This article will be a continuation of Theodore Millon’s explanation of the history of the diagnostic category of schizoid personality disorder. It was Eugen Bleuler who originally coined the term “schizoidie” (1922, 1929) to describe a set of traits relate to Hoch’s “shut-in” and Kraepelin’s “autistic” personality. Bleuler saw this trait as present in everyone to a degree. For him, it was merely a question of degree of intensity and biological penetrance that distinguished one individual from another. Its most extreme form, he believed, was in full-blown schizophrenia, whereas those who possessed it in moderate intensity could be described as exhibiting a mild schizoid personality.
Bleuler described these individuals as indifferent to their state and to everything else. They have little capacity for response to either good or bad fortunate, do not seem to care about interpersonal interaction, and so on. He referred to the personality trait of genercl detachment from reality as “autism,” which, he said, is not always readily detected at first sight. They can seem quite normal at first, but it eventually becomes obvious that they are interested only in themselves.
It was Carl Jung, a student of Bleuler himself, who articulated the concept of introversion. He wrote of the schizoid, saying that “They are mostly silent, inacccessible, hard to understand…They neither shine nor reveal themselves. Their outward demeanor…is inconspicuous…with no desire to affect others, to impress, influence, or change them in any way…which may actually turn into a disregard for the comfort and well-being of others. One is distinctly aware then of the movement of feeling away from the object.”
It was not until Ernst Kretschmer (1925) that a more refined look into the diagnostic characteristics of schizoid personality disorder began to emerge. Millon himself would later articulate the distinctions between avoidant and schizoid personalities, which would influence how the DSM-III and DSM-IV characterized the two disorders. Kretschmer articulated two distinct subgroups: The hyperaesthetic and the anaesthetic schizoid types. In the first case, there is what the DSM would later refer to as avoidant personality disorder. He described the hyperaesthetic as shy, timid, sensitive, excitable, nervous, habitually wounded, and so on. They “feel all the harsh, strong colors and tones of everyday life…as shrill, ugly…even to the extent of being psychically painful. Their autism is a painful cramping of the self into itself. They seek as far as possible to avoid and deaden all stimulation from the outside.”
On the other hand, there is a anaesthetic-schizoid type, who is similar to what the DSM would later refer to as “schizoid personality disorder.” Krestschmer (1925) writes of this as well:
“We feel that we are in contact with something flavorless, boring…What is there in the deep under all these masks? Perhaps there is a nothing, a dark, hollow-eyed nothing – affective anemia. Behind an ever-silent facade, which twitches…with every expiring whim – nothing but broken pieces, black rubbish heaps, yawning emotional emptiness, or the cold breath of an arctic soullessness.”
They take no interest in things that are typically of interest to individuals. Their autism is an anaesthetic, rather than a self-induced, hyperaesthetic, one. He said that this is the most frequently observed pre-psychotic type he observed, referring to it as “affective lameness” and exhibiting psychomotor abnormalities and deficits. Sch a person is affectively “lame,” says Krestschmer. When in the presence of a neurotypical individual, there is a sense of emotional rapport, but that is not the case of the schizoid. They tend to seem distant and unsympathetic.
Kretschmer believed that both anaesthetic and hyperaesthetic tendencies can coexist in many individuals. The individual may appear ordinary and quiet but may suffer from intense inner tension that is not apparent to the casual observer. “As soon as we come into close personal contact with such schizoids, we find, very frequently, behind the affectless numbed exterior…a tender personality-nucleus with the most vulnerable nervous sensitivity.” Thus, the schizoid may, in at least some cases, be far from phlegmatic or dull, but may simply be so withdrawn and internally occupied that he gives no evidence of emotion, and so people conclude that he must not have them.
In 1931, Eugen Kahn articulated a complex structured framework in order to understand different psychopathic personalities. He described the “athymic” temeprament in terms of what contemporary psychiatrists know as a schizoid personality. They
“are striking first of all for the poverty and slowness of their motor, they are characterized by a marked inertia and it is occasionally difficult to get them in motion. [These persons] are indifferent, inexcitable, and unmoved, but usually do not give th eimpression of coldness…The affective resonance is either present in a very slight degree or completely lacking.”