October 21, 2025 • 37 mins
In this episode of The Personality Couch, we (licensed clinical psychologists Doc Bok and Doc Fish) compare and contrast avoidant and schizoid personalities. While schizoid and avoidant personality disorders have overlapping traits but distinct characteristics, personality psychologists have argued about it for decades. In this episode, we explore the definitions of each disorder and ongoing debates surrounding if these disorders are the same thing or not. We end by sharing our thoughts about whether schizoid personality and avoidant personality are the same or different, while giving a critical opinion about the DSM’s limiting definitions of both.
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Chapters 00:00 Intro & Schizoid and Avoidant Definitions 02:29 Historical Context of Avoidant Personality Disorder 04:31 Kretschmer's Theory & Anesthesia vs Hyperasthesia 08:17 The Argument for Splitting or Merging Disorders 10:51 Overlapping Symptoms of Avoidant and Schizoid 11:49 Differences in Schizoid and Avoidant Personalities 20:19 Our Opinions and Discussion 35:21 Summary & Conclusion
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(01:00:00):
Welcome to the Personality Couch podcast,where we discuss all things personality
and clinical practice. I'm your host, Doc
Bok, and I'm here with myco host, Doc Fish.
We are both licensed clinical psychologistsin private practice. And today we are
continuing our series on schizoidpersonality.
(01:00:21):
We are tackling a frequentlyasked and much debated
question about schizoid versusavoidant personality.
In this episode, we will unpack the controversyaround these types and give our
thoughts and opinions aboutif they should
be the same or if in factthey are different.
(01:00:41):
Let's dive in. We need to start with
definitions to make sure that we'reall on the same page.
So we are talking about theDSM definitions of
avoidant versus schizoid personalitydisorder.
Both are pervasive by early adulthood andpresent in multiple areas of life.
Yes, yes. And just a quick recap on schizoid.Per the DSM, there has to be a
(01:01:05):
pattern of social detachment and restrictedemotional expression plus four or more
criteria involving not wanting,enjoying, and or lacking
close relationships, lack of interestin sexual experiences,
choosing solitary activities, not taking pleasurein things, appearing indifferent
(01:01:26):
to praise or criticism, andshowing emotional
coldness, detachment, or flattenedaffectivity.
Also, there's no psychosis or autism.
Right. And then for avoidant, the DSM definesavoidant personality disorder as a
pervasive pattern of social inhibition,feelings of inadequacy, and
(01:01:48):
hypersensitivity to negative evaluationplus four or more criteria involving
avoidance of social contact,even at work, due to
fears of and or preoccupation withcriticism or rejection.
Avoidance of new situations and or risk toprevent embarrassment and because of
(01:02:10):
feeling inadequate, sociallyinept, and inferior.
Avoidance of participating in social situationsunless certain of being liked and
holding back in relationships dueto a fear of being shamed.
Yep, exactly. Okay, so now that we've gotthat out of the way, let's go to the
(01:02:31):
history. So this part is really interestingto me. Unlike other personality
disorders that have origins dating back tothe early 1900s or even before, avoidant
personality disorder did not come onthe scene until the 1960s.
It wasn't until 1969 that Milan suggestedit and it didn't actually show up
(01:02:55):
formally in the DSM untilthe DSM-3 in 1980.
In the DSM-3, they actually split schizoidpersonality disorder into avoidant,
schizotypal, and schizoid. And ever since,they've been arguing about it.
Mm-hmm, of course they have been. Yeah,so in the 1980s, how do you suppose
(01:03:17):
personality theorists and shrinks argued?
Why? They wrote letters back and forth toeach other in journals. So I found about
eight theorists and their associates commentingon the split of schizoid and
avoidant in the American Journal of Psychiatryfrom about 1985 to 1989.
That is so fascinating and funny.So these are angry
(01:03:40):
letters to each other in a professionalway. Yeah, they were.
What were they arguing about, Doc Fish?
The main argument was how schizoid and avoidantwere split up in the actual DSM. As
some, I think rightly, complained that theDSM categories overlapped too much and
were too vague to highlight thedifferent disorders.
(01:04:03):
But that also led to a deeperargument about whether
schizoid and avoidant should conceptuallybe split up in general.
Ooh, yes. And some theorists thought thatthey were two different flavors of the
same core personality, kind of similar tovulnerable and grandiose narcissism.
Some theorists thought that avoidant and
(01:04:24):
schizoid were two sides of thesame personality coin.
Exactly. And here I think is a good placeto introduce Kretschmer, who describes
schizoid personalities as having threegroups of characteristics.
So the first is being unsociable, quiet, reserved,serious, and eccentric. Now he's
(01:04:46):
suggested that this first group of featuresis the core of schizoid and, quote,
"runs like a scarlet thread through thewhole of schizoid characterology."
Mmm, that's interesting. Yeah. So the secondis being timid, shy, with delicate
feelings, sensitive, nervous, excitable,and fond of nature and books.
(01:05:11):
He called this hyperaesthesia, capturingsensitivity or over-sensitivity.
Okay, so then we have the thirdone, and that's being
pliable, kindly, honest, indifferent,dull-witted, and silent.
He called this anesthesia, capturing the
(01:05:34):
coldness or insensitivity ofthese individuals.
So he put the second and third groups of featureson a continuum, noting that the
sensitivity and insensitivity stand in oppositionto each other, and that schizoids
can move along the spectrum, makingtheir position unstable.
So the tension between the two is whatis distressing. It is a conflict.
(01:06:01):
Ding, ding, ding. Yes, schizoidis characterized
by an internal conflict accordingto psychodynamic.
Mm-hmm.
Now, Kretschmar stated, quote, "Themajority of schizoids are neither
over-sensitive nor cold, but they are over-sensitiveand cold at the same time and
(01:06:24):
in quite different relative proportions."
Very interesting. Yes, so the first strandof the schizoid personality in his
theory is the observable characteristics.
So being quiet, reserved,possibly eccentric.
And then the next two strandsare the internal stuff,
(01:06:44):
which exist on a continuum where theschizoid feels conflict.
