Reflections On Schizoid Dynamics

Table of contents:

Video: Reflections On Schizoid Dynamics

Video: Reflections On Schizoid Dynamics
Video: Socializing For Schizoid/Avoidant *TIPS* 2024, March
Reflections On Schizoid Dynamics
Reflections On Schizoid Dynamics
Anonim

Source:

Author: McWilliams N

For many years now I have been engaged in the development of a deeper understanding of the subjective life of people with a schizoid personality organization. This article is about a different version of schizoid personality disorder from a descriptive psychiatric taxonomy (such as the DSM). Here I am referring to a more practical, phenomenologically directed, psychoanalytic understanding of the schizoid personality, since I have always been interested in the study of individual differences more than in the debate about what is pathology and what is not. I have found that when people with schizoid dynamics - patients, colleagues, friends - feel that their self-disclosure will not be met with neglect (or will not be “criminalized,” as one therapist they know), they want to share their inner world. And, as is true in other areas, if a person noticed something once, he begins to see it everywhere.

Gradually, I realized that people with schizoid dynamics are more common than people think, and that there is a large gradient of mental and emotional health among them: from the psychotic level to an enviable reliable mental stability. And although it is believed that the central problem of the schizoid person is not on the neurotic spectrum (Steiner, 1993), I can note that the most highly functioning schizoid people, of whom there are many, seem in all senses (by criteria such as life satisfaction, sense of their strength, affective regulation, the constancy of "I" and the object, personal relationships, creative activity) healthier than many with an authentically neurotic psyche. I prefer to use the term "schizoid" (despite the fact that Jungian "introversion" is not so stigmatizing), since "schizoid" implicitly refers to a complex intrapsychic life, while "introversion" refers to a preference for introspection and the desire for loneliness - more - less superficial phenomena.

One of the reasons mental health professionals fail to notice highly functional schizoid dynamics is that many of these people “hide” or pass “through” non-schizoid others. Their personality traits include an "allergy" to being the object of intrusive attention, and in addition, schizoids are afraid of being exposed to the public as freaks and madmen. Since non-schizoid observers tend to attribute pathology to people who are more reclusive and eccentric than themselves, the schizoid's fear of being scrutinized and exposed as abnormal or not entirely normal is quite realistic. In addition, some schizoids are concerned about their own normality, whether they have actually lost it or not. The fear of being in the category of psychotics may be a projection of a belief in the intolerance of their inner experience, which is so private, unrecognizable and not mirrored by others that they think their isolation equals madness.

Many lay people find schizoid people strange and incomprehensible. In addition, even mental health professionals can equate schizoid with mental primitiveness and primitiveness with abnormality. Melanie Klein's (Klein, 1946) brilliant interpretation of the paranoid-schizoid position as the basis for the ability to withstand separation (that is, the depressive position) has been a contribution to the perception of early developmental phenomena as immature and archaic (Sass, 1992). In addition, we suspect that schizoid personality manifestations are likely precursors to schizophrenic psychosis. The behavior that is normal for the schizoid personality can certainly mimic the early stages of schizophrenia. An adult who begins to spend more and more time in isolation in his room among his fantasies and eventually becomes overtly psychotic is not an uncommon clinical picture. In addition, schizoid and schizophrenia may be related. Recent studies of schizophrenic disorders have identified genetic preconditions that can manifest themselves in a wide range from severe schizophrenia to a normal schizoid personality (Weinberger, 2004). On the other hand, there are many people diagnosed with schizophrenia whose premorbid personality can be described as predominantly paranoid, obsessive, hysterical, depressive, or narcissistic.

Another possible reason for the association of schizoids with pathology may be that many of them feel inclined towards people with psychotic disorders. One of my colleagues, who describes himself as schizoid, prefers to work with more psychotic people than with “healthy neurotics” because he perceives neurotic people as “dishonest” (that is, using psychic defenses), while psychotics are perceived by him as engaged in a completely authentic struggle with their inner demons. The earliest researchers of personality theory - for example, Carl Jung and Harry Sullivan - not only were characterologically schizoid by many estimates, but also probably experienced brief psychotic episodes that did not become a prolonged attack of schizophrenia. It seems likely that the ability of these analysts to empathically understand the subjective experiences of more severely disturbed patients has much to do with access to their own potential for psychosis. Even highly effective and emotionally stable schizoids can worry about their normalcy. A close friend of mine was deeply alarmed while watching the movie “A beautiful mind,” which depicts the gradual descent into psychosis of the brilliant mathematician, John Nash. The film dramatically draws the audience into the hero's illusory world, and then reveals that the people that the viewer believed to be real were Nash's hallucinatory delusions. It becomes apparent that his thought processes have shifted from creative genius to manifestations of psychosis. My friend was painfully alarmed to realize that, like Nash, he could not always discern when he creates a creative connection between two seemingly unrelated phenomena that are actually connected, and when he creates completely idiosyncratic connections that might seem ridiculous and crazy to others. He talked about this anxiety with his relatively schizoid analyst, whose sadly ironic response to his description of his lack of confidence in the ability to rely on his own mind was "Well, yes, who are you telling!" (In the section on consequences for therapy, it will become clear why I think this was an empathetic, disciplined, and therapeutic intervention, even though it looks like an accidental departure from the analytic stance.)

