalty of others

·      Flat emotions

Still not sure what a SPD looks like in person?  Lisa Kudrow who played Pheobe from “Friends” did a wonderful job portraying SPD.  Remember the “Smelly Cat” song or the “Pigeon” song (look them up on YouTube)?  None of her songs ever made sense which added to the humor of the show but for a SPD what they are saying makes perfect sense and everyone else is crazy.

So how do you deal with a person who might have SPD?  Here are a few suggestions:

·      Don’t follow them down the rabbit trail, stay focused on the topic.

·      Don’t try to apply logic to random comments; it only frustrates you, not them.

·      Emotional reasoning won’t work either because their emotions don’t make sense with the circumstances.

·      They will agree with you even when they don’t.

·      Put everything in writing for future reference.

·      Expect to re-explain over and over.

·      Be patient, show no emotion.  They shut down when confronted.

·      Questions should be simple almost child-like.

SPDs live in their own world and are very happy that way.  While they will invite you in on occasion, the level of intimacy will not be the same as other people in your life.  Be patient with SPDs and allow them to control the speed of the relationship, they will be much more willing to engage that way. 

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