According to Theodore Millon, itt was in 1950s that S. Rado coined the term “schizotypal” in a paper delivered to the New York Academy of Medicine. As he explained in 1953 to the American Psychiatric Association, and to further readers in 1956 and onward, in various publications, the diagnostic category was an abbreviation of “schizophrenic phenotype,” implying overt representation of an underlying hereditaroy genotype, in which the individual suffered from both a “proprioceptive diathesis” and an “integrative pleasure deficiency.” Writing in 1956, he said:
“In general, absence of sufficient pleasure slows down and hinders psychodynamic integration…In particular, (1) it weakens the motivating power of the welfare e motions, such as pleasurable desire, joy, affection, love and pride; (2) it weakens the counter balancing effect ordinarily exerted by the welfare emotions on the emergency emotions, thus allowing fears and rages to rise to excessive strength; (3) it reduces the coherence of the action-self, which is viewed as the highest integrative system of the organism, and the very basis of its self-awareness; (4) it undermines the schizotype’s self-confidence and sense of security in relation to both himself and his social environment; (5) it makes the development of a well-integrated sexual function impossible; (6) it limits the schizotype’s capacity for the appropriate enjoyment of his life activities, as well as for love and affectionate give and take in human relationships.
The proprioceptive diathesis further damages the composition of the action-self. This two-fold impairment of the action-self appears to be the deepest root of the patient’s tormenting lack of self-confidence and also, of his feelings that he is hopelessly different from other people. Furthermore, brittleness of the impaired action-self predisposes the patient to disintegrative breakdown marked by thought disorder.”
Rado referred to those who attempt to make up for innate defects as engaging in “schizoadaptation.” According to Theodore Millon, Rado said that the success of this adaptation depends upon “the interplay of three reparative processes: the careful husbanding of the scare pleasure capacityhe ability to shift the burden of adaptive tasks to others despite ambivalent overdependency; and the adquacy with which nonemotional thoughts can replace limited pleasurable feelings. He did not see the schizotypal pattern as inevitably fixed but as an adapative developmental process that can move forward and back between four stages: compensated, decompensated, disintegrated and deteriorated.” Radio, writing in 1969, described the stages according to the following sequence:
“”Compensated schizotypal behavior means that in favorable circumstances the schizotype may go through life without a breakdown…In decompensated schizotypal behavior, “emergency dyscontrol” is bound to break the compensatory system of adaptation and thus precipitate decompensation, characterized by what appears to be a scramble of phobic, obsessive, depressive, and still other overreactive mechanisms…
The stage of disintegrated schizotypal behavior is known as overt schizophrenic psychosis. Disorganization of his action-self has reduced the patient to adaptive incompetence, the disintegrative process resulting in thought disorder, activity disorder, and the like…The process of schizotypal disintegration may go on for an indefinite period of time. There is, however, a chance of spontaneoues remission, as well as a threat of progressive deterioration. Deteriorated schizotypal behavior is marked by a progressive cessation of function, a nearly complete withdrawal from the adaptive task.”
P. Meehl (1962, 1973, 1991) coined the term “schizotaxia,” describing it as a “neural integrative defect” which results in what Radio referred to as the “schizotype.” He wrote:
“I hypothesize that the statistical relation between schizotyaxia, schizotypy, and schizophrenia is class inclusion: All schizotaxics become, on all actually existing social learning regimens, schizotypic in personality organization; but most of these remain compensated. A minority, disadvantaged by other (largely polygenically determined) constitutional weaknesses, and put on a bad regimen by schizophrennogenic mothers (most of whom are themselves schizotypes) are thereby potentiated into clinical schizophrenia. What makes schizotaxia etiologically specific is its role as a necessary condition. I postulate that a nonschizotaxic individual, whatever his other genetic makeup and whatever his learning history, would at most develop a character disorder or a psychoneurosis; but he would not become a schizotype and therefore could never manifest its decompensated form, schizophrenia.”
One group of researchers, influenced by this line of thought, saw to find the environmental and genetic differential relationships which gave rise to schizotypal phenomenon, and that there is basically a schizophrenia spectrum. Various schizophrenic phenomena may manifest themselves in different phenotypes of different qualities of expression and quantities of severity. They articulated variants into 4 categories across a “schizophrenic spectrum.” First, there is “chronic schizophrenia,” which corresponds to Kraepelin’s understanding of dementia praecox. Those with this form exhibit poor premorbid functioning and progressive deterioration. They are the “true” or “process” schizophrenics. Next, they articulated the “acute schizophrenic reaction.” These have decent premorbid histories and are potentiated by an external event. Next, there is “borderline” schizohprenia, which paralleled the DSM-III understanding of schizotypal personality disorder. Finally, there is the “inadequate personality,” which bore more resemblance to the schizoid personality, than the schizotypal.
As for the borderline schizophrenic subgroup, Wender (1977) said:
“[There is] a chronic history of psychological aladaptation with abnormalities in the following areas: (1) Thinking – strange, vague, illogical mentation which tends to ignore reality, logic and experience, and results in poor adaptation to life experiences; (2) Affective life (characterized by “anhedonia,” the inability to experience intense pleasure, so that the individuals report a history of having never been happy (although they may never have been seriously depressed); (3) Interpersonal relations – characterized by a tendency to polar opposites which may include either the absence o deep, intense involvement with other people or excessively “deep” and dependent involvement with others. There also exist difficulties in sexual adjustment which may be characterized by either a very low sexual drive or a promiscuous and chaotic pattern of sexual interaction; (4) Psychopathology – characterized not only by its intensity but by its lack of constancy with multiple neurotic manifestations that may shift frequently obsessive concerns, phobias, conversion symptoms, psychosomatic symptoms, etc.); severe, widespread anxiety and occasionally short-lived episodes, designated as “micropsychotic,” during which the individual experiences transient delusions, hallucinations, feelings of depersonalization or de-realization. The course of these disturbances tends to be lifelong, generally without deterioration, and the illness seems refractory to neuroleptic drugs.”