Understanding The Link Between Schizoid Personality Disorder And Social Isolation

Many kinds of mental illness can impair an individual’s ability to maintain successful interpersonal relationships. However, there are few psychiatric conditions more strongly associated with social isolation than schizoid personality disorder (SzPD). Affected individuals are often described with terms like “aloof,” “detached,” and “closed off,” and an extreme disconnection from social life tends to be one of this condition’s defining traits. This article will discuss the factors driving isolation in people with SzPD and how this disorder can be addressed in treatment.

People with schizoid personality disorder typically show a long-running pattern of solitude throughout their lives, forming very few close relationships. They often experience severe discomfort with emotional intimacy, and their limited interpersonal skills can make social interaction difficult for them. While people with this condition may not recognize or express a need for connection with others, they may experience a variety of hardships resulting from their isolation, including unacknowledged emotional pain. Although many individuals with this disorder choose not to seek professional help, therapy may be beneficial for those interested in building interpersonal skills.

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Identifying schizoid personality disorder

As defined by the American Psychiatric Association, a personality disorder is a persistent “way of thinking, feeling, and behaving” that differs sharply from societal and cultural norms, causing psychological distress or functional challenges. 

There are 10 personality disorders recognized by the current Diagnostic and Statistical Manual of Mental Disorders (DSM-V). Well-known examples include borderline personality disorder and antisocial personality disorder. Schizoid personality disorder, or SzPD, is categorized as a “Cluster A” personality disorder, meaning it’s generally associated with behaviors regarded as odd or eccentric rather than fearful or exploitative tendencies.

The defining symptoms of SzPD include the following: 

• Little to no pleasure or satisfaction from interpersonal relationships
• Almost exclusively pursuing solitary activities
• Limited or nonexistent interest in sexual contact with other people
• Lack of enjoyment and pleasure in most activities
• Very few close connections aside from immediate relatives
• Little to no interest in receiving praise or avoiding criticism
• Low emotional responsiveness and expressivity, often seeming cold, disinterested, and apathetic

These symptoms occur even in the absence of other known psychological or medical conditions, though in some individuals, schizoid personality disorder may appear as a precursor to schizophrenia. The tendencies described above generally persist throughout the individual’s life, beginning in adolescence or early adulthood. 

Schizoid vs. avoidant personality disorder

Schizoid personality disorder may be easily confused with avoidant personality disorder (AVPD), another condition that frequently involves isolation due to a tendency to avoid social interactions. Some researchers have argued that SzPD and AVPD are similar enough that they should be combined into a single diagnostic category.

However, other studies have found that these two conditions are distinct in certain clinically relevant ways. A 2015 review reported that avoidant personality disorder is usually strongly associated with a sense of internalized shame and an urge to experience a sense of social belonging. Although affected individuals may have a deep desire to connect with others, their intense fear of rejection may cause them to avoid contact.

People with schizoid personality disorder are typically less likely to experience strong shame and less motivated to “fit in.” Instead, limited enjoyment of social situations could be a more significant factor in their avoidant behavior.

That said, there may still be some overlap between these conditions, at least in some individuals. The same review paper described above noted that avoidant and schizoid personality traits seem to be strongly correlated in women, who often experience these pathologies as intertwined.

Factors driving social isolation in schizoid personality disorder

Many of the characteristic features of schizoid personality disorder can contribute to a greater likelihood of social disconnection. People with this disorder typically don’t seek out relationships and may deliberately avoid interacting with others, often choosing hobbies, occupations, and living situations that enable solitude. 

In addition, their limited range of emotional expression can cause other people to perceive them as lacking warmth and empathy. As such, an affected individual’s peers may not make much effort to bond with them. They may also be targeted for mockery, bullying, or ostracism by peers who perceive them as “strange” or “awkward,” resulting in further isolation.

Are people with schizoid personality disorder better off alone?

Diagnostic descriptions of schizoid personality disorder can sometimes give the impression that affected individuals simply don’t desire social connections. As such, some readers might be wondering whether there’s any reason to try to help those with SzPD overcome social isolation. Are these individuals happier without others in their lives?

Loneliness in SzPD

In other words, these individuals may choose solitude because they believe it makes their lives simpler.

However, they may still experience conflicting emotions about their lack of connection, and some studies have found evidence that SzPD is associated with feelings of loneliness. 

Although updated research may be necessary, one researcher argued that an “unbearable and inescapable loneliness” is at the heart of this condition, viewing the isolating behaviors exhibited by affected individuals as defense mechanisms against the pain of internal conflicts.

Some people with SzPD might also wish that they could live a more “normal” lifestyle, even if they don’t experience a strong pull toward social interaction. They may experience sadness, unfulfillment, and other negative emotions related to their lack of connection with others. 

Negative life outcomes in SzPD

Even individuals who don’t report loneliness or other unpleasant feelings about isolation may experience poor outcomes as a result. The Centers for Disease Control (CDC) have reported that a lack of interpersonal connections can significantly increase the risk of the following:

• Dementia
• Heart disease
• Stroke
• Depression and anxiety
• Early mortality from all causes

Achieving career success and financial stability can also be more difficult without social support, and several studies have reported a high prevalence of schizoid personality disorder among the homeless population. 

Another potential concern is that personality disorders commonly occur alongside other mental health conditions. People with SzPD may experience comorbid illnesses like anxiety, depression, and post-traumatic stress disorder. Their lack of social support might make their co-occurring symptoms harder to manage, potentially resulting in greater distress and impairment.

Those living with schizoid personality disorder might also be at risk of suicide. Their rate of attempted suicide doesn’t appear to be higher than that of the general population, but their attempts may be more damaging and lethal when they do occur.

Overcoming social isolation in schizoid personality disorder

If you’re living with schizoid personality disorder and looking to improve your ability to relate to others, you may find psychotherapy helpful. There are few studies comparing the effectiveness of different treatments for this condition since those with this disorder are rarely motivated to seek help. However, therapies structured around gaining insight into your disorder while building mental or interpersonal skills may enable you to achieve greater closeness with others.

Possible examples include those listed below:

• Cognitive-behavioral therapy (CBT), which generally aims to help individuals understand, reframe, and change unhelpful habits of thought and behavior
• Interpersonal therapy, which typically focuses on developing stronger social and communicative abilities
• Dialectical behavior therapy, which can help people learn mindful self-awareness, coping mechanisms for distress, interpersonal skills, and emotional regulation
• Psychodynamic therapy, which can help individuals work through difficult life experiences like parental neglect or emotional abuse that may have contributed to their condition

Therapy can help you develop stronger social connections

Build your skills with a licensed counselor

Many people with SzPD find it difficult to seek treatment, even if they want to recover from their symptoms. Interpersonal interactions are typically at the core of psychotherapy, which can be stressful and challenging for those with this condition. One option that might help is seeking treatment online. Some people receiving mental health treatment over the internet report that it gives them a greater sense of distance and control, enhancing their comfort with the therapeutic process.

There’s no existing literature on the use of online therapy for schizoid personality disorder. That said, this type of treatment has been found to produce positive change and client satisfaction in a broad range of psychiatric illnesses, often with effect sizes similar to face-to-face treatment. A 2017 review article examining prior studies concluded that online psychotherapy could be an effective and affordable way to address mental health challenges.