Character disorders

The person’s sense of self and structure is disordered.

The neurotic can suffer low self-esteem, low awareness, high anxiety, depression, shame.
But they have uninterrupted self-observation - it is cohesive, continuous over time. They
have positive affect re entitlement, accurate perception, are emotionally oriented to
relationships with others, have awareness of self and other.
With character disorders:
Ability to self-support and self-regulate sometimes falls apart.
Continuity, cohesion and self-esteem are lost.
A lot of difficulty with: containing, assimilating
soothing, calming selves
balancing entitlement with sense of good will
self-reflection, responsibility
continuous and accurate perception of self and others
trusting self and environment
orienting to the present, engaging with creative possibilities
engaging in relationships with awareness of self and other
emerging figures
creatively adjusting to consensual reality
allowing the interaction
presenting oneself with the minimum of self-deceit
Denial of choice: eg ‘you made me do it’, ‘I’m a coward’.
Issues with dichotomies and polarities - problems with bringing together polarities,
eg closeness or isolation, inflation or deflation.

Schizoid disorder
Approach ⇔ withdrawal

out of need out of fear denial of fear

Denial of need for attachment

Illusion of self-sufficiency - ‘I don’t need anybody’
Futility, loneliness, despair, depression
Therapist → sleepy - there is a lack of contact
Ordinary depression - ‘love made angry’
Schizoid depression - ‘love made hungry’ - they are afraid of their own need
Schizoids are reliable: they keep coming - they don’t work → futility for the therapist
There is a lack of engagement, even though they seem to be engaging at some level
They can’t tolerate comments on relationships
They can’t tolerate more aggressive contacting
Little acknowledgement of or contact with the therapist → sleepy therapist
Splitting of self:
‘The living heart has fled, and leaves an empty shell’
- behaviour to survive or to meet the needs of the parent
Further split internally:
- a need comes up - what do I do? I can’t acknowledge it. I can’t ignore it.
→ create a boundary around it, and then attack it (sometimes viciously).

A boundary connects and separates: if there are splits → problems

Become stuck on one side of a polarity, eg togetherness - aloneness.
Isolation becomes like dying - they crave connection - need it so much they don’t want to
separate
Fear of living alone in the universe, fear of being merged
Live in fantasy: isolated phase - dreams of being devoured, being ‘as one’
merged phase - fantasies of time by oneself
The schizoid compromise:
live half-way, not intimate, not distant
serial monogamy
two lovers - too close to one → go to the other (no awareness of this)
compromise of intimacy
Schizoid therapist? - using clients for easy intimacy
Compromise in therapy - the client keeps the work at a certain level and then - stop?
or go deeper? - scary

long-term therapy

How to work with the schizoid patient

Emphasise the here-and-now relationship between you
Be aware of the twin dangers of intrusion and abandonment
Be contactful, emotionally direct, easy-going
You need to contact the hidden, isolated, core self without being intrusive
Resistance is important and to be respected (it is paradoxically contactful)
In a group: invite participation but allow the passive role

They may experience feelings of shame about the length of time they have been or need to
be in therapy - acknowledge and make explicit their progress - truthfully. Clarify what’s in
progress, what might be next. Tell them it does take a long time (if you know that).
How does a schizoid get to be so?
1. We don’t know
2. Individual propensities
3. Biological?
4. Parents intrusive/abandoning - treat child as invisible - ie the real child
→ narcissistic disturbances

Need
Child needs to experience that they are not alone, that they are connected emotionally, at
one with a world of people, to experience being alone in mother’s presence.

Borderline
• believe they can’t take care of themselves
• bid for you to care for them
• present as needing a lot of care
• have a high ability to tolerate their own dysfunction
• it is dangerous to the therapist’s mental health to attempt to meet these demands
• they exercise power by manipulation
• often have a high degree of trauma in their life - child sexual abuse? They may
suffer post-traumatic stress disorder
A question to ask: ‘Do you want to be able to move for yourself?’
The time may come to let them go - you can’t do everything.

Colin White/Gary Yontef 1998