The Schizoid vs. the Depressive Personality

Some people come to therapy saying they are depressed, but actually they are “schizoid.” People who are schizoid are distant, detached, and uninterested in the world. In contrast to someone who is depressed, the schizoid person oscillates between starvation for another person and refusal to eat.

The depressive may fear over-dependence, but then feel angry and abandoned by the other. The depressive doesn't withdraw entirely; he remains object-related and angry. The depressed person gets into a rage and then it is over and he feels guilty and depressed. But when the schizoid person is aggressive, the hate is cold and unfeeling, destructive and paranoid.

The markedly schizoid person comes into treatment complaining about feeling cut off, out of touch, and shut off; things do not feel real. One patient described himself as a robot. He or she expresses a feeling of futility and may say, “I’m depressed.”

I was not able to distinguish schizoid phenomena from depression until I read Harry Guntrip’s brilliant book of essays: Schizoid Phenomena, Object Relations and the Self. Here are the process notes from a patient who initially seemed detached and uninterested in the world. She literally withdrew from the world—she became a nun.

P: You want me to go away.

A: What is it about you that would make me want you to go away?

P: I’m sorry. I have too many feelings about you.

A: You mean, I can’t stand your feelings about me?

P: I’m sorry. I want too much and you won’t want to give it and you’ll want me to go away.

A: What makes your feelings so intolerable to me?

P: I want to talk to you all the time. I’m sorry.

A: If you want to talk to me all the time, do I have to do it? Why can’t you want whatever you want?

P: I want you to do it! (She was crying and angry in tone.)

A: If I felt I had to do whatever you want, I wouldn’t be able to stand your feelings. But I don’t feel I have to do whatever you want.

P: I don’t think my mother could stand my feelings. She wanted me to go away.

This patient was not schizoid; she was depressed. Many people fear their over-dependence will overwhelm the other, but it is when that fear makes the person withdraw into their internal world as a result that it is schizoid. This patient yearns for love and connection and gets angry at the prospect of being abandoned because of her neediness. She wanted to come three times per week immediately and asked if I would “let” her do so.

The extremely schizoid person fears good and loving relationships. As soon as he gets close to someone, he experiences an unaccountable loss of interest. Harry Guntrip said the common refrain of schizoid patients is the dread of being smothered—e.g., “suffocated,” “possessed,” “swallowed up,” or “imprisoned.” The safeguarding of independence leads to the fear of commitment to anyone or anything.

For example, one of my patients cannot commit to a place to live or a job. He cannot finish a book because as soon as he starts, he thinks of another book he’d rather read. He cannot commit to finishing a book. Similarly, as soon as he starts a relationship with a woman, he fantasizes about other “better” women. The markedly schizoid person cannot compromise, yet his whole life is a compromise position (one foot in and one foot out) in order to avoid commitment.

Another patient is a compulsive gambler who stopped when he won $1,000. At the moment he was collecting all the money, he decided he would never gamble again. Getting fed (i.e. winning money) made him feel that he must break away to free himself or he would be devoured. He joined Gamblers’ Anonymous soon after his big win.

The schizoid suffers from oscillations between the need to possess (i.e. hungry eating) and the refusal to eat (perhaps even vomiting). Bulimia nervosa (bingeing and then purging) is the physical manifestation of the schizoid condition. You can't eat your cake and have it too — unless you eat it and then vomit it out.

Personality Essential Reads

Why Some People Are More Easily Creeped Out Than Others

Fun-Lover or Go-Getter: Which Fits Your Personality?

The fundamental cause of the development of the schizoid condition is the experience of isolation resulting from the loss of mental rapport with the mother. The loss of connection with the mother can be the result of illness; marital problems, etc. Attachment has been achieved by the schizoid, but then denied in an effort to escape engulfment and merging. It is an attempt to cancel external object relations and live in a detached and withdrawn way. Hence, the attitude toward the outer world is non-involvement, distant observation without feeling.

In summary, schizoid phenomena are on a continuum, but when the schizoid position is dominant in a patient, the analyst has to manage the patient’s unwillingness to make a commitment to the treatment and refusal to admit being effected by the analyst. Maintaining boundaries and not giving advice is extremely important to reassure the patient that you are not trying to take them over. But when the schizoid patient wants to be in another treatment at the same time; go on vacation for two months; or do his laundry instead of coming to his session, be calm, but stand strong.

For more of my thoughts on the schizoid personality, read this post.