Ep 42: The Almost Psychotic Personality | Schizotypal in the DSM

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.

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Chapters 00:00 Intro & History of Schizotypal Personality 01:15 DSM Criteria Schizotypal Personality 02:59 Ideas of Reference 05:35 Odd Beliefs and Magical Thinking 08:18 Exploring Cultural Oddities vs Psychosis 11:05 Unusual Perceptual Experiences 12:44 Odd Thinking & Speech 17:45 Suspiciousness and Paranoia 18:34 Emotional Expression, Behavior, and Appearance 20:13 Lack of Close Relationships and Anxiety 23:42 Schizotypal Differential Diagnosis 24:46 Schizotypals’ Relationship to Schizophrenia 29:33 Summary and Conclusion