Like, basically, I'm very sensitive,but I come across as cold
as a result, both to varying degreesdepending on the person.
Yes, so the sensitivity and insensitivityexist within the same turtle.
Like, it's just how comfortableor safe the turtle feels
(01:07:07):
that determines where it's at onthat sensitivity continuum.
Right. But then Milan came inand was like, "Uh, it's
not a continuum. These are twoseparate personalities."
So he attributes hyperaesthesia to avoidantpersonalities, described as timid,
withdrawn, and sensitive, andthen anasthesia to
(01:07:30):
asocial personalities who are affectionlessand insensitive.
Now, "asocial" was used because Milan didn'twant to use the word "schizoid" here
to describe the deficits of insensitivityand indifference.
He really wanted to use the word "asocial."He thought using the word "schizoid"
(01:07:51):
was like too confusing and inaccurate,
which I agree with, kind ofexplain some things.
Aha, very interesting. So because of whatschizoid had historically been versus
what it was watered down tobecome in the DSM.
But he ended up losing his argument for "asocial,"and of course it still became
(01:08:13):
the schizoid that we know in the DSM.So now cue the arguing.
Okay, so some argued that Kretschmer shouldhave split up the sensitivity continuum
to be more like subtypes, likeMilan did, while
others argued that it shouldstay on a continuum.
Right. And then of course, some cited ouroverall problems with classifying
(01:08:35):
personality into categoriesin the DSM, because as
we know, personalities don'tfit neatly into boxes.
Akhtar then noted that thework of Fairburn and
Kernberg were ignored in splittingup avoidant and schizoid.
Right, so he actually highlighted that schizoidsuse lower-level defenses, like
(01:08:56):
splitting, resulting in identity diffusionand a borderline organization, while
avoidants use higher-level defenses, likerepression, symbolism, and displacement,
that do not result in anyidentity diffusion.
He actually noted that avoidant personalityis a neurotic organization and is a
(01:09:18):
personality of phobic neurosis,like of anxiety.
That is interesting. I can see that. Yeah,yeah. So Akhtar is saying that schizoid
is a borderline level oforganization, and
avoidant is a neurotic levelof organization.
So basically, it's just a different wayto categorize personality health.
(01:09:41):
So then Akhtar went on to point out thatchildhood trauma, ego deficits, and
problems with the self in relationto others make
schizoid more severe than avoidantat the disorder level.
And then he later basicallysaid that in avoidant
personality disorder, the anxietyis egosyntonic.
(01:10:03):
So it becomes one with the personand the personality. And
so all of the anxiety, it's likean all-encompassing trait.
I can absolutely see that. Yes, yes. Butmeanwhile, Milan was like, "Excuse me,
y'all weren't on the DSM taskforce, so you're missing
data and you're wrong." So flexinghis muscle, right?
(01:10:27):
And then other theorists said, "Well, youknow, there's not many schizoids, so
maybe we should just deleteit from the DSM."
And then Akhtar chimed in again and wantedto delete schizoid and keep avoidant,
but then relabel avoidant as schizoid,because that's not confusing, right?
It's personality chaos, basically.So no wonder
we're still confused about thesepersonality types.
(01:10:50):
So what was actually agreed upon?
Good question.
You know that there is a clearoverlap between
schizoid and avoidant, but let'stalk about what that is.
So overall, they are both detached personalities,so they move away from people and
they lean towards an avoidant ordismissive attachment style.
They're introverted and sociallyisolated and can come
(01:11:12):
across as chilly, socially awkward,or socially backward.
So while they're both highly sensitive,
they often struggle in intimaterelationships.
They both avoid others out of fear, butthe fear is from different origins,
criticism for the avoidant and intrusionfor the schizoid.
(01:11:34):
Yeah.
But I think we need to get into the
differences, though, because there'sa lot more of these.
And this can actually getpretty confusing.
So we made a table for the blog.So we'll link that
in the show notes if you need avisual to follow along.
So as we discuss these differences, Doc Fish,why don't you take schizoid and I'll
take avoidant and we'll compareand contrast.
(01:11:55):
Does that sound all right?
Sounds great.
So the first difference is thatschizoids have low
attachment anxiety where they arejust basically detached.
But notably, someone did saythat if a schizoid
loses a main attachment, theycan feel extremely lost.
Now, lost isn't anxious, though.
(01:12:17):
Yeah. Yeah.
And then avoidance have excessiveinvestment in
interpersonal relationships to keep fromrejection and humiliation.
Yeah.
Schizoids experience social anhedonia or
obtaining limited or no joyfrom relationships.
So they don't really respondas much socially.
(01:12:38):
And then in contrast, avoidance have socialhyper vigilance, which is anxiety about
relationships to keep attachment secureor to keep from being criticized.
So they're actually hyper attuned and veryresponsive to the relationship and
what's happening versus being indifferentlike the schizoid.
(01:12:59):
Now, a schizoid has a low need to belong.
This is more about indifference.
Like they don't really careif you like them.
Yeah.
Versus avoidance have a highneed to belong.
Like love me.
Don't criticize me.
Approve of me.
Then schizoids have a glass plate dynamic
where their connection is limitedby a barrier.
(01:13:22):
So like they can see through it.
You can see them.
But it's really, really hard to actually joinin with the schizoid and vice versa.
It's a passive detachment.
And while they maybe cancome off as kind of
passive aggressive, it's nota defining feature.
And it's probably actually like their
actual aggression, like a turtleyelling at you.
(01:13:43):
Uh-huh.
I can see that.
Yeah.
And then avoidance have what is called a chasedodge dynamic or essentially a push
pull feel to their relationship or like,come here, go away due to anxiety.
And they can be very passiveaggressive too.
So you can see that in thisdynamic as well.
(01:14:04):
Mm-hmm.
Schizoids have decreased empatheticexpression.
So the emotion is on the inside, but it'snot necessarily shown on the outside.
Mm-hmm.
And then avoidance have high fearbased shyness and timidity.
