The terminology that is related to certain conditions, disorders, and neurotypes being appropriated by others to be used in commonplace situations necessarily creates problems for those whose conditions these terms are supposed to belong to and help. It stigmatises certain behaviours, makes them the butt of the joke, or underplays how debilitating they can be.

For someone who has to live with bipolar disorder, people using "bipolar" or "mania" loosely suggests that the actual bipolar people are overreacting, or else that their condition is a joke when in fact this condition not only hinders them in an ableist world, but also brings violence and discrimination against them because of the condition.

Such also is the case for personality disorders and complex disorders like schizophrenia. Using "psychotic" as an insult or a modifier erases the fact that it's a condition which most aversely affects the psychotic person, it stigmatises them as dangerous when in fact psychotic people are the ones more likely to receive violence than inflict it statistically and historically.

Saying psychopath when you mean a serial killer and sociopath when you mean someone who is cruel is also wrong in that same vein because these are ((now redundant)) subtypes of anti social personality disorder, which does not make people more likely to cause harm or to be "evil" or abusive, but rather causes issues in their own lives due to a lack of empathy, which must also not be confused with a lack of compassion.

Narcissistic personality disorder similarly is a cluster of self esteem issues, identity crisis, and a fragmented sense of self that shows itself in certain behaviours. Borderline personality disorder also is similarly stigmatised, when in fact people with this disorder are far more likely to be victims of abuse. Terms like "narcissistic abuse" or "borderline abuse" suggest that these people abused you because of their disorder, which is not at all true, and any idea of abuse can already be encompassed simply by calling it "abuse" plain and simple rather than stigmatizing a bunch of people in the process of this.

It is easy to underestimate or misunderstand the pain that people with Schizoid Personality Disorder suffer because two of their common coping mechanisms are to become extremely independent and intensely private.

Their early life taught them that they could not depend on other people, and that intimate relationships are dangerous. Therefore, they rarely trouble other people with their problems, because this would feel both unsafe and futile.

My clients with Schizoid Personality Disorder report having experienced some combination of:

Highly intrusive parenting

Lack of parental attunement to their feelings

Some combination of emotional, physical or sexual abuse

Being treated as an object, not a person

Lack of adult protection and interpersonal safety

Some of the common adaptations that Schizoid individuals make to their early childhood situations include:

Dissociation: The ones who were abused often suffer from involuntary “dissociation.” This can take the form of feeling cut off from their emotions and their body, alienated from their life, and unable to connect with other people. This has been described to be me in various ways:

“There is an invisible wall that comes down between me and other people when I try to get emotionally close.”

“I feel like a robot, not a real person.”

“I feel as if I am an alien and very different than anyone else.”

“Sometimes my life feels unreal, like I am in a black and white movie, just playing a part.”

Fantasy Life: Many Schizoid clients substitute a rich fantasy life in which they have total control over what happens for real relationships that they cannot control. They may see someone attractive on the street and construct an elaborate romantic fantasy about them. Sometimes, if this person lives or works near them, they may arrange their schedule to accidentally run into them. They use this possibility to enliven their life and give them hope that someday—when they get the nerve to ask the person out—they may have a real relationship. They rarely pursue this person in an attempt to start a “real” relationship. They settle for a safe fantasy instead.

Partial Relationships: Many Schizoid individuals can have intimate relationships as long as there is some built in barrier that prevents them from becoming fully intimate. They often have relationships with people who are geographically unavailable who they can only see in person a few times per year, or who are married, or who they only contact through the internet.

Structured and Limited Sexual Relationships: Some get involved in sexual relationships that are highly structured and narrowly focused, as in S&M/B&D relationships. Or they may be the third person having sex with a couple, or engage in anonymous one-night stands.

Existential Dread: Many of my Schizoid clients fear getting so disconnected from other human beings that they will be unable to reconnect. They fear that they will be living a deadened and inherently meaningless life.

Live Alone: Most of my Schizoid clients choose to live alone or with a pet for company. This gives them the sense of control over their personal environment that they did not have as children.

I could go on, but I think the above gives a good glimpse into the painful symptoms, limitations, and interpersonal fears that people with Schizoid Personality Disorder have to deal with on a daily basis. Some make an adequate enough adjustment to their difficulties that they accept the limitations of their life and never come for psychotherapy. Others are in too much pain and want more out of life.

When they do come for therapy, they often make great clients. Because they never want to be beholden to anyone else and they have little basic trust, they usually come regularly, exactly on time, and are scrupulous about paying their bill. They can be very persistent and are often willing to come to therapy for many years because they understand exactly how complicated their problems are.

There is an old Woody Allen joke that captures this perfectly: “My therapy isn’t going very well. I’ll give it another fifteen years, and then, if it doesn’t get better, I’m out of here!”

A2A

Elinor Greenberg, PhD, CGP

In private practice in NYC and the author of the book: Borderline, Narcissistic, and Schizoid Adaptations: The Pursuit of Love, Admiration, and Safety.

www.elinorgreenberg.com