When we think of personality disorders, often our minds go
right to the front runners that are popular in the media and get a lot of
attention because of the nature of the behaviors associated with them,
typically Narcissistic PD or Borderline PD. But, there are 8 other PDs that we
often seem to look over because the manifestations of symptoms are much more
reserved in nature. Schizotypal PD is a great example of this. Schizotypal PD
is hallmarked by odd and bizarre behaviors that deviate markedly from those of
"normal" people but are not so extreme that they reach the point of
psychotic type symptoms seen in schizophrenia. This brief video gives a great
overview of Schizotypal PD and touches on the types of treatment, or lack
thereof, found to be effective in treating Schizotypal PD:
As the video mentions, there is controversy over whether or
not Schizotypal PD should be listed in the DSM as a disorder as the behavioral
manifestations or “symptoms” are not disruptive to the person’s ability to
function and are not harmful to other people. Also, the video mentions that
psychotherapy is really the only treatment modality appropriate for this PD as
there is really no justification in medicating odd and eccentric behavior, unless
more acutely psychotic symptoms being to manifest. Often a client-centered
approach to therapy is most effective with these individuals as their bizarre
beliefs often leave them feeling alienated from social situations. Further,
social skills training or other behavioral approaches are often appropriate for
treating people with Schizotypal PD in order to help them adapt to and function
in social situations more effectively.
I feel that Schizotypal PD leaves us with some thought
provoking questions. How much is too much? At what point are bizarre beliefs
and behaviors that differ significantly from the norm to be considered a
disorder, given that no harm is being caused to themselves or others? Are people who are
socially avoidant, but are comfortable with isolation and stunted emotional
expression in need of treatment? It is my thought that a disorder, any
disorder, is not an issue in need of treatment until it is causing distress to
the individual or is significantly disrupting the well being or functionality of
someone else. If a person holding strange beliefs who keeps to themselves and
presents with a flat affect is content with this, would it be ethical to force
treatment upon them in order to “change” them into a socially appropriate person?
I believe that until a person with Schizotypal PD is having acutely psychotic
episodes or severely delusional thought patterns that are negatively affecting
their functionality, let them be in their odd an eccentric behavior. Not until
the person presents to therapy with a desire to learn adaptive social behaviors do I feel that they should be left in their eccentricity as long
as there are a happy (in their own way), functioning individual.
PJ supports my thoughts on this weeks post as he can relate to being odd and eccentric. He is fully comfortable with his bizarre behaviors (such as biting my hands relentlessly every morning until I wake up and feed him) and feels that he should be left to bask in the greatness of his own quirks and idiosyncrasies, after all they make him the loveable kitty that he is.
Kim
http://www.mentalhealth.com/dis/p20-pe03.html
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