And I actually think maybe you could seethis in a schizoid with social anxiety
(01:14:25):
disorder who's trying to like pop outof the turtle shell and connect.
However, any social detachmentof the avoidant
here is really due to fearof criticism, right?
Making them seem docile and shy.
And then schizoids have diminishedor constricted affect.
(01:14:45):
So again, their facial expressions are mutedpossibly because their emotions are
more split off and possibly because theyprotect against their emotions more.
Mm-hmm.
And then avoidance have negativeaffectivity or neuroticism.
So avoidance can actually bequite grumpy at times
and irritable with flavors ofnegativistic personality.
(01:15:11):
So sometimes you see their neurotic energyarising from fear of humiliation.
Mm-hmm.
Now, schizoids have neither a positivenor negative self regard.
Again, there can be an indifference towardsthe self, but there's no shame.
Exactly.
Yeah.
But in contrast, avoidance have negativeself regard and internalized shame.
(01:15:33):
So shame fuels their hypervigilance.
They actually avoid others to minimize anxietyagainst their fears of rejection and
criticism, even though they desireapproval from others.
I actually think this is one ofthe biggest differences
between schizoid and avoidant,like that view of self.
But that's going to be hard to see outsideof close relationships or therapy
(01:15:57):
because the behavior can look very similarthat's stemming from that.
Mm-hmm.
I agree.
And schizoids have neither high nor lowself-efficacy and self-agency.
Again, there's an indifferenceor a middle ground here.
Like there's no difficultywith these things.
Mm-hmm.
Versus avoidance have low self-efficacyand low self-agency.
(01:16:20):
So low self-esteem, basically.
And they don't really recognize their ownpower to make the changes that they need
to in their lives because theymay not feel worthy.
So again, it comes back to thisnegative self view.
Mm-hmm.
Then schizoids have low antagonism.
So they don't prefer to engagein conflict.
(01:16:41):
It's too much energy.
The conflict goes around the schizoid.
Mm-hmm.
And then avoidance havelow disinhibition.
So what does this mean?
It means that they inhibit or restrain theirimpulses and emotions for fear of
rejection, which makes thempassive aggressive.
(01:17:02):
So their anger or antagonismdoes come out,
but it's sideways becauseit's suppressed.
Mm-hmm.
Then for schizoids, psychodynamictreatment usually works
better and is used to work on theself in relation to others.
Uh-huh.
And in contrast, avoidance respondwell to cognitive
(01:17:23):
behavioral therapy or CBT to work on thatfear in relation to others.
Mm-hmm.
Schizoids protect their existenceagainst others
possibly like consuming, impinging,or engulfing them.
Mm-hmm.
Versus avoidance protect againstothers hurting,
criticizing, or rejecting them, and pokingat their internalized shame.
(01:17:48):
Mm-hmm.
One article said that schizoids havea well-defended detachment.
So they build a castle wall.
They don't have those negativeemotions, and they
don't give people a clue aboutwhat they're guarding.
Very interesting.
Yes, but in contrast, avoidance havea poorly defended attachment.
(01:18:11):
So it's almost like a straw house.
It's unstable because of that negativeaffectivity, right?
So sometimes that grumpiness or that negativity,you can sometimes get a little
peek at what they're guarding,shame, due to
those increased reactionsand negative mood.
Mm-hmm.
(01:18:31):
So schizoids isolate from others.
They wall themselves off.
There's that glass plate in between them.
They shut down.
They don't expect social reciprocity.
They're walling off theirneeds and finding
contentment in, like, alonenessor loneliness.
And there's often a diminishedsearch for intimacy.
Mm-hmm.
(01:18:52):
Avoidance, in contrast, do not really isolatefrom others, though they may keep
them at a safe distance or engage in thatsort of chase, dodge, or pushway.
Dodge or push-pull dynamic.
They do maintain hope or an expectation thatsocial reciprocity is possible, but
they insulate just in case of painful rejectionand interpersonal failures.
(01:19:16):
So what does the DSM have to say, though,about the differences?
So the DSM's differential diagnoses for avoidantand schizoid states that while
both are characterized by social isolation,those with avoidant personality
disorder want to have relationships with othersand feel their loneliness deeply,
(01:19:39):
whereas those with schizoid personalitydisorder may
be content with and even preferthe social isolation.
It also says that social isolation and avoidantpersonality disorder stems from a
fear of being embarrassed or found
inadequate and excessive anticipationof rejection.
(01:20:00):
Then, in contrast, schizoid personalitydisorder involves a more pervasive
detachment and limited desirefor social intimacy.
Right. Yes, yes.
Okay, so we laid out the facts here aboutwhat overlaps and then the differences,
but I think we need to talk about ourthoughts and opinions here.
(01:20:22):
So as we're doing that, my first question toyou, Doc Fish, is why in the world are
we so late in coining avoidantpersonality disorder?
Like, that is the piece thatsticks out to me here.
Like, why not earlier? This personality disorder,its origins are way, way, way
later than any other personality disorderthat we've come across thus far.
(01:20:46):
So the fact that early psychodynamic and psychoanalytictheorists missed avoidant
personality disorder isinteresting to me.
So I want to talk about why and what yourthoughts are. And, you know, if it is
different from schizoid, then like,why did we miss it?
Okay, so I think maybe in part we missed itbecause psychodynamic considered it to
(01:21:11):
be part of schizoid personalities and theynever actually really accepted the DSM-3
split of schizoid into schizoid,schizotypal and avoidant.
Right. Yeah. Yeah. So they consider theschizotypal and avoidant to be just
different flavors of schizoid. So thisis similar to Kretschmer.
Yeah.
Then the DSM criteria of schizoid and avoidantare still too vague and overlapping.
(01:21:35):
There's research on that.They're not quite
sufficient to capture like agenuine distinction.
But Milan seemingly had to havehis claim to fame
by coining this disorder. Thatsticks out to me.
And then if we truly separate avoidant personalitybased on the core internal
(01:21:57):
experiences of things like defenses, neuroticism,that chase-dodge dynamic,
we kind of start to see that avoidant ismore similar to the anxious avoidant or
phobic personalities thatwere described in
psychodynamic instead of theschizoid personality.
