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 02:31 Neurotic Personality Organization 04:47 Psychotic Personality Organization 05:48 Borderline Personality Organization 07:57 Schizotypal Personality & Instability 08:57 Why Personalities Are Unstable (according to Millon) 13:55 Personalities that Coexist with Schizotypal 16:30 Borderline Personality & Instability 21:16 Personalities that Coexist with Borderline 23:18 Paranoid Personality & Instability 26:52 Personalities that Coexist with Paranoid 30:18 Our Experiences with Diagnosing Unstable Personalities 33:39 Summary & Conclusion

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 00:00 Intro & History of Schizotypal Subtypes 02:45 Theodore Millon’s Theory on Schizotypal Personality 07:00 The Mild Eccentric Level 08:21 Disengaged Eccentrics 09:39 Apprehensive Eccentrics 10:48 The Moderate Schizotypal Level 11:57 Insipid Schizotypal 18:17 Timorous Schizotypal 21:26 The Severe Schizophrenic Level 22:56 Immobile Schizophrenic 26:08 Disorganized Schizophrenic 29:05 Summary & Conclusion

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 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

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 00:00 Intro & History of Schizotypal Personality 01:34 Genetic Research on Schizotypal 05:17 Clinical Research on Schizotypal 08:47 Schizotypal in the DSM 09:29 Schizotypy and Borderline Personality Organization 12:17 Schizotypy Defined 14:32 Schizotaxia Defined 17:39 Schizotypic Endophenotypes Explained 19:57 When Schizotypy Manifests 21:28 Observable Traits of Schizotypal Personality Disorder 30:44 Summary and Conclusion

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 00:00 Introduction & Defining Terms 01:14 Schizoid Personality Defined 01:49 Schizotypal Personality Defined 06:30 Schizophrenia Defined 09:05 Overlap of Schizoid, Schizotypal, & Schizophrenia 12:48 Differences Among Schizoid, Schizotypal, & Schizophrenia 14:34 Meehl’s Model of Schizotypy & Genetics 16:29 Schizotypy Defined 20:00 Premature Birth & Low Birth Weight in Schizo Disorders 22:39 Schizoids’ Unique Relationship to Schizotypy 28:34 Summary & Conclusion

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 00:00 Intro & Schizoid and Avoidant Definitions 02:29 Historical Context of Avoidant Personality Disorder 04:31 Kretschmer's Theory & Anesthesia vs Hyperasthesia 08:17 The Argument for Splitting or Merging Disorders 10:51 Overlapping Symptoms of Avoidant and Schizoid 11:49 Differences in Schizoid and Avoidant Personalities 20:19 Our Opinions and Discussion 35:21 Summary & Conclusion

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 00:00 Introduction & Schizoid Personality Recap 02:21 Historical Subtypes - Brief Review 03:09 Akhtar’s Covert & Overt Schizoid 05:08 Understanding Millon’s Personality Theory 07:51 Millon’s Mild Subtype: The Reserved Apathetic 10:32 Millon’s Mild Subtype: The Introspectively Apathetic 12:15 Millon’s Moderate Subtype: The Remotely Asocial 14:34 Millon’s Moderate Subtype: The Languidly Asocial 16:52 Millon’s Severe Subtype: The Depersonalized Schizoid 19:16 Millon’s Severe Subtype: The Affectless Schizoid 22:04 Doc Bok & Fish Subtype: The Master Masker 25:19 Doc Bok & Fish Subtype: The Quietly Antisocial 27:38 Doc Bok & Fish Subtype: The Depressive Schizoid 30:08 Doc Bok & Fish Subtype: The Slothy Schizoid 32:03 Doc Bok & Fish Subtype: The Scattered Professor 34:25 Conclusion and Listener Engagement

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 00:00 Introduction to Schizoid Personality 00:50 Pronunciation of Schizoid 04:19 How The Hosts Know About Schizoid 09:54 The Role of Masking in Schizoid Personalities 13:16 Gender Differences in Schizoid Expression 14:46 Does Mom Really Matter? 16:52 Alternative Pathways to Schizoid Development 24:04 Power Dynamics, Fear, & Control in Schizoid Behavior 30:00 Anger & Emotional Expression in Schizoids 34:02 Schizoid & The Big 5 Personality (OCEAN) 35:18 Schizoids & Raisins 37:05 Conclusion & Final Thoughts