Schizoid Personality Disorder Treatment
Table of Contents
While there are many suggested treatment approaches one could make for
Schizoid Personality Disorder, none of them are likely to be easily effective. As with all
personality disorders, the treatment of choice is individual
psychotherapy.
However, people with this disorder are unlikely to seek treatment unless they
are under increased stress or pressure in their life. Treatment will usually be
short-term in nature to help the individual solve the immediate crisis or
problem. The patient will then likely terminate therapy. Goals of treatment most
often are solution-focused using brief therapy approaches.
The development of rapport and a trusting therapeutic relationship will
likely be a slow, gradual process that may not ever fully develop as in seeing
people with other disorders. Because people who suffer from this disorder often
maintain a social distance with people in their lives, even those close to them,
the clinician should work to help ensure the client's security in the
therapeutic relationship. Acknowledging the client's boundaries are important
and the therapist should not look to confront the client on these types of
issues.
Long-term psychotherapy should be avoided because of its poor treatment
outcomes and the financial hardships inherent in lengthy therapy. Instead,
psychotherapy should focus on simple treatment goals to alleviate current
pressing concerns or stressors within the individual's life.
Cognitive-restructuring exercises may be appropriate for certain types of clear,
irrational thoughts that are negatively influencing the patient's behaviors. The
therapeutic framework should be clearly defined at the onset. Stability and
support are the keys to good treatment with someone who suffers from schizoid
personality disorder. The therapist must be careful not to "smother" the client
and be able to tolerate some possible "acting-out" behaviors.
Group therapy may be an alternative treatment modality to examine, although
it is usually not a good initial treatment choice. A person who suffers from
this disorder who is assigned to group therapy at the onset of therapy will
likely terminate treatment prematurely because he or she will be unable to
tolerate the effects of being in a social group. If, however, the person is
graduating from individual to group therapy, they may have enough minimal social
skills and abilities to tolerate group therapy much better.
People who suffer from Schizoid Personality Disorder see little to no reason for
social
interactions and often will be quite quiet in group therapy, contributing little
to others and offering little of themselves. This is to be expected and the
individual who has schizoid personality disorder should not be pushed into
participating more fully in the group until he or she is ready and on their own
terms. Group leaders must be careful to help protect the individual from
criticism from other group members for their lack of participation. Eventually,
if the group can tolerate the initially silent member with this disorder, the
individual may gradually participate more and more, although this process will
be very slow and drawn out over months. Clinicians should be wary of too much
isolation and introspection on the part of the patient. The goal is not to keep
the individual in therapy as long as possible (although they may appreciate, if
not fully utilize, therapy). As in group therapy, the individual who suffers
from this disorder may engage in long periods of not talking and silence in
session. These may be difficult to bear for the clinician. The patient may eventually reveal a plethora of
fantasies, imaginary friends, and fears of unbearable dependency - even of
merging with the therapist. Oscillation between fear of clinging to the
therapist may be followed by fleeing through fantasy and withdrawal. These
types of feelings must be normalized by the clinician and brought into proper
focus in the therapeutic relationship.
Medication is usually not an issue for someone who suffers from Schizoid
Personality Disorder, unless they also have an associated psychological disorder, such as
major depression. Most patients show no additional improvement with the addition
of an antidepressant medication, though, unless they are also suffering from
suicidal ideation or a major depressive episode. Long-term treatment of this
disorder with medication should be avoided; medication should be prescribed only
for acute symptom relief. Additionally, prescription of medication may interfere
with the effectiveness of certain psychotherapeutic approaches. Consideration of
this effect should be taken into account when arriving at a treatment
recommendation.
The medical profession often overlooks self-help methods for the treatment of
Schizoid Personality Disorder because very few professionals are involved in them. The social
network provided within a self-help support group can be a very important
component of increased, higher life functioning and a decrease in an inability
to function in the face of unexpected stressors. A supportive and non-invasive
group can help a person who suffers from schizoid personality disorder overcome
fears of closeness and feelings of isolation. Many support groups exist within
communities throughout the world that are devoted to helping individuals with
this disorder share their commons experiences and feelings.
Patients can be encouraged to try out new coping skills and learn that social
attachments to others don't have to be fraught with fear or rejection. They can
be an important part of expanding the individual's skill set to develop new,
healthier social relationships.
next:
Therapy and Medication Issues
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Reviewed: 4/2006
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