Interesting. So if I'm hearingyou correctly, do you
(01:22:19):
think that psychodynamic gasp?Maybe got it wrong too?
It's possible.
Okay. But let's be like super clear becausethis is so confusing. I personally
think, and I can always be wrong, I think theDSM schizoid and the DSM avoidant are
(01:22:39):
too similar to be put intodifferent categories.
Fair.
It's almost like the DSM schizoid describesthe turtle shell and the DSM avoidant
describes some of those processes thatmay exist inside the turtle.
Then psychodynamic captures both the DSM schizoidand DSM avoidant under schizoid
(01:23:00):
because it sees both as a full turtle.And that does make sense to me.
Mm hmm. That's really interesting. I thinkwe did get some feedback at the
beginning of our series saying we were describingavoidant much more than schizoid
by showcasing the psychodynamicconceptualization of schizoid.
And given our discussion here,that makes sense.
(01:23:24):
Exactly. There's so many different perspectivesin psychology and different people
argue different things. Butin my opinion, I would
differentiate schizoid and avoidantway more clearly.
Yeah.
I do think schizoid should encompass allof the psychoanalytic processes of
schizoid. Like maybe keep Kretschmer's continuumof that sensitivity regarding how
(01:23:48):
far the turtle comes in and out of its shell.Plus there's like different kinds of
turtles and some are more sociableor sensitive than others.
Sure.
So maybe like, I don't know,throw out the DSM
schizoid description becauseit kind of sucks.
Yes. You've been saying that this whole series.Yes. And I agree. It's not great.
Yeah. But I'm hoping you can tell me a littlemore. I know you have more to say.
(01:24:12):
Always. So then then I describe avoidant asa psychoanalytic, anxious avoidant or
phobic personality. So it's not quite a turtle.It's a hair, a bunny. Like they're
always on guard against threat. They runreally fast away from danger.
But they also hide in their like lovely,cozy bunny homes with other bunnies
(01:24:34):
because they really do want connection. Uh-huh.So they're sociable but fearful.
They actually scope out a boltlocation where they can
easily and quickly run to whenthey're feeling danger.
Uh-huh. I can see this. I can see what you'rethinking about here. Yeah. So you're
(01:24:54):
saying two different species who are fearfulin some type of way but for different
reasons and who cope with itlike way differently.
So basically both personalities move awayfrom others. But schizoid fears,
engulfment or intrusion and the avoidantfears humiliation.
(01:25:16):
Yeah. But what do you think, Doc Bock?
Mm-hmm. Well, I mean, firstly, I like whatyou have to say here. I think you might
be onto something like maybe puttingit in a different
category from psychodynamic. Like Ithink that's a possibility.
But then there's another part of me that ishonestly really not quite sure what to
(01:25:36):
think about avoidant personalitydisorder. I have
a lot of conflicting thoughtsand opinions here.
So the piece that continually sticks out tome is the late origins of it. Like I'm
really skeptical about it being so lateand being in the 1960s versus other
(01:25:56):
personality disorders that haveway, way, way more
research and time to make sure thatthey're actually legit.
And with that, I think we have to look atthe cultural and socio political factors
that maybe contributed to Milan'sseeing this like
hypersensitive trait being a fullblown personality disorder.
(01:26:20):
Okay. So this is an interesting train of thought.So you think perhaps avoidant as
a trait that could be part of multipletypes of personalities.
That's what I'm wondering. I'm curious aboutit. I'm not sold on it yet, but I want
to kind of explore it more as I learnmore and research more about it.
(01:26:41):
But I just I can't help but consider the contexthere. So like 1960s, right? Let's
remember what that time was like.I wasn't born yet.
But in the 1960s, World War IIwas not that long ago.
Boomers are born or coming of age. JFK wasassassinated in 1963. And in America,
(01:27:04):
which Milan was an American psychologist,that was the height of the civil rights
movement. And then the war in Vietnam escalated.Nixon, a very, very fearful
personality, was elected as presidentin 1969. Multiple
theorists have said he's a paranoidpersonality structure.
Anyway, even though I wasn't there in the1960s to be able to say from what I know
(01:27:28):
about it, it was a time ofa lot of anxiety and
a lot of upheaval and politicalupheaval as well.
So one of my questions is, is it possiblethat Milan was capturing a rabbit like
fear based personality trait that wasso prevalent in that timeframe?
(01:27:50):
I think that's very possible. It makes me wondertoo if Milan was maybe an avoidant
personality, because researchers love toresearch their own internal dynamics.
Don't they?
I think it's also possible that Milan hada hole in his theory where he needed to
find a dichotomous categorization for detachedpersonalities. So he came up with
(01:28:13):
avoidant to fill that hole,or maybe just saw
an opportunity to make hismark on the field.
Yeah, very possible. He perhapsdid have more of an
egotistical streak, as unfortunatelymany shrinks often do.
But I'm also wondering ifthis shame-filled,
hypersensitive to rejection trait can bea part of other personalities.
(01:28:37):
So for example, one could argue that borderlinepersonality disorder has a strong
avoidant flavor, right? The go away, the push-pull,but then they flip that switch
to dependent, like, "Come here, come here,come here. I love you. Don't leave me."
I've actually seen that pattern on MCMI profilesa lot with borderline personality
(01:29:00):
disorder, so that's interesting. Along thelines of the MCMI, so that's Milan's
measure of personality, there's high overlapbetween schizoid and avoidant scales.
And I also can't help but wonder if maybeavoidant could overlap with a
negativistic or passive-aggressivepersonality too.
Yes, okay, so I see what you're saying here.Yeah, and that made me think on the
(01:29:25):
MCMIs that I have seen, sometimesthat negativistic
trait is also elevated, or thatpassive-aggressive trait.
So there's some overlap here among thesepersonalities, at least in regard to
Milan's theory and his personalitymeasures.
And then I also think of avoidant types beingpassive-aggressive and even bitter
(01:29:49):
because they're trying tohide their shame.