Contrary to the links between schizoid psychology and psychotic vulnerability, I have repeatedly been impressed by the high creativity, personal satisfaction and social value of schizoid people who, despite intimate acquaintance with what Freud called the primary process, were never at risk of psychotic breakdown. Many of these people work in the arts, theoretical sciences, philosophical and spiritual disciplines. And also in psychoanalysis. Harold Davis (personal communication) reports that Harry Guntrip once joked that "psychoanalysis is a schizoid profession for schizoids." Empirical studies of the personality of psychotherapists conducted at Macquarie University in Sydney, Australia (Judith Hayde, personal communication) show that although the main personality type modality among female therapists is depressive, schizoid traits are predominant among male therapists.

My guess as to why this is so includes the observation that highly organized schizoid people are not surprised or intimidated by the evidence for the existence of the unconscious. Due to an intimate and often difficult acquaintance with processes that are outside of observation for others, psychoanalytic ideas are more accessible and intuitive for them than for those who spend years on the couch, breaking psychic defenses and gaining access to hidden impulses, fantasies and feelings. … Schizoid people are characterologically introspective. They enjoy exploring every nook and cranny of their own mind, and in psychoanalysis they find many relevant metaphors for their discoveries in these studies. In addition, the professional practice of psychoanalysis and psychoanalytic therapy offers an attractive solution to the central conflict of proximity and distance that dominates the schizoid psyche (Wheelis, 1956).

I have always been attracted to schizoid people. I have discovered in recent years that most of my closest friends can be described as schizoid. My own dynamic, which tends more towards depressive and hysterical, participates in this interest in the way I will discuss below. In addition, I was pleasantly surprised by the unexpected responses to my book on diagnostics (McWilliams, 1994). Typically, readers are grateful for a chapter that has been helpful in understanding a particular personality type, working with a patient, or reflecting on their own dynamics. But something characteristic happened to the chapter on the schizoid personality. Several times after a lecture or seminar, someone (often someone from those quietly sitting in the back rows, closer to the door) came up to me, trying to make sure that they did not scare me by a sudden approach, and said: "I just wanted to say thank you for See the chapter on the schizoid personality. You really understand us."

In addition to the fact that these readers are expressing personal gratitude rather than professional gratitude, I was amazed at the use of the plural "us". I wonder if schizoid people are mentally in the same position as people belonging to sexual minorities. They are sensitive to the risk of appearing deviant, sick, or behavior-disturbed to those with normal mentalities, simply because they are truly a minority. Mental health professionals sometimes discuss schizoid topics in a tone similar to that previously used when discussing the LGBT community. We have a tendency to both equate dynamics with pathology and generalize a whole group of people on the basis of individual representatives who were looking for a cure for diseases associated with their idiosyncratic version of the psyche.

The schizoid fear of stigmatization is understandable given that people unwittingly reinforce each other on the assumption that the more common psychology is normal and the exceptions are psychopathology. Perhaps there are notable internal differences between people, expressing psychodynamic factors as well as others (constitutional, contextual, differences in life experience), which in terms of mental health are no better or worse. The tendency of people to rank differences according to some scale of values is deeply rooted and minorities belong to the lower rungs of such hierarchies.

I would like to emphasize once again the importance of the word "us". Schizoid people recognize each other. They feel like they are part of what a reclusive friend of mine called the "community of loneliness." As homosexual people with gaydar, many schizoids can notice each other in a crowd. I have heard them describe feelings of deep and empathic kinship with each other, even though these relatively isolated people rarely verbalize these feelings or approach each other to explicitly express recognition. However, a genre of popular books has begun to appear that normalizes and even describes as valuable such schizoid topics as hypersensitivity (Aron, 1996), introversion (Laney, 2002), and a preference for loneliness (Rufus, 2003). A schizoid friend told me how he walked along the corridor with several fellow students to a seminar, accompanied by a teacher who, in his opinion, had a similar personality type. On their way to class, they passed a photograph of Koni Island, which showed a beach on a hot day, crowded with people so dense that no sand could be seen. The teacher caught my friend's eye and, nodding at the photo, winced, expressing anxiety and a desire to avoid such things. My friend opened his eyes wide and nodded. They understood each other without words.

