Personality Couch

In this episode of the Personality Couch Podcast, we (licensed clinical psychologists Doc Bok and Doc Fish) unpack the DSM’s Avoidant Personality Disorder (AvPd), exploring its hotly debated history, the DSM criteria, and its overlap with social anxiety. We discuss the developmental aspects of AvPd, the challenges of low self-esteem with this disorder, and how it can cause problems in employment. We end with our own unfiltered thoughts on whether or not we think it should be a diagnosis, questioning the zeitgeist in which it was coined, the lack of historical research, and its overlap with multiple other personality disorders.  

🆘In need of psychodynamic therapy or a psychological evaluation? OR are you a provider stuck on a tricky case? To schedule with us, please visit the practice website and fill out the inquiry form! 👉https://www.questpsych.org/ (Clinicians use the email listed on the website.)

Chapters

In this episode of the Personality Couch Podcast, we (licensed clinical psychologists Doc Bok and Doc Fish) explore the 3 most unstable personality disorders: schizotypal, borderline, and paranoid. All 3 types are at risk of psychosis. We first discuss historical personality classifications of neurotic, psychotic, and borderline, highlighting that the borderline space between neurotic and psychotic is the most prone to instability. This borderline space is where schizotypal, borderline, and paranoid personalities sit. We discuss the risky traits of each personality, including cognitive slippage, emotional instability, and extreme rigidity. We also discuss some of our thoughts and experiences in diagnosing these rather tricky disorders!

🆘Are you a clinician stuck on a case? To schedule a consultation, please visit the practice website! 👉https://www.questpsych.org/

Chapters

00:00 Intro & Psychodynamic Personality Organization

In this episode of The Personality Couch Podcast, we (licensed clinical psychologists Doc Bok and Doc Fish) unpack the 6 subtypes of schizotypal personality disorder, according to Dr. Theodore Millon. We outline Millon’s take on “structurally defective structures” as being at risk of falling apart into psychosis at all levels of functioning, with the most severe levels of schizotypal deteriorating into schizophrenia. We then discuss the characteristics of mild, moderate, and severe subtypes, specifically: Disengaged Eccentrics, Apprehensive Eccentrics, the Insipid Schizotypal, the Timorous Schizotypal, the Immobile Schizophrenic, and the Disorganized Schizophrenic. 

🆘Are you a clinician stuck on a case? To schedule a consultation, please visit the practice website! 👉https://www.questpsych.org/

Chapters

In this episode of the Personality Couch Podcast, we (licensed clinical psychologists Doc Bok and Doc Fish) dive into the origins, diagnostic criteria, and oddities associated with schizotypal personality disorder and what it means to be almost psychotic, but not quite. We unpack idiosyncrasies and “cognitive slippage” of schizotypals that include odd speech patterns, suspiciousness, emotional expression, and social anxiety. This episode also highlights the importance of cultural context in diagnosis and not overpathologizing trends or religious norms. We also explore the overlap with and risk of schizophrenia in schizotypals, along with long-term implications of living in a quasi-psychotic cognitive space.

🆘Are you a clinician stuck on a case? To schedule a consultation, please visit the practice website! 👉https://www.questpsych.org/

Chapters

In this episode of The Personality Couch, we (licensed clinical psychologists Doc Bok and Doc Fish) explore the origins and nuances of schizotypal personality disorder, its genetic links to schizophrenia, and the clinical observations that define it. We discuss the evolution of the term 'schizotypal' in the DSM, the implications of schizotypy, and how environmental factors and social learning influence its development. We also uncover observable traits of schizotypal individuals, their social interactions, and self-concept, providing a comprehensive overview of this intriguing personality disorder that is not quite psychotic, but close.

🆘Are you a clinician stuck on a case? To schedule a consultation, please visit the practice website! 👉https://www.questpsych.org/

Chapters

In this episode of The Personality Couch, we (licensed clinical psychologists Doc Bok and Doc Fish) compare and contrast schizoid and schizotypal personality disorders, as well as schizophrenia. We define key terms, explore the overlap and differences among these disorders, and introduce the concept of schizotypy as a genetic predisposition towards schizophrenia. We further discuss the concept of schizotaxia, or “cognitive slippage” and the impact of birth trauma on schizo development. We also share our opinions about where schizoid fits on this continuum and if they are schizotypes or not. 

🆘Are you a clinician stuck on a case? To schedule a consultation, please visit the practice website! 👉https://www.questpsych.org/

Chapters

In this episode of The Personality Couch, we (licensed clinical psychologists Doc Bok and Doc Fish) compare and contrast avoidant and schizoid personalities. While schizoid and avoidant personality disorders have overlapping traits but distinct characteristics, personality psychologists have argued about it for decades. In this episode, we explore the definitions of each disorder and ongoing debates surrounding if these disorders are the same thing or not. We end by sharing our thoughts about whether schizoid personality and avoidant personality are the same or different, while giving a critical opinion about the DSM’s limiting definitions of both.

🆘Are you a clinician stuck on a case? To schedule a consultation, please visit the practice website! 👉https://www.questpsych.org/

Chapters

In this episode of The Personality Couch, we (licensed clinical psychologists Doc Bok and Doc Fish) take a critical look at the subtypes of schizoid personality, critiquing existing definitions and theories, particularly the 6 subtypes of Dr. Theodore Millon. We explore his mild, moderate, and severe subtypes: the Reserved Apathetic, Introspectively Apathetic, Remotely Asocial, Languidly Asocial, Depersonalized Schizoid, and Affectless Schizoid. We propose our own 5 subtypes and invite our schizoid listeners and viewers to share which type they identify with the most!

🆘Are you a clinician stuck on a case? To schedule a consultation, please visit the practice website! 👉https://www.questpsych.org/

Chapters

In this episode of The Personality Couch, we (licensed clinical psychologists Doc Bok and Doc Fish) answer your most-asked questions about schizoid personality. We address misconceptions about schizoid and settle its pronunciation debate (is it skii-zoid or skitz-oid?). We also explore the significant role (or not) of maternal relationships in schizoid’s development. Relatedly, we take a critical look at emotional expression, where we discuss the impact of gender expectations, and the nuanced understanding of fear of intrusion. We further explore power dynamics at play in schizoid behavior, their expression of anger, and how this personality navigates our highly social world.

🆘Are you a clinician stuck on a case? To schedule a consultation, please visit the practice website! 👉https://www.questpsych.org/

Chapters

In this episode of The Personality Couch, we (licensed clinical psychologists Doc Bok and Doc Fish) unpack the differences and similarities between schizoid personality disorder and autism spectrum disorder, and whether you can be diagnosed with both. We start by discussing the limitations of current research before investigating the underlying causes of social withdrawal seen in both conditions. We conclude by emphasizing that while they may share observable traits, their origins and implications are fundamentally different.

🆘Are you a clinician stuck on a case? To schedule a consultation, please visit the practice website! 👉https://www.questpsych.org/

Chapters