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Abstract: Schizoid Personality Disorder (SZPD) is among the most under-researched, difficult to treat of the personality disorders. It is difficult to research and treat clinically because the asocial nature of the condition predisposes the afflicted to avoid professional help and most other social contact. Near-total isolation associated with the Schizoid condition is problematic because it increases risk for mental decompensation, violence, and substance abuse. Most of what is known about this condition comes from psychoanalytic theory, an approach that is rich in the depth of understanding it can apart, though may be insufficient to treat more severe and co-occurring disorder cases that frequent community mental health. With these limitations in mind, a proposed treatment integrates the psychoanalytic-object relations approach with Alcoholics Anonymous principles. The integrated approach is illustrated in the case of Will: An individual with Schizoid personality, longterm involvement with Alcoholics Anonymous, and a significant propensity for violence.
Key Words: schizoid personality disorder, object relations, Alcoholics Anonymous, substance abuse treatment.
Schizoid personality disorder (SZPD) is one of the least researched and most difficult to treat of the personality disorders (Triebwasser, Cheriminski, and Roussos et al., 2012). SZPD is under researched because the defining feature of the disorder is near-autistic introversion (Esteberg, Goulding, and Walker et al., 2010). As a result, Schizoids live in near-total social isolation and rarely participate in research or therapy (Triebwasser et al., 2012). Their gross impairment in sociability also makes it exceedingly difficult to maintain relationships and gainful involvement in educational or vocational pursuits, and is associated with risk for health problems, substance abuse, and harm to self and others (Triebwasser et al., 2012; Slavik, Sperry, and Carlson, 1992; Jackson, 1963; Lenzenwegger and Willet, 2009; Akhtar, 1987; Thylstrup and Hesse, 2009; Blum, Braverman, Wu, Cull, and Chen et al., 1997; Kosson, Blackburn, Byrnes, Park, and Logan et al., 2008; Novovic, Misic-Pavkov, Smederevac, Drakie, and Lukie, 2013). When Schizoid individuals seek professional help, it is usually for what can be considered consequences of their isolation, including drug abuse, depression, or suicidal behavior, rather than seeking treatment for the isolative predisposition in and of itself (Triebwasser et al., 2012; Slavik et al., Sperry, and Carlson, 1992; Lenzewegger and Willet, 2009).
Most knowledge about SZPD is derived from applied psychoanalytic theories transcribed...