How do I define a schizoid personality?

I use the term schizoid as understood by British object relations theorists, not as the DSM interprets it (Akhtar 1992; Doidge 2001; Gabbard 1994; Guntrip 1969). The DSM arbitrarily and without empirical basis distinguishes between schizoid and avoidant personality, arguing that avoidant personality disorder includes a desire for intimacy despite distancing, while schizoid personality disorder expresses an indifference to intimacy. At the same time, I have never met among patients and other people someone whose reclusiveness was not inherently conflictual (Kernberg, 1984). Recent empirical literature supports this clinical observation (Shedler & Westen, 2004). We are attachment-seeking beings. The detachment of the schizoid personality is, among other things, a defensive strategy for avoiding hyperstimulation, traumatic assault and disability, and the most experienced psychoanalytic clinicians know how not to take this at face value, no matter how heavy and insecure this detachment may cause.

Before the invention of antipsychotics, when the first analysts worked with psychotic patients in hospitals like Chestnut Lodge, many cases of even catatonic patients returning from their isolation if they felt safe enough to try again with people were reported. A famous case, which I cannot find in written sources, describes how Frieda Fromm-Reichmann sat next to a patient with catatonic schizophrenia for one hour a day every day, occasionally making comments about what the patient might be feeling about what was happening in the yard. … After nearly a year of these daily meetings, the patient suddenly turned to her and declared that he did not agree with something she had said a few months ago.

The psychoanalytic use of the term schizoid comes from the observation of the splitting (Latin schizo - to split) between the inner life and the externally observed life of the schizoid person (Laing, 1965). For example, schizoid people are openly detached, while in therapy they describe the deepest longing for intimacy and vivid fantasies of involved intimacy.

Schizoids seem self-sufficient, but at the same time, anyone who is familiar with such a person can confirm the depth of his emotional need. They can appear extremely absent-minded, while remaining subtle observers; may appear completely unresponsive and still suffer from a subtle level of sensitivity can appear affectively inhibited, and at the same time struggle within themselves with what one of my schizoid friends calls "protoaffect", a feeling of frightening flooding with intense emotions. They may appear extremely indifferent to sex, feeding on a sexualized, elaborate fantasy life, and may impress others with unusual softness, but loved ones may learn that they are harboring detailed fantasies about the destruction of the world.

The term "schizoid" may also have originated from the fact that the characteristic anxieties of such people include fragmentation, blurring, a feeling of falling apart. They feel too vulnerable to the uncontrolled disintegration of the self. Many schizoid people have described to me their ways of coping with feelings of dangerous self-separation. These methods include wrapping in a blanket, rocking, meditating, wearing outerwear indoors, hiding in a closet, and other self-soothing means that betray an inner conviction that other people are more frustrating than soothing. Anxiety of absorption is more characteristic for them than anxiety of separation, and even the healthiest of schizoids can agonize over the psychotic horror that the world can explode, flood, fall apart at any moment, leaving no ground under their feet. The need to urgently protect the sense of a central, inviolable self can be absolute (Elkin, 1972; Eigen, 1973).

Initially trained in a model of ego psychology, I have found it helpful to think of the schizoid personality as defined by a fundamental and habitual reliance on a defense mechanism of avoidance. Avoidance can be more or less physical, like a person who goes into a cave or some other remote area whenever the world is too unbearable for him, or internal, like in the case of a woman who simply goes through daily life, in reality only present in internal fantasies and worries. Object relations theorists have emphasized the presence in schizoid people of a central conflict of interpersonal closeness and distance, a conflict in which physical (not internal) distance usually wins (Fairbairn, 1940; Guntrip, 1969).

In more severely disturbed schizoid individuals, avoidance may appear as a continuous state of mental inaccessibility, and in those who are healthier, there are marked fluctuations between contact and disconnection. Guntrip (1969, p. 36) coined the term “inward and outward program” to describe the schizoid pattern of seeking intense affective connection with the subsequent need to distance and reassemble the sense of self that was threatened by this intensity. This pattern can be especially noticeable in the sexual sphere, but it seems to apply to other manifestations of intimate emotional contact as well.

I suspect that one of the reasons why I find people with central schizoid dynamics attractive is that detachment is a relatively “primitive,” global and all-encompassing defense (Laughlin, 1979; Vailliant, Bond & Vailliant, 1986) that can do unnecessary use of more distorting, suppressive and presumably more "adult" defenses. A woman who just walks away, physically or mentally, when she is stressed, does not need denial, displacement, reactive formations, or rationalization. Consequently, the affects, images, ideas and impulses that non-schizoid people hide from consciousness are easily accessible to her, making her emotionally honest, which strikes me and, possibly, other non-schizoid people, as something unexpected and excitingly sincere.

The defensive characteristic of schizoid people (of those that can be understood negatively, as perversion, or positively, as strength of character) is indifference or open avoidance of personal attention and recognition. While they may wish for their creative work to have an impact, most schizoid people I know would rather be ignored than honored. The need for personal space far outstrips their interest in ordinary narcissistic nourishment. Known among college students for originality and flamboyance, my late husband's colleagues often grieved at his habit of publishing articles in strange and marginal journals without any discernible desire to build a broad reputation for himself in the mainstream of his field of research. Fame alone did not motivate him; to be understood by those who were personally important to him was much more important. When I told a schizoid friend that I had heard reviews of him as “brilliant, but frustratingly shut off from everyone,” he became alarmed and asked, “Where did they get“brilliant”? “Fenced off” was fine, but “brilliant” could direct someone in his direction.

How do people become schizoid?

I have written earlier about the possible causes of schizoid dynamics (McWilliams, 1994). In this article, I prefer to remain at the level of phenomenology, but let me make some general remarks about the complex etiology of various variations in schizoid personality organization. I am very impressed by the central constitutionally sensitive temperament that is visible from birth, possibly due to the genetic predisposition I mentioned earlier. I think one of the results of this genetic inheritance is a level of sensitivity in all its negative and positive aspects (Eigen, 2004) that is much more powerful and painful than most non-schizoid people. This acute sensitivity manifests from birth, continuing in behavior that rejects life experiences, experienced as too overwhelming, too destructive, too invasive.

Many schizoid people have described their mothers to me as being cold and intruding at the same time. For the mother, coldness can be experienced as coming from a child. Several self-diagnosed schizoids reported from their mothers how, as infants, they rejected the breast, and when they were held or rocked, they pulled away, as if overstimulated. A schizoid friend of mine told me that his inner metaphor for nursing is “colonization”: a term that conjures up the exploitation of innocent people by invading imperial power. Associated with this image, the widespread anxiety of poisoning, poor milk, and toxic eating also often characterizes schizoid people. One of my schizoid friends asked me during lunch: “What is it about these straws? Why do people like to drink through a straw? " “You need to suck,” I suggested. "Ugh!" she shuddered.

Schizoids are often described by family members as hypersensitive and thin-skinned. Doidge (2001) emphasizes their “increased permeability,” the feeling of being skinless, lack of adequate protection from stimuli, and notes the prevailing patterns of damaged skin in their fantasy life. After reading an early version of this article, one schizoid colleague commented, “The sense of touch is very important. We are afraid of him and we want him at the same time. As early as 1949, Bergmann and Escalona observed that some children show from birth heightened sensitivity to light, sound, touch, smells, movements and emotional tone. Several schizoids have told me that their favorite childhood fairy tale was The Princess and the Pea. The feeling that they will easily be overwhelmed by invasive others is often expressed in fear of flooding, fears of spiders, snakes and other eaters, and, following E. A. For fear of being buried alive.

Their adaptation to a world that overstimulates and leads to agony is further complicated by the experience of rejection and toxicity of significant others. Most of my schizoid patients recall that their angry parents told them that they were “oversensitive,” “intolerable,” “too picky,” that they were “making an elephant out of a fly.” Thus, their painful experiences were constantly rejected by those who had to take care of them, and who, due to their different temperaments, could not identify with the acute sensitivity of their child and often treated him with impatience, resentment and even contempt. Khan's (1963) observation that schizoid children exhibit the effect of “cumulative trauma” is one way of labeling this repetitive rejection. It is easy to see how care becomes the preferred mode of adaptation: the outside world is overwhelming, the experience is annihilated, the schizoid child is required to behave that is excruciatingly difficult and is treated like a madman for reacting to the world in a way that he cannot control.

Citing Fairbairn's work, Doidge (2001), in a delightful analysis of schizoid problems from The English Patient, summarizes the complexities of the schizoid's childhood:

“Children… develop an internalized view of a hopeful but rejecting parent… to which they are desperately attached. Such parents are often incapable of love or too busy with their own problems. Their children are rewarded when they demand nothing, and are devalued and ridiculed for expressing dependence and need for affection. Thus, the child's picture of “good” behavior is distorted. The child learns never to demand or even desire love, because this makes the parent more distant and stern. The child can then cover up feelings of loneliness, emptiness and being mocked with fantasies (often unconscious) about their self-sufficiency. Fairbairn argued that the tragedy of the schizoid child is that … he believes that the destructive force within him is love, not hate. Love devours. Therefore, the main activity of the psyche of the schizoid child is to suppress the normal desire to be loved."

Describing the central problem of such a child, Seinfeld (1993) writes that the schizoid has "an overwhelming need depending on the object, but this threatens to lose himself." This inner conflict, carefully studied in many ways, is the center of the psychoanalytic understanding of the structure of the schizoid personality.

Some rarely described aspects of the schizoid psyche

1. Reactions to loss and separation

Non-schizoid people, which seem to include the authors of the DSM and many other descriptive psychiatric traditions, often conclude that schizoids are unable to bond strongly with others and do not respond to separation, as they solve the problem of proximity / distance in favor of distancing, and seem to flourish, being alone. However, they can have very strong attachments. The attachments they have may be more invested than those of people with a more "anaclitic" psyche. Because schizoid people feel safe with very few others, any threat or real loss of connection with people they really feel comfortable with can be devastating. If there are only three people in the world who really know you, and one of them has disappeared, then a third of all support has disappeared.

A common reason for seeking psychotherapy in a schizoid person is loss. Another related cause is loneliness. As Fromm-Reichmann (1959/1990) pointed out, loneliness is a painful emotional experience that remains strangely unexplored in professional literature. The fact that schizoid people regularly withdraw and seek solitude is not evidence of their immunity to it; nothing more than avoidance of affect by the obsessive person - evidence of indifference to strong emotions, or the clinging of a depressed person - evidence of a reluctance to autonomy. Schizoids may seek therapy because, as Guntrip (1969) writes, they have become so distant from meaningful relationships that they feel exhausted, sterile, and internally dead. Or they come to therapy with a specific goal: to go on a date, become more social, start or improve sexual relations, overcome what others call "social anxiety" about them.

2. Sensitivity to the unconscious feelings of others

Perhaps due to the fact that they themselves are not protected from the nuances of their own primary thoughts, feelings and impulses, schizoids can be surprisingly attuned to the unconscious processes of others. What is obvious to them often remains invisible to less schizoid people. Sometimes I thought that I was behaving completely at ease and quite ordinary, while discovering that schizoid friends or patients were interested in my “normal” state of mind. In my book on psychotherapy (McWilliams, 2004), I tell the story of a schizoid patient, the woman who had the most intense affection for animals, who was the only one of my patients who noticed something bothering me a week after I was diagnosed with breast cancer and tried to keep this fact a secret while awaiting further medical procedures. Another schizoid patient once came to a session in the evening, when I was expecting to spend a weekend with an old friend, looked at me while I sat down in my seat, thinking that I was moving quite normally, remaining in a professional frame, and jokingly said to me: “Well, today we are so happy!”

One rarely noticed difficulty that interpersonal schizoids are constantly drawn into is social situations in which they perceive what is happening on a non-verbal level better than others. Schizoids have most likely learned from their painful history of parental neglect and their social oversights that some of the things he or she observes are obvious to everyone, and some are unambiguously invisible. And since all hidden processes can be equally visible to the schizoid, it is impossible for him to understand what to talk about socially acceptable, and what is unnoticed or indecent to have in mind. Thus, some part of the departure of a schizoid personality may not be so much an automatic defense mechanism as a conscious decision that caution is the best part of courage.

This situation is inevitably painful for a schizoid person. If a metaphorical invisible elephant has crept into a room, he or she will begin to question the meaning of the conversation in the face of such tacit denial. Since the schizoid lacks suppressive defenses, it is difficult for them to understand such defenses in other people, and they are left alone with the question "How can I get involved in a conversation without showing that I know the truth?" There may be a paranoid side to this experience of unspokenness: perhaps others are well aware of the elephant and have conspired not to mention it. What danger do they feel that I do not? Or they sincerely do not see the elephant, in which case, their naivety or ignorance can be equally dangerous. Kerry Gordon (Gordon, unpublished article) observes that the schizoid person lives in a world of the possible, not the probable. As with all patterns that repeat a theme over and over again, having the property of a self-fulfilling prophecy, schizoid withdrawal simultaneously increases the tendency to live in the primary process and creates even more withdrawal due to the aggressive circumstances of incredibly intimate living in a reality where the primary processes are clear. are visible.

3. Unity with the universe

Schizoid personalities are often characterized as having defensive fantasies of omnipotence. For example, Doidge (2001) mentions a seemingly collaborating patient who “discovered deep in therapy that he always had an omnipotent fantasy that he was in control of everything I said.” However, the schizoid sense of omnipotence is critically different from that of the narcissistic, psychopathic, paranoid, or obsessive personality. Rather than investing in grandiose self-presentation, or maintaining a defensive drive for control, schizoid people tend to feel a deep and interpenetrating connection with their environment. They may admit, for example, that their thoughts influence their environment, just as the environment influences their thoughts. It is an organic, syntonic belief rather than a wish-fulfilling defense (Khan, 1966). Gordon (unpublished paper) characterized this experience as “omnipresence” rather than omnipotence, and associates it with Matte-Blanco's notion of symmetric logic (Matte-Blanco, 1975).

This sense of connection with all aspects of the environment can include animating the inanimate. Einstein, for example, approached the understanding of the physics of the universe by identifying with elementary particles and thinking about the world from their point of view. The tendency to feel an affinity for things is understood as a consequence of the rejection of other people, but it can also be unsuppressed access to an animist position that only emerges in dreams or vague memories of how we thought in childhood. One day when my friend and I were eating cupcakes, she commented, "It's good that these raisins don't bother me." I asked what was wrong with the raisins: "Don't you like the taste?" She smiled: “Don’t you understand, raisins could be flies!” A colleague with whom I shared this story recalled that her husband, whom she recognizes as schizoid, does not like raisins for another reason: "He says raisins are hiding."

4. Schizoid-hysterical romance

Above, I mentioned that I am attracted to people with schizoid psychology. When I think about this phenomenon and see the frequency with which heterosexual women with hysterical dynamics become involved in relationships with men with schizoid traits, I find that, in addition to the disarming honesty of schizoid people, there are dynamic reasons for this resonance. Clinical descriptions abound with descriptions of hysteroid-schizoid couples, their misunderstandings, the problems of approaching and receding partners, the inability of each side to see that the partner is not powerful and demanding, but scared and needy. But despite our recent recognition of the interpersonal processes of two people, surprisingly little professional work has been done on the intersubjective consequences of specific and contrasting personality traits. Allen Willis's story The Illusionless Man and the Visionary Maid (1966/2000) and the classic definition of the occaphile and philobath Balint (1945) seem to me more relevant to schizoid-hysteroid chemistry than any recent clinical descriptions.

The mutual admiration between the more hysterical and more schizoid individuals is rarely the same. While a hysterically organized woman idealizes the ability of a schizoid man to be lonely, “speak the truth to the powers that be,” contain affect, rise to levels of creative imagination that she can only dream of, a schizoid man admires her warmth, comfort with others, empathic, grace in expressing emotions without clumsiness or shame, the ability to express one's own creativity in relationships. With the same power with which opposites attract, and hysterical and schizoid people idealize each other - then they drive each other crazy when their mutual needs for closeness and distance collide in conflict. Doidge (2001) aptly compares a love relationship with a schizoid person to a legal battle.

I think the similarities between these personality types go much further. Both schizoid and hysterical psychology can be described as hypersensitive and obsessed with the fear of overstimulation. While the schizoid personality is afraid of being overstimulated by external sources, the hysterical person feels fear of drives, impulses, affects and other internal states. Both personality types are also described as associated with cumulative or severe trauma. Both are almost certainly more right-brain than left-brain. Both schizoid men and hysterical women (at least those who identify themselves as heterosexual - my clinical experience is not enough to generalize to other cases) tend to see the parent of the opposite sex as the center of power in the family and both feel that their mental life is too easily invaded by this parent. Both of them suffer from an absorbing feeling of hunger, which the schizoid person tries to tame, and the hysterical person - to sexualize. If I am correct in describing these similarities, then some of the magic between the schizoid and hysterical personality is based on similarities, not differences. Arthur Robbins (personal communication) goes so far as to claim that there is a hysteroid inside the schizoid personality and vice versa. Researching this idea is the material for a separate article that I hope to write in the future.

Therapeutic implications

People with marked schizoid dynamics, at least those on the healthy edge, more vital and interpersonal competent, tend to be drawn into psychoanalysis and psychoanalytic therapy. Usually they cannot imagine how one can agree in therapy to protocol interventions that lower individuality and the exploration of inner life into secondary roles. If they have the resource to sustain the therapeutic work, then highly functioning schizoid people are excellent candidates for psychoanalysis. They like the fact that the analyst interrupts their associative process relatively little, they enjoy the safe space provided by the couch, they like to be free from potential overstimulation by the therapist's materiality and facial expressions. Even once a week in a face-to-face setting, schizoid patients are grateful when the therapist is careful to avoid premature intimacy and intrusion. Since they “understand” the primary process and know that the training of the therapist includes understanding this process, they can hope that their inner life will not cause shock, criticism, or devaluation.

Although most highly functional schizoid patients accept and value traditional analytic practice, what happens in successful treatment of such patients is not well reflected in the classical Freudian formulation of unconscious-to-conscious translation. While some of the unconscious aspects of schizoid experience, especially the addictive drive that elicits defensive withdrawal, do become more conscious in successful therapy, much of what brings about therapeutic transformation involves new experiences of self-development in the presence of an accepting, non-intrusive, yet highly responsive. another (Gordon, unpublished article). The famous hunger of the schizoid personality, in my experience, is the hunger for recognition, about which Benjamin (2000) so emphatically wrote, for the recognition of their subjective life. It is the ability to invest in the struggle to be recognized and to restore this process when it is disturbed - that was wounded most deeply in those of them who come to us for help.

Winnicott, whose biographers (Kahr, 1996; Phillips, 1989; Rodman, 2003) describe him as a deeply schizoid person, described the development of the infant in language that is directly applicable to the treatment of the schizoid patient. His concept of a caring other that allows the child to “continue being” and “be alone in the presence of the mother” could not be more relevant. Accepting the importance of a supportive environment characterized by non-intrusive others who value the true vital self, rather than trying to follow the defense mechanisms of others, may be a recipe for psychoanalytic work with schizoid patients. As long as the psychoanalyst's narcissism does not express itself in the need to overwhelm the analysand with interpretations, classical analytic practice gives the schizoid personality the space to feel and speak at a pace that he can sustain.

However, the clinical literature has paid attention to the special needs of schizoid patients who require something that goes beyond standard techniques. First, since speaking sincerely can be unbearably painful for the schizoid person, and receiving a response with emotional immediacy can be comparatively overwhelming, the therapeutic relationship can be extended by intermediate means of transmitting feelings. One of my patients, who had to struggle every session just to speak, ended up calling me on the phone in tears. “I want you to know that I want to talk to you,” she said, “but it hurts too much.” In the end, we were able to make therapeutic progress in a rather non-standard way - I read to her the available and least pejorative psychoanalytic literature on schizoid psychology and asked if the descriptions given fit her experience. I hoped to free her from the agony of articulating and giving voice to feelings that she found unbearable to others and which she considered symptoms of deep secluded madness. She said that for the first time in her life she learned about the existence of others, like her, people.

A schizoid patient who cannot directly describe excruciating isolation may speak of such a state of consciousness if it appears in a film, poem, or story. Empathic therapists who work with schizoid clients often find themselves either initiating a conversation or responding to conversation about music, the visual arts, theater, literary metaphors, anthropological discoveries, historical events, or the ideas of religious and mystical thinkers. In contrast to obsessive patients who avoid emotion through intellectualization, schizoid patients may find it possible to express affect as soon as they have the intellectual means by which to do so. Because of this transitory method, art therapy has long been considered particularly suitable for these patients.

Second, sensitive clinicians note that schizoid people have a “radar” to recognize avoidance, pretense, and falsehood. For this and other reasons, the therapist may need to be more “real” with them in therapy. Unlike analysands who readily exploit information about the therapist to serve their intrusive needs, or to fill with idealization and devaluation, schizoid patients tend to accept the therapist's disclosure with gratitude and continue to respect his private space. An Israeli patient writing under a pseudonym notes:

“People with a schizoid personality … tend to feel more comfortable with those who stay in touch with themselves, who are not afraid to expose their weaknesses and look like mere mortals. I refer to an informal and relaxed atmosphere where it is accepted that people are wrong, may lose control, act childish, or even unacceptable. In such conditions, a person who is very sensitive by nature can be more open and spend less energy trying to hide his difference from others”(“Mitmodedet”, 2002).

Robbins (1991) describes a schizoid woman who came to him devastated by the sudden death of her analyst and was unable to talk about her pain. The fantasy she had awakened in him - a stranger on a lonely island, simultaneously satisfied and begging for salvation - looked potentially too intimidating to share. The therapy began to deepen when the session brought up a trivial topic: “One day she came in and mentioned that she had just had a snack at the nearest pizzeria … We started talking about different pizzerias on the West Side, both agreed that Sal was the best. We continued to share this shared interest, now continuing to talk about pizzerias all over Manhattan. We exchanged information and seemed to have mutual pleasure in such an exchange. Definitely a strong departure from standard analytic procedure. On a more subtle level, we both began to learn something very important about something else, although I suspect that her knowledge remained largely unconscious. We both knew what it meant to eat on the run, hungry to intercept something filling an unspeakable black hole, which at best was just a palliative for an unquenchable hunger. This hunger, of course, was kept to themselves, for those who could bear the intensity of such predation. … Talking about pizza became our bridge for unification, a reproduction of a common bond that eventually became the starting point for shaping the patient's present and past. Our contact through pizza served as a refuge, a place where she felt understood."

One of the reasons that disclosing the therapist's personal experience catalyzes therapy with the schizoid patient is that, even more than other people, these patients need their subjective experience to be recognized and accepted. The affirmation of feelings is calming to them, and a “naked” interpretation, however neat it may be, may not cope with conveying the idea that the interpreted material is something ordinary and even somewhat positive. I know many people who have spent years in analysis and come up with a detailed understanding of their underlying psychodynamics and yet felt that their self-disclosures were shameful confessions rather than expressions of their basic humanity in all their normal depravity and virtue. The analyst's ability to be “real” - to be flawed, to be wrong, crazy, insecure, struggling, alive, agitated, authentic - is a possible way of promoting self-acceptance of the schizoid personality. This is why I consider my friend's sarcastic saying "Well, who are you telling!" (reaction to his own worries about losing his mind) - both typically psychoanalytic and deeply empathic.

Finally, there is a danger that when the schizoid patient becomes more comfortable opening up in therapy, he will make the professional relationship a surrogate to meet the needs for communication, instead of seeking relationships outside the analytic room. Many therapists have worked with a schizoid patient for months and years, feeling increasing gratitude for their involvement, before remembering, with shock, that the person originally came because they wanted to develop an intimate relationship that has not yet begun, and there are no signs their beginning. Since the line between being inspirational and boringly nagging can be thin, it is a difficult art to reward a patient without arousing your impatience and criticism, as was the case with his early subjects. And when the therapist inevitably fails to perceive differently, discipline and patience are needed to contain the pain and violent resentment that the schizoid is once again feeling dragged into toxic addiction.

Final comments

In this article, I found myself feeling like a messenger for a community that prefers not to get involved in public relations. It is interesting which aspects of psychoanalytic thinking are included in the public professional sphere as they are, and which aspects remain relatively hidden. In his own right, Guntrip's work was to do for schizoid psychology what Freud did for the oedipal complex or Kohut for narcissism; that is, to reveal its presence in many areas and to destigmatize our attitude towards it. Yet even some experienced psychoanalytic therapists are unfamiliar with the topic or indifferent to analytic thinking about schizoid subjectivity. I assume that, for objective reasons, no author who understands schizoid psychology from the inside has the drive that Freud and Kohut had to start agitating for the universality of the topic, which extends to their own subjectivity.

I also wonder if there is a broader parallel process here, in such a lack of general interest in psychoanalytic knowledge of schizoid issues. George Atwood once told me that doubting the existence of multiple personality (dissociative personality disorder) is strikingly consistent with the ongoing spontaneous inner struggle of the traumatized personality who developed the dissociative psychology: “Am I remembering this correctly, or am I just making it up? Did it really happen or am I imagining it? As if the community of professional psychotherapists as a whole, in its dichotomous position about whether or not dissociative personalities really exist, is caught up in a vast unconscious countertransference that reflects the struggles of the patients. Similarly, we may wonder if our marginalization of the schizoid experience is not a reflection of the internal processes that keep schizoid people on the fringes of our society.

I think that we in the psychoanalytic community both understand and do not understand the schizoid personality. We have been devoted to brilliant work on the nature of schizoid dynamics, but similar to what happens in psychotherapy with insight without self-acceptance, the discoveries of the most fearless researchers in this field have too often been translated into the framework of pathology. Many patients who come to us in search of help do have pathological versions of schizoid dynamics. Others, including countless schizoids who have never felt the need for psychiatric treatment, present highly adaptive versions of a similar dynamic. In this article, I explore the differences between schizoid psychology and other forms of “I” and emphasize that this difference is not inherently worse or better, not more or less mature, neither a suspension nor an achievement of development. This is simply what a given psychology is, and it needs to be accepted as it is.

Acknowledgments

Translated from English by M. A. Isaeva

Recommended: