Some thoughts on the schizoid/avoidant distinction

Social withdrawal is a defining characteristic of both Schizoid Personality Disorder (SzPD) and Avoidant Personality Disorder (AvPD). 

But that’s where the similarity between the two disorders ends. Well, according to the DSM anyway (The Diagnostic and Statistical Manual of Mental Disorders). 

SzPD and AvPD are classed as two distinct disorders in the DSM.  Why? Because it is understood that the schizoid and the avoidant socially isolate for different reasons:  

• The avoidant person socially distances because they fear other people will reject, ridicule, shame, and/or criticise them. They want to form relationships, but their social anxieties get in the way. 
• The schizoid on the other hand keeps to themselves because they are fundamentally disinterested in forming close attachments to others. It’s social anhedonia, rather than social anxiety, that defines the schizoid.    

It was the psychologist Theodore Millon who first laid out the differences between avoidants and schizoids, and in doing so established the very concept of AvPD.

He said “crucial” differences lie between the schizoid and the avoidant, namely in “the capacity for emotional feeling” and “the wish for social companionship”. 

Millon described the schizoid as someone who is “insensitive, aloof, cold, and detached”. According to Millon, the schizoid doesn’t merely lack interest in connecting with others; they “lack a basic capacity for emotion and intimacy, even with their closest friends” (emphasis mine). This is in stark contrast to the avoidant who has “ample capacity for warmth and intimacy” as well as a “a rich emotional life” but “flee[s] from contact with others out of fear of embarrassment, shame, or humiliation”. 

Furthermore, Millon understood the avoidant to be someone who desires social acceptance but who also experiences an equally intense desire “to withdraw into a private world of shame” – the avoidant has a poor opinion of themselves and is convinced they are inferior to others. The schizoid on the other hand, being “emotionally vacant”, “suffer[s] little conflict, ambivalence, or disillusionment” vis-a-vie interpersonal relationships. 

Needless to say I find this all very interesting, and I think the SzPD/AvPD differential diagnosis does have some utility.  However, I also find some of the distinctions between SzPD and AvPD – particularly those drawn by Millon (whose work on this informed the DSM criteria for both personality disorders) –  problematic, and even a little unconvincing… 

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So, what do I take issue with? Well, first of all I don’t agree that it’s only avoidants who socially isolate out of fear. The schizoid does as well.

The schizoid stays away from others because they fear people will engulf and enslave them; that they will lose themselves if they let people get too close. The fear experienced by the schizoid is quite different to the sort experienced by the avoidant – who worries people will ridicule and reject them –  but fear does form part of the schizoid’s social isolation nonetheless. 

Which brings me to the other issue I have with the schizoid/avoidant distinction. I reject the notion that schizoids – by definition – are cold, emotionless robots (which is the impression I got from Millon), completely devoid of any inner life, with no interest in, or inklings for, other people at all.  How can this be the case given the schizoid’s dread of engulfment etc.?  

(Indeed Millon himself wrote: “The deepest fear of schizoid persons is engulfment, the notion that others will enmesh them in relationships, thereby obliterating their individuality and identity.” So how does this square with his description of the schizoid – in the same text! – as “emotionally vacant” and “suffer(ing) little conflict [or] ambivalence” vis-a-vie their social relations?)

The schizoid may be more content to go through life alone than the avoidant. But that’s not to say the schizoid would never harbour any desires for companionship. A fair few schizoids do. Yet, the fear of what that companionship might bring – e.g., impingement, loss of self  – keeps the schizoid shut up inside their shell.

In other words, the characterisation of the schizoid as completely indifferent to – nay, completely incapable of – (close) relationships with others,  does not allow for the existence of ‘the schizoid dilemma’.

(I think it’s worth pointing out here that the DSM’s diagnostic criteria for personality disorders is based on observable characteristics, rather than the internal dynamics that also underpin people’s behaviour; therefore something like ‘the schizoid dilemma’ wouldn’t really be on the DSM’s radar). 

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When I look at the criteria for SzPD versus the criteria for AvPD the biggest question that comes up for me though is this: can’t you be schizoid AND avoidant? 

The two disorders are distinguished from one another primarily on the basis of what drives an individual’s social isolation – if it’s social anxiety then they’re avoidant, if it’s social anhedonia they’re schizoid. But such a distinction seems to leave little, if any, scope for being able to acknowledge that someone might experience both; that someone could have schizoid, as well as, avoidant traits. 

Of course, I’m saying all this because I see my own socially distant self reflected in the criteria for both SzPD and AvPD – as well as in other (non-DSM) descriptions of the schizoid and avoidant personalities. 

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Like the avoidant, I experience “excessive social anxiety and inhibition” when interacting with people – even with members of my immediate family.  

This is mainly because 1) I’m not very good at socialising/talking and 2) I think people will think me weird for the loner life I lead: 

“When I’m asked about my weekends/holidays/home life, I stiffen, I shrink, I shrivel up inside, because I FEAR…  I fear that people will think me strange if I admit to how much of a loner I am. I fear their raised eyebrows, their questions, their incredulity.  I fear they’ll misunderstand me, pity me.  I fear that they’ll try to coax me out of my shell, tell me I’m not normal.”

Oh, how I wish I could be that aloof, indifferent, emotionally detached, schizoid stereotype at times!  But I’m not. I’m very much the opposite – incredibly sensitive, excruciatingly self-conscious, “constantly scan[ing] [my] environment for potential threats” (Millon). 

And yet – unlike the avoidant I do not have any strong desire for intimacy or social interaction. I am okay with not having any friends; I am not interested in a romantic relationship. I have a real, deep-down-to-my-soul-core preference for my own company. So, in this sense I’m more schizoid. And like the schizoid, I also experience social anhedonia. Generally speaking, social interactions don’t give me much pleasure. If a social situation isn’t causing me anxiety, then it’ll likely be boring/irritating me instead. Unlike the avoidant, I don’t experience FOMO; I don’t get lonely; I don’t believe having close relationships or more of a social life would make me any happier.  

So –  if I don’t want to make friends with people (schizoid), why do I worry so much about what people might think of me (avoidant)?!

The schizoid/avoidant distinction doesn’t really help me to answer this question. Going off the DSM, someone who is disinterested in forming relationships (the schizoid) wouldn’t experience social anxiety (as the avoidant does). 

But why not? 

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Earlier I mentioned that both the schizoid and the avoidant experience anxiety when it comes to social interaction – the avoidant because they fear being rejected by people, the schizoid because they fear being ‘taken over’. 

My own social withdrawal could probably be classed as more ‘avoidant’ in nature; however there’s definitely a schizoid-y element to it as well.  

I seek to avoid social situations primarily because I fear being scrutinised, criticised, questioned, ridiculed and shamed – for who I am, essentially. 

But when I ponder what establishing a connection with someone might be like – well, that scares me as well. Yes, I worry about being chastised or laughed at;  but I also worry about the total opposite happening; that someone might actually like me, relate to me, ‘see’ me – and seek to get to know me further, to establish a relationship with me. 

Why does this worry me so? Because when I imagine being close to someone all it conjures is a sense of:  boundaries overthrown, effacement, diminishment, lack of control, entanglement, suffocation – i.e. the schizoid fear of loss of self. 

So on the one hand, I socially distance because, like the avoidant, I don’t want to be rejected. But similar to the schizoid, I don’t want to become attached either. 

This brings to mind a brilliant line by R. D. Laing: “Dread is unmitigated by love”. Support for the avoidant would usually focus on alleviating their social anxiety so they can begin to establish the emotional connections they deeply desire. But for me, forming an intimate bond with someone would only induce another world of pain! 

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There is a long-standing debate amongst psychologists about “the validity of the schizoid-avoidant distinction”. Are AvPD and SzPD two completely different disorders, or would it be more useful/accurate to view schizoid and avoidant traits as existing more on a spectrum, to allow for some overlap between the two? Or should either/both personality disorders be done away with entirely?

My own (layperson’s) view is this: there will be avoidant individuals for whom the schizoid criteria doesn’t apply, and vice-versa. So, I think there is some value in maintaining the distinction. 

However, as I’ve outlined here, I also see problems and limitations with treating the schizoid and avoidant constructs as wholly different from one another.  

There would also be some value, I think, in constructing a category, or spectrum, which would allow for the co-existence of schizoid and avoidant traits in socially distant individuals. 

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References:

• AvPD Wikipedia
• R. D. Laing, (1960), The Divided Self
• Theodore Millon, (2004), The Schizoid Personality, in Personality Disorders in Modern Life (2nd ed). Available via the Schizoid Reddit Wiki.
• Daniel Winarick, The Disappearance of the Schizoid Personality at Psychology Today
• 7 Indicators of Social Anhedonia  
• The Schizoid Dilemma