it is about the behavior indicators of schizoid personality disorder

1. Schizoid Personality Disorder
by Tania Curley
Caoimhe Richmond
Ella Zhang

2. Agenda
1. What is Schizoid Personality Disorder (SPD)?
2. What does SPD look like? - The Characteristics
3. How is SPD Diagnosed?
4. Schizoid Personality Vs Disorder
5. Signs when coaching
6. When to refer
7. Treatment options and referral recommendations
8. Key principles to remember when coaching

3. What is SPD
Schizoid Personality Disorder (or SPD) is the disorder that is
characterized by:
 avoidance of social situations and close contact with other people
 a lack of interest in social interaction and relationships
Those afflicted usually drift towards a solitary lifestyle, which includes
 secretiveness,
 emotional coldness, and apathy, and
 may demonstrate an elaborate internal fantasy world.
What is SPD
 falls into the Cluster A (odd), schizoid, schizotypal & paranoid,
 Defined by Bleuler in 1924 – tendency to turn inward
 Schizo – splitting & Oid – representing or like
Some Confusion
 Schizotypal (Axis II - experience perceptual distortions, paranoia or illusions)
 Schizophrenia (Axis I - confused thinking, delusions & hallucinations)

4. Cognitive & Behavior of SPD __ Typical case conceptualization of SPD
Trigger Event: Close interpersonal interaction
Auto thoughts: - I need plenty of personal space
- I don’t fit in, I’m different
- Relationship is too messy,
Cognitive
-It is important to be
independent
- I’m self sufficient
- I set up my own
standard
- It is better to be alone
than to feel ‘stuck’ with
others
- absent-minded
- autistic thinking, odd use
of language
…..
Behavioral
-Detach from social
relationships
- avoidance of
opportunities for
intimacy & close
relationships
- choose solitary over
companion
- lack of desire for
sexual experiences
- aloof
Emotional
-Maintain an
indifference to the
approval or criticism or
others
- constricted, having
difficulty in expressing
anger
- unwavering absence
of feeling
- feel confused
- Feel unable to
experience pleasure
Physiological
- Anxiety
- withdrawn
- Slow respond
- Mind goes
blank
- Sweaty
Consequences: - Prefer being alone
- unmotivated and tend to underperform
- Feel socially isolated, don’t care about people
Reinforce:
-Life is less
complicated without
other People
- Relationships are
problematic
- I can manage
things on my own
without other’s help

5. How is SPD diagnosed
DSM IV
A pervasive pattern of detachments from social relationships
& a restricted range of expression of emotions in
interpersonal settings, present in a variety of contexts,
as indicated by four (or more) of the following:
1. Neither desires nor enjoys close relationships including
being part of a family (most indicative criterion)
2. Almost always chooses solitary activities
3. Has little (if any) interest in having sexual experiences
with another
4. Takes pleasure in few, if any activities
5. Lacks close friends or confidants other than first degree
relatives
6. Appears indifferent to the praise or criticism of others
7. Shows emotional coldness, detachment or flattened
affectivity
APA (2000 p. 67)
Diagnostic criteria (ICD-10)
According to WHO ICD-10, schizoid personality disorder is
characterized by at least three of the following criteria:
1. Emotional coldness, detachment
2. Limited capacity to express positive or negative emotions
towards others
3. Consistent preference towards solitary activities
4. Very few if any close friends or relationships, with a lack of
desire for such
5. Indifference to praise or criticism
6. Taking pleasure in few if any activities
7. Indifference towards social conventions or norms
8. Preoccupation with introspection or fantasy
9. Lack of desire for sexual experiences with another individual

6. So what might this look like?
A lesson from the movies – Remains of the day

7. Personality Style
Little need for companionship No desire/joy in close relationships
Don’t require others to enjoy experiences Almost always solitary activities
Calm, even tempered, rarely sentimental Rarely appear/claim emotion
Can enjoy sex but low need No desire to have sex with another
Confident in own behaviour Indifferent to criticism/praise
Unswayed by criticism/praise and show little affect e.g. cold
Disorder

8. Likelihood of working with
someone with this disorder in coaching?
• Less than 1% of the clinical population diagnosed with this disorder
• Patients don’t feel the need to go to therapy… likely to extend to coaching.
• May be more likely in life coaching than leadership coaching
• Likely to present with coaching needs around interpersonal challenges
• Unlikely to be initiated by themselves - sent by frustrated others e.g
“technically he or she is brilliant… just doesn’t relate well”
• Tend to like working in roles that a solo – Ranger, Night audit, security,
research, IT, writer, dealing with things or information

9. Signs when coaching - Behaviour
•Unlikely to mirror or reciprocate your attempts at rapport building
•Lack of reaction to praise or criticism although likely to intellectualise
•Regardless of your questioning (i.e. open/closed) response will be short
•Conversation can wander off track oscillating between eloquence and
vagueness, sometimes can come across as eccentric
•Monotone speech

10. Signs when coaching - Emotion
•Lack of physiological signs
•Deadpan when talking about emotion e.g. may make comments about lack of
pleasure or sadness
•Emotional reactions learned and non spontaneous e.g. social expectation to
be pleasant = smile
• Note: If coach continues to probe to express emotion may result in anxiety or
panic attack

11. Signs when Coaching - Cognitive
• Schizoids are generally very intelligent so are often aware of their difference
and know to hide this from others,
• They may be very unlikely to express their true thoughts and will tend to
intellectualise
“What is normal anyway?”
“What is feedback anyway? Its based on individuals perception…just
because they interpret my actions one way does not mean this is true”
“I am a bit of a loner, I always have been”

12. Signs when Coaching - Cognitive
Underlying belief often unexpressed
“I'm not remotely dangerous to anyone, even myself; all I want to do is avoid
responsibility for others' feelings, avoid getting sucked in to emotional
relationships and be left alone to enjoy my solitude when” I need it”
http://secretschizoidspeaks.wordpress.com

13. When to refer
• If the pattern of behaviour is leading to significant distress or impairment in
social, occupational or other important areas of functioning
or
• If it is associated with another mental health issue, such as depression or anxiety
or
• You have reached your personal point of referral

14. Treatment options
Treatment amenability is low and so usually focuses on increasing general coping
skills, improving social interaction, communication and self-esteem. Specific approach
depends on the person’s expectations and resilience.
Clinical Psychologists
-Cognitive behavioural therapy
-Social skills training
-Supportive techniques
-Group therapy
Medication?
Medication is rarely used but atypical antipsychotic medication may be used to help
with symptoms (Risperidone or olanzapine can work for the social deficits and blunted
affect and Wellbutrin for anhedonia (inability to experience pleasure))

15. Mental Health Referrals – Clinical psychologists with experience dealing in SPD. For alternatives/other locations
visit www.psychology.org.au/findapsychologist/Default.aspx?Mode=Advanced
Name Address Phone number Web address
Dr Gus Norris Glebe, Miranda, Kogarah 02 8207 6733 www.gusnorris.com.au
Dr Lissa Johnson & Associates
•Dr Paul Pusey
Suite 1014, 185 Elizabeth St
Sydney (Wed and Thurs)
02 9331 0756 www.psychologistsydney.
com/paulpusey.htm
Australian Clinical Psychologists
•Joe Gubbay
Macquarie St, Woolahra and
Maroubra
1300 66 44 13 http://australianclinicalps
ychologists.com.au
LifeConnect
•David Baldwin
•Lyndsay Babcock
•Dr Jennifer Gibbs Bestel
243 Miller Street North Sydney,
NSW 2065 Australia
02 9922 6699 www.lifeconnect.com.au
Psychology4everyone
•Dr Karen B Tilker
Crows Nest
*internet/phone options
0404 074041 www.psychology4everyo
ne.com
Mental Health Referrals – GPs with experience dealing with personality disorders. For alternatives/other locations
visit www.beyondblue.org.au/get-support/find-a-professional and use Advanced Search
Name Address Phone number Web address
Dr Simon Cowap L1, Fountain St, Alexandria, 2015 02 9699 1491 www.yourmentalhealthgp
.com.au
Dr Susan Allman L11, 221 Miller St, North Sydney,
2060
02 9955 8006 www.millerstreetmedical.
com.au
Dr Ankita Roy L1, 70 Pitt Street, Sydney, 2000 02 92333399 www.sydneydoctors.com.
au

16. Key principles to remember when coaching
Key points:
• Schizoid styles are likely to want to
avoid coaching just as they avoid
relationships in general
• They generally do not believe they
have a problem
• They usually present due to the
urging of a manager or family
member and so may feel ‘mandated’
• They are more likely to prematurely
end the coaching relationship
• There is likely to be only a small
window of opportunity to engage
them

17. Key principles to remember when coaching
Build trust
• Recognize rapport and engagement
may be impossible
• Find something they are interested in
and take it from there
• Don’t expect to make a connection
through humour
• Ask for permission to ask questions
and be sensitive to the fact that the
individual may not want to disclose
or discuss
• Demonstrate empathy
• Avoid asking them about feelings and
emotions - take an intellectual rather
than emotional approach
Be patient
• Be patient with slow speech
(maintain your focus and attention)
• Be tolerant of limited verbal
exchange and hold the silence
• There is likely to be little motivation
to change, or at the very least
ambivalence – consider using
decisional balance
• Remember it is not about you – they
are not responding to you personally,
this is the way they are

18. Remember what you know – stick to the
principles of good coaching:
• Solution focused coaching is likely to
appeal (coaching is usually short-term
in nature to help the individual solve
the presenting issue)
• Establish clear goals and focus on goal
attainment
• Support self-efficacy by building on
strengths
• A collabourative case conceptualisation
is helpful, to point out the links
between the presenting issues and
provide feedback on the possible
impact on others
• Seek feedback on their level of anxiety
about possible action steps
Useful questions If coaching has been
mandated:
“Whose idea was it that you come
and see me?”
“How did xxx get the idea that you
need to come and see me?”
“How would xxx (co-
workers/family/friends) say that xxx
is a problem for you?”
“Do you agree with their ideas?”
“How will xxx know that the
problem they think that you have is
solved?”
“What will he/she be doing
different then?”
“What will be different about your
relationship?”
“What else would be different in
your life?”
“How would that be helpful?”

19. “Its not easy being green”

20. References
• Sperry, L. (2003). Handbook of Diagnosis and Treatment of DSM-IV-TR Personality Disorders (2nd ed.). New York: Routledge
• Schizoid Personality Disorder, retrieved on Aug 19 2013, from www.bandbacktogether.com/schizoid-personality-disorder-
resources
• Schizoid Personality Disorder retrieved on Aug 19 2013, from www.regionalcenter.org
• Schizoid personality disorder retrieved on Aug 19 2013, from www.anxietyzone.com/conditions/schizoid_personality_disorder
• Psychology today (n.d.) retrieved on Aug 25 2013, from http://www.psychologytoday.com/conditions/schizoid-personality-
disorder
• Schizoid Personality Disorder retreived on Aug 25 2013, from www.pchtreatment.com/schizoid-personality-discorder-clinc