But anyway, I'm just not sure about thisone. I feel like I have more questions
than I have answers about avoidant personalitydisorder, especially that late
recognition. That reallysticks out to me.
But I mean, that said, I have diagnosed itclinically, and I've seen presentations
(01:30:13):
that "check the DSM boxes" and have confidentlymade that diagnosis as a result.
But then I think of something else, and that'sthat avoidant personality disorder
is often taught, and it was taught to me inschool as an extreme version of social
anxiety disorder or social phobia, butit's to the extreme, right?
(01:30:36):
So then it kind of becomes integratedwith the personality, so it becomes
all-pervasive and all-encompassing, significantlyaffecting relationships.
So we call this egosyntonic, right? The anxietyis one with the personality. But
I'm wondering if certain structures maybeare prone to these avoidant traits, but
(01:31:01):
perhaps any personality can havethem. I don't know.
Okay, so you're saying that the anxiety isegosyntonic, so it's turned in versus
like egodistonic, like a disc, I think of,like you throw it out. So you can just
have anxiety on the outside, but the
avoidant is anxiety that's withinthe personality.
(01:31:23):
Yes.
Okay, so that makes me think of obsessivecompulsive personality disorder, so that
technically is OCD intertwinedwith the personality.
Mm-hmm, turned inward.
Mm-hmm. We also used to have depressivepersonality disorder in previous DSM's
appendices. Milan also has melancholic, butthat's depression that's egosyntonic.
(01:31:48):
It's in. It's not like outside. It'swithin the personality.
So it would make sense that we maybecould have an egosyntonic, anxious
personality. But also, avoidant traits couldjust be that. Like I'm thinking it
makes sense as humans, I don't think mostof us like to be rejected or humiliated.
(01:32:09):
Yeah.
So there could be a social thread throughoutmany personalities with that. I really
think it's worth focusing on like the rootof where personalities stem from.
Yeah, I agree with you. I think you bring upsome really, really interesting points
here, Doc Fish. Yeah. So then my questionis like, okay, is this avoidant
(01:32:30):
personality trait a common thread in all ofus that can get a bit extreme, right?
Mm-hmm.
So that's what's making me question it. Like,and then the time period in which it
was coined. Like, think about if we coineda new personality disorder right now.
Right now. In 2025, when we're recordingthis podcast in this post-pandemic
(01:32:52):
landscape, one that highlighted hypersensitivityand anxiety, later researchers
would probably raise an eyebrowat us, right?
Because taking a sample of the clinical populationnow is very different than in
years past. Like we're on guardright now. We're
hypervigilant, we're despondent,we're polarized.
(01:33:15):
Like I like to think of it, if we take a randomladleful of personalities from the
personality soup, it's goingto come up with more
anxiety, fear, and hypervigilancethan in other decades.
Like my question is, wouldthis personality
disorder that we coined today withstandthe test of time?
(01:33:35):
Ooh, okay. Like where you're headed with this.So one thought I had is in like when
those theorists were going back and forthin the journal and arguing, one argument
was the sample size of the avoidant personalitydisorders. It was small. It was
like in the 80s. So we're taking a ladle.
Oh, yeah.
That is really small. Yes.
(01:33:58):
It is. So there's that. Then I'm also thinkingmaybe about how histrionic came from
a time period of high female restriction.And so now maybe
avoidant comes from an anxioussocio-political time period.
Right, right. But with histrionic, even thoughthe name sucks, we'll get to that
(01:34:21):
one in another in anotherseries. That one
historically there we've beenable to test. Yeah.
Yeah. I think it was just so much moreprevalent because of the time period.
Exactly. Exactly. Similar to paranoid personality,which has arguably been more
present since the pandemic, but like coininga personality disorder without a whole
(01:34:46):
lot of research and without the historicalresearch and just taking a very
polarized time in history ofupheaval and anxiety.
I'm actually suspicious about this personalitydisorder, similar to if we coined a
new personality disorder rightnow in this exact moment,
given everything that's happenedin our world recently.
(01:35:09):
But that said, I am open to new data. We dohave an avoidant personality disorder
series in the works. So perhapsmy viewpoint will
change as I learn more. I'm alwaysopen to learning more.
But I also am really curious what our listenersand viewers think. So we presented
the data and the researchas well as our own
opinions. But I want to hearyour thoughts.
(01:35:31):
Doc Fish wants to hear your thoughts. Likelet us know in the comments, is avoidant
personality disorder different fromschizoid or is it part
of it? Should it even be a thing?Should it just be a trait?
Should we consider cultural things or not
in the making of this diagnosis?Let us know.
And I did want to bring up that regardlessof label, so no matter what you named
(01:35:56):
it, you're an individual with individualtreatment and growth needs. So your
journey does not depend on what psychologistsor psychiatrists argue about.
It's so true. That's so true. Yeah, regardlessof what we call it, your experience
and your symptoms are important.Like never mind the
shrinks arguing in the backgroundover here. Right?
(01:36:18):
They're always going to.
Always, always very opinionated. Anywho, wewent deep as usual and I honestly have
more questions than answers about schizoidversus avoidant. If they should be the
same thing under schizoid or differentthings or traits. I don't even know.
So personality is super complicated and weshrinks have disagreed about it for like
(01:36:42):
ever, which is why we made thispodcast dedicated to
talking about the deep end ofthe personality pool.
And don't forget to let us know if there'ssomething in that deep end of the
personality pool that you wantto know more about.
Absolutely. Absolutely. We'll do the heavylifting. Okay. So on that note, that's a
wrap. Thank you for joining us today onthis episode of the personality couch.
(01:37:05):
Make sure to check out our blogs thatcoincide with these episodes at
www.personality couch.com. And as always,don't forget to give us a thumbs up or
rate and review us on yourfavorite podcast app.
And on YouTube, hit that bell so you don'tmiss a single episode of our schizoid
personality series. Be well, be kind and
(01:37:26):
we'll see you next time on thepersonality couch.
This podcast is for informational purposesonly and does not constitute a
professional relationship.If you're in need of
professional help, please seek out appropriateresources in your area.
Information about clinical trends or diagnosesare discussed in broad and universal
terms and do not refer to anyspecific person or case.
Welcome to the Personality Couch podcast,where we discuss all things personality
and clinical practice. I'm your host, Doc
Bok, and I'm here with myco host, Doc Fish.
We are both licensed clinical psychologistsin private practice. And today we are
continuing our series on schizoidpersonality.
(01:00:21):
We are tackling a frequentlyasked and much debated
question about schizoid versusavoidant personality.
In this episode, we will unpack the controversyaround these types and give our
thoughts and opinions aboutif they should
be the same or if in factthey are different.
(01:00:41):
Let's dive in. We need to start with
definitions to make sure that we'reall on the same page.
So we are talking about theDSM definitions of
avoidant versus schizoid personalitydisorder.
Both are pervasive by early adulthood andpresent in multiple areas of life.
Yes, yes. And just a quick recap on schizoid.Per the DSM, there has to be a
(01:01:05):
pattern of social detachment and restrictedemotional expression plus four or more
criteria involving not wanting,enjoying, and or lacking
close relationships, lack of interestin sexual experiences,
choosing solitary activities, not taking pleasurein things, appearing indifferent
(01:01:26):
to praise or criticism, andshowing emotional
coldness, detachment, or flattenedaffectivity.
Also, there's no psychosis or autism.
Right. And then for avoidant, the DSM definesavoidant personality disorder as a
pervasive pattern of social inhibition,feelings of inadequacy, and
(01:01:48):
hypersensitivity to negative evaluationplus four or more criteria involving
avoidance of social contact,even at work, due to
fears of and or preoccupation withcriticism or rejection.
Avoidance of new situations and or risk toprevent embarrassment and because of
(01:02:10):
feeling inadequate, sociallyinept, and inferior.
Avoidance of participating in social situationsunless certain of being liked and
holding back in relationships dueto a fear of being shamed.
Yep, exactly. Okay, so now that we've gotthat out of the way, let's go to the
(01:02:31):
history. So this part is really interestingto me. Unlike other personality
disorders that have origins dating back tothe early 1900s or even before, avoidant
personality disorder did not come onthe scene until the 1960s.
It wasn't until 1969 that Milan suggestedit and it didn't actually show up
(01:02:55):
formally in the DSM untilthe DSM-3 in 1980.
In the DSM-3, they actually split schizoidpersonality disorder into avoidant,
schizotypal, and schizoid. And ever since,they've been arguing about it.
Mm-hmm, of course they have been. Yeah,so in the 1980s, how do you suppose
(01:03:17):
personality theorists and shrinks argued?
Why? They wrote letters back and forth toeach other in journals. So I found about
eight theorists and their associates commentingon the split of schizoid and
avoidant in the American Journal of Psychiatryfrom about 1985 to 1989.
That is so fascinating and funny.So these are angry
(01:03:40):
letters to each other in a professionalway. Yeah, they were.
What were they arguing about, Doc Fish?
The main argument was how schizoid and avoidantwere split up in the actual DSM. As
some, I think rightly, complained that theDSM categories overlapped too much and
were too vague to highlight thedifferent disorders.
(01:04:03):
But that also led to a deeperargument about whether
schizoid and avoidant should conceptuallybe split up in general.
Ooh, yes. And some theorists thought thatthey were two different flavors of the
same core personality, kind of similar tovulnerable and grandiose narcissism.
Some theorists thought that avoidant and
(01:04:24):
schizoid were two sides of thesame personality coin.
Exactly. And here I think is a good placeto introduce Kretschmer, who describes
schizoid personalities as having threegroups of characteristics.
So the first is being unsociable, quiet, reserved,serious, and eccentric. Now he's
(01:04:46):
suggested that this first group of featuresis the core of schizoid and, quote,
"runs like a scarlet thread through thewhole of schizoid characterology."
Mmm, that's interesting. Yeah. So the secondis being timid, shy, with delicate
feelings, sensitive, nervous, excitable,and fond of nature and books.
(01:05:11):
He called this hyperaesthesia, capturingsensitivity or over-sensitivity.
Okay, so then we have the thirdone, and that's being
pliable, kindly, honest, indifferent,dull-witted, and silent.
He called this anesthesia, capturing the
(01:05:34):
coldness or insensitivity ofthese individuals.
So he put the second and third groups of featureson a continuum, noting that the
sensitivity and insensitivity stand in oppositionto each other, and that schizoids
can move along the spectrum, makingtheir position unstable.
So the tension between the two is whatis distressing. It is a conflict.
(01:06:01):
Ding, ding, ding. Yes, schizoidis characterized
by an internal conflict accordingto psychodynamic.
Mm-hmm.
Now, Kretschmar stated, quote, "Themajority of schizoids are neither
over-sensitive nor cold, but they are over-sensitiveand cold at the same time and
(01:06:24):
in quite different relative proportions."
Very interesting. Yes, so the first strandof the schizoid personality in his
theory is the observable characteristics.
So being quiet, reserved,possibly eccentric.
And then the next two strandsare the internal stuff,
(01:06:44):
which exist on a continuum where theschizoid feels conflict.
Like, basically, I'm very sensitive,but I come across as cold
as a result, both to varying degreesdepending on the person.
Yes, so the sensitivity and insensitivityexist within the same turtle.
Like, it's just how comfortableor safe the turtle feels
(01:07:07):
that determines where it's at onthat sensitivity continuum.
Right. But then Milan came inand was like, "Uh, it's
not a continuum. These are twoseparate personalities."
So he attributes hyperaesthesia to avoidantpersonalities, described as timid,
withdrawn, and sensitive, andthen anasthesia to
(01:07:30):
asocial personalities who are affectionlessand insensitive.
Now, "asocial" was used because Milan didn'twant to use the word "schizoid" here
to describe the deficits of insensitivityand indifference.
He really wanted to use the word "asocial."He thought using the word "schizoid"
(01:07:51):
was like too confusing and inaccurate,
which I agree with, kind ofexplain some things.
Aha, very interesting. So because of whatschizoid had historically been versus
what it was watered down tobecome in the DSM.
But he ended up losing his argument for "asocial,"and of course it still became
(01:08:13):
the schizoid that we know in the DSM.So now cue the arguing.
Okay, so some argued that Kretschmer shouldhave split up the sensitivity continuum
to be more like subtypes, likeMilan did, while
others argued that it shouldstay on a continuum.
Right. And then of course, some cited ouroverall problems with classifying
(01:08:35):
personality into categoriesin the DSM, because as
we know, personalities don'tfit neatly into boxes.
Akhtar then noted that thework of Fairburn and
Kernberg were ignored in splittingup avoidant and schizoid.
Right, so he actually highlighted that schizoidsuse lower-level defenses, like
(01:08:56):
splitting, resulting in identity diffusionand a borderline organization, while
avoidants use higher-level defenses, likerepression, symbolism, and displacement,
that do not result in anyidentity diffusion.
He actually noted that avoidant personalityis a neurotic organization and is a
(01:09:18):
personality of phobic neurosis,like of anxiety.
That is interesting. I can see that. Yeah,yeah. So Akhtar is saying that schizoid
is a borderline level oforganization, and
avoidant is a neurotic levelof organization.
So basically, it's just a different wayto categorize personality health.
(01:09:41):
So then Akhtar went on to point out thatchildhood trauma, ego deficits, and
problems with the self in relationto others make
schizoid more severe than avoidantat the disorder level.
And then he later basicallysaid that in avoidant
personality disorder, the anxietyis egosyntonic.
(01:10:03):
So it becomes one with the personand the personality. And
so all of the anxiety, it's likean all-encompassing trait.
I can absolutely see that. Yes, yes. Butmeanwhile, Milan was like, "Excuse me,
y'all weren't on the DSM taskforce, so you're missing
data and you're wrong." So flexinghis muscle, right?
(01:10:27):
And then other theorists said, "Well, youknow, there's not many schizoids, so
maybe we should just deleteit from the DSM."
And then Akhtar chimed in again and wantedto delete schizoid and keep avoidant,
but then relabel avoidant as schizoid,because that's not confusing, right?
It's personality chaos, basically.So no wonder
we're still confused about thesepersonality types.
(01:10:50):
So what was actually agreed upon?
Good question.
You know that there is a clearoverlap between
schizoid and avoidant, but let'stalk about what that is.
So overall, they are both detached personalities,so they move away from people and
they lean towards an avoidant ordismissive attachment style.
They're introverted and sociallyisolated and can come
(01:11:12):
across as chilly, socially awkward,or socially backward.
So while they're both highly sensitive,
they often struggle in intimaterelationships.
They both avoid others out of fear, butthe fear is from different origins,
criticism for the avoidant and intrusionfor the schizoid.
(01:11:34):
Yeah.
But I think we need to get into the
differences, though, because there'sa lot more of these.
And this can actually getpretty confusing.
So we made a table for the blog.So we'll link that
in the show notes if you need avisual to follow along.
So as we discuss these differences, Doc Fish,why don't you take schizoid and I'll
take avoidant and we'll compareand contrast.
(01:11:55):
Does that sound all right?
Sounds great.
So the first difference is thatschizoids have low
attachment anxiety where they arejust basically detached.
But notably, someone did saythat if a schizoid
loses a main attachment, theycan feel extremely lost.
Now, lost isn't anxious, though.
(01:12:17):
Yeah. Yeah.
And then avoidance have excessiveinvestment in
interpersonal relationships to keep fromrejection and humiliation.
Yeah.
Schizoids experience social anhedonia or
obtaining limited or no joyfrom relationships.
So they don't really respondas much socially.
(01:12:38):
And then in contrast, avoidance have socialhyper vigilance, which is anxiety about
relationships to keep attachment secureor to keep from being criticized.
So they're actually hyper attuned and veryresponsive to the relationship and
what's happening versus being indifferentlike the schizoid.
(01:12:59):
Now, a schizoid has a low need to belong.
This is more about indifference.
Like they don't really careif you like them.
Yeah.
Versus avoidance have a highneed to belong.
Like love me.
Don't criticize me.
Approve of me.
Then schizoids have a glass plate dynamic
where their connection is limitedby a barrier.
(01:13:22):
So like they can see through it.
You can see them.
But it's really, really hard to actually joinin with the schizoid and vice versa.
It's a passive detachment.
And while they maybe cancome off as kind of
passive aggressive, it's nota defining feature.
And it's probably actually like their
actual aggression, like a turtleyelling at you.
(01:13:43):
Uh-huh.
I can see that.
Yeah.
And then avoidance have what is called a chasedodge dynamic or essentially a push
pull feel to their relationship or like,come here, go away due to anxiety.
And they can be very passiveaggressive too.
So you can see that in thisdynamic as well.
(01:14:04):
Mm-hmm.
Schizoids have decreased empatheticexpression.
So the emotion is on the inside, but it'snot necessarily shown on the outside.
Mm-hmm.
And then avoidance have high fearbased shyness and timidity.
And I actually think maybe you could seethis in a schizoid with social anxiety
(01:14:25):
disorder who's trying to like pop outof the turtle shell and connect.
However, any social detachmentof the avoidant
here is really due to fearof criticism, right?
Making them seem docile and shy.
And then schizoids have diminishedor constricted affect.
(01:14:45):
So again, their facial expressions are mutedpossibly because their emotions are
more split off and possibly because theyprotect against their emotions more.
Mm-hmm.
And then avoidance have negativeaffectivity or neuroticism.
So avoidance can actually bequite grumpy at times
and irritable with flavors ofnegativistic personality.
(01:15:11):
So sometimes you see their neurotic energyarising from fear of humiliation.
Mm-hmm.
Now, schizoids have neither a positivenor negative self regard.
Again, there can be an indifference towardsthe self, but there's no shame.
Exactly.
Yeah.
But in contrast, avoidance have negativeself regard and internalized shame.
(01:15:33):
So shame fuels their hypervigilance.
They actually avoid others to minimize anxietyagainst their fears of rejection and
criticism, even though they desireapproval from others.
I actually think this is one ofthe biggest differences
between schizoid and avoidant,like that view of self.
But that's going to be hard to see outsideof close relationships or therapy
(01:15:57):
because the behavior can look very similarthat's stemming from that.
Mm-hmm.
I agree.
And schizoids have neither high nor lowself-efficacy and self-agency.
Again, there's an indifferenceor a middle ground here.
Like there's no difficultywith these things.
Mm-hmm.
Versus avoidance have low self-efficacyand low self-agency.
(01:16:20):
So low self-esteem, basically.
And they don't really recognize their ownpower to make the changes that they need
to in their lives because theymay not feel worthy.
So again, it comes back to thisnegative self view.
Mm-hmm.
Then schizoids have low antagonism.
So they don't prefer to engagein conflict.
(01:16:41):
It's too much energy.
The conflict goes around the schizoid.
Mm-hmm.
And then avoidance havelow disinhibition.
So what does this mean?
It means that they inhibit or restrain theirimpulses and emotions for fear of
rejection, which makes thempassive aggressive.
(01:17:02):
So their anger or antagonismdoes come out,
but it's sideways becauseit's suppressed.
Mm-hmm.
Then for schizoids, psychodynamictreatment usually works
better and is used to work on theself in relation to others.
Uh-huh.
And in contrast, avoidance respondwell to cognitive
(01:17:23):
behavioral therapy or CBT to work on thatfear in relation to others.
Mm-hmm.
Schizoids protect their existenceagainst others
possibly like consuming, impinging,or engulfing them.
Mm-hmm.
Versus avoidance protect againstothers hurting,
criticizing, or rejecting them, and pokingat their internalized shame.
(01:17:48):
Mm-hmm.
One article said that schizoids havea well-defended detachment.
So they build a castle wall.
They don't have those negativeemotions, and they
don't give people a clue aboutwhat they're guarding.
Very interesting.
Yes, but in contrast, avoidance havea poorly defended attachment.
(01:18:11):
So it's almost like a straw house.
It's unstable because of that negativeaffectivity, right?
So sometimes that grumpiness or that negativity,you can sometimes get a little
peek at what they're guarding,shame, due to
those increased reactionsand negative mood.
Mm-hmm.
(01:18:31):
So schizoids isolate from others.
They wall themselves off.
There's that glass plate in between them.
They shut down.
They don't expect social reciprocity.
They're walling off theirneeds and finding
contentment in, like, alonenessor loneliness.
And there's often a diminishedsearch for intimacy.
Mm-hmm.
(01:18:52):
Avoidance, in contrast, do not really isolatefrom others, though they may keep
them at a safe distance or engage in thatsort of chase, dodge, or pushway.
Dodge or push-pull dynamic.
They do maintain hope or an expectation thatsocial reciprocity is possible, but
they insulate just in case of painful rejectionand interpersonal failures.
(01:19:16):
So what does the DSM have to say, though,about the differences?
So the DSM's differential diagnoses for avoidantand schizoid states that while
both are characterized by social isolation,those with avoidant personality
disorder want to have relationships with othersand feel their loneliness deeply,
(01:19:39):
whereas those with schizoid personalitydisorder may
be content with and even preferthe social isolation.
It also says that social isolation and avoidantpersonality disorder stems from a
fear of being embarrassed or found
inadequate and excessive anticipationof rejection.
(01:20:00):
Then, in contrast, schizoid personalitydisorder involves a more pervasive
detachment and limited desirefor social intimacy.
Right. Yes, yes.
Okay, so we laid out the facts here aboutwhat overlaps and then the differences,
but I think we need to talk about ourthoughts and opinions here.
(01:20:22):
So as we're doing that, my first question toyou, Doc Fish, is why in the world are
we so late in coining avoidantpersonality disorder?
Like, that is the piece thatsticks out to me here.
Like, why not earlier? This personality disorder,its origins are way, way, way
later than any other personality disorderthat we've come across thus far.
(01:20:46):
So the fact that early psychodynamic and psychoanalytictheorists missed avoidant
personality disorder isinteresting to me.
So I want to talk about why and what yourthoughts are. And, you know, if it is
different from schizoid, then like,why did we miss it?
Okay, so I think maybe in part we missed itbecause psychodynamic considered it to
(01:21:11):
be part of schizoid personalities and theynever actually really accepted the DSM-3
split of schizoid into schizoid,schizotypal and avoidant.
Right. Yeah. Yeah. So they consider theschizotypal and avoidant to be just
different flavors of schizoid. So thisis similar to Kretschmer.
Yeah.
Then the DSM criteria of schizoid and avoidantare still too vague and overlapping.
(01:21:35):
There's research on that.They're not quite
sufficient to capture like agenuine distinction.
But Milan seemingly had to havehis claim to fame
by coining this disorder. Thatsticks out to me.
And then if we truly separate avoidant personalitybased on the core internal
(01:21:57):
experiences of things like defenses, neuroticism,that chase-dodge dynamic,
we kind of start to see that avoidant ismore similar to the anxious avoidant or
phobic personalities thatwere described in
psychodynamic instead of theschizoid personality.
Interesting. So if I'm hearingyou correctly, do you
(01:22:19):
think that psychodynamic gasp?Maybe got it wrong too?
It's possible.
Okay. But let's be like super clear becausethis is so confusing. I personally
think, and I can always be wrong, I think theDSM schizoid and the DSM avoidant are
(01:22:39):
too similar to be put intodifferent categories.
Fair.
It's almost like the DSM schizoid describesthe turtle shell and the DSM avoidant
describes some of those processes thatmay exist inside the turtle.
Then psychodynamic captures both the DSM schizoidand DSM avoidant under schizoid
(01:23:00):
because it sees both as a full turtle.And that does make sense to me.
Mm hmm. That's really interesting. I thinkwe did get some feedