What Exactly is a Schizoid? - Dual Diagnosis, Alcoholism, Drug Abuse and Effective Addiction Treatment and Drug Rehabilitation -- Rachel Hayon, MPH

September 8, 2004 -- Most people like having sometime to themselves, but when does being alone cross the line into solitude - to the point of being pegged a loner? An extreme example of this is what is termed as a Schizoid Personality Disorder (SPD). One of the characteristics of SPD is avoiding human contact. Schizoids don't often feel they fit in to the general population. Probably the main reason why this occurs is they have a very difficult time expressing emotion- in fact they just don't [1.
SPD is marked by an absence of affect or emotion; most of these individuals show no reaction to things that most individuals would. Another mark of SPD, is a lack of want or need for companionship [2. The reasons behind solitude being the preferential state are questionable. It is hard to decide if the reason schizoid's prefer solitude is because they just like being alone, or because they avoid human contact since it is hard for them to fit into everyday society. Most academic opinions, agree with the latter explanation.

What is an SPD like?
The following case study illustrates the life story of an average SPD individual:
"Bill D., a highly intelligent but quite introverted and withdrawn 33 year old computer analyst, was referred for psychological evaluation by his physician, who was concerned that Bill might be depressed and unhappy. At the suggestion of his supervisor, Bill had recently gone to the physician for rather vague physical complaints and because of his gloomy outlook on life. He lived alone in his apartment, worked in a small office by himself, and usually saw no one at work except for the occasional visits of his supervisor to give him new work and pick up completed projects. He at lunch by himself and about once a week, on nice days, went to the zoo for his lunch break.

Bill was a lifelong loner; as a child he had had few friends and always had preferred solitary activities over family outings (he was the oldest of five children). In high school he had never dated and in college had gone out with a woman only once- and that was with a group of students after a game. He had been active in sports, however, and had played varsity football in both high school and college. In college he had spent a lot of time with one relatively close friend- mostly drinking. However this friend now lived in another city.
Bill reported rather matter-of-factly that he had a hard time making friends; he never knew what to say in a conversation. On a number of occasions he had though of becoming friend with other people but simply couldn't' think of the right words, so "the conversation just died.' He reported that he had given thought lately to changing his life in an attempt to be more "positive," but it never had seemed worth the trouble. It was easier for him not to make the effort because he became embarrassed when someone tried to talk with him. He was happiest when he was alone [3."

Does Schizoid have anything to do with Schizophrenia?
It was once thought that SPD was a precursor to Schizophrenia, however, further research has shown that schizophrenia is more closely related to schizotypal personality disorder. The difference between schizotypal and schizoid is a question of severity. Not only are schizotypal individuals very introverted and withdrawn, they also may experience transient psychotic symptoms as well as oddities in thinking patterns and speech [4. Though schizoid's speech may be very laconic and meager the things said are usually not abnormal [5. Schizoids seem to take on the more negative traits of schizophrenia like withdrawal and anhedonia (the inability to gain pleasure from normally pleasurable experiences) [6.

Does drug use coincide with SPD?
Since SPD is characterized by unsociable behavior, it is less likely that these individuals will become influenced by the peer pressure involved in the drug scene. However, these individuals may be more likely to become influenced by individuals with stronger personality disorders if they are in a mental health treatment setting. SPD individuals do have the capability to obtain various different kinds of narcotics and may be coerced into doing so if they are around the wrong individuals. Though it isn't feasible to try to associate one type of drug with a certain disorder, there is a propensity of for individuals with SPD to be attracted to the use of psychedelic drugs. From a psychological perspective, drug choice depends on a positive fit with the individual's usual style of coping. Since many SPD's enjoy living in a kind of fantasy world it makes perfect sense that they would enjoy mind altering substances [7.
Treatment procedures for dual diagnosis of this disorder may be difficult because of the affective state of these individuals. Telling a schizoid to use insight or focusing a great deal on emotional issues may not work because schizoids don't necessarily understand emotional cues. Furthermore, presentation of such information in an emotional and confrontational context may just frighten schizoids so that they close themselves off. Since it is easy for these individuals to withdraw from uncomfortable situations without physically disappearing, it is important for therapists to take this into account [7.

SPD is something that will affect most individuals their entire life. However, if the disorder is caught at an early stage in life it is feasible to think that therapy focusing on altering the individuals' affective state may make their relationships with other individuals much more rewarding and possible. Schizoid personality disorder affects approximately 4.9 million or 2.4% of the United States population [8. The problem with this estimate is the issue of misdiagnosis or non-diagnosis. Many people may just think of individuals with this disorder as different or strange and may not ever seek help. For this reason, families and teachers need to be made aware of the signs of this personality disorder and others- doing so might just reduce the amount of grief or isolation an individual with a personality disorder has to face.

More information on addiction topics and drug and alcohol rehabilitation programs can be found can be found at

1.    Frances, A., First, M.B., & Pincus, H.A. (1995). DSM-IV Guidebook. Washington, D.C., American Psychiatric Press, Inc.

2.    Beck, A.T., Freeman, A. (1990). Cognitive Therapy of Personality Disorders. New York: The Guilford Press.

3.    Carson, R.C., Butcher, J.N., & Mineka, S. Eds. (2000). Abnormal Psychology and Modern Life, 11th Edition. Allyn and Bacon: pg 338-339

4.    Kalus, O., Bernstein, D.P., & Siever, L.J. (1995). Schizoid Personality Disorder. In W. J. Livesley (Ed.), The DSM-IV personality disorders. (pp. 58-70). New York: Guilford.

5.    Kantor, M.D. (1992). Aggression in Personality Disorders and Perversions. New Haven: Yale University Press.

6.    The American Heritage Dictionary of the English Language, Fourth Edition (2000) by Houghton Mifflin Company. Published by Houghton Mifflin Company.

7.    Ekleberry, S.C. (2000). Dual Diagnosis and the Schizoid Personality Disorder. http://www.toad.net/~arcturus/dd/ddhome.htm. Accessed 8 August 2004.

8.    Landmark Survey Reports the Prevalence of Personality disorders in the United States. 2 August 2004. NIH News.Accessed 20 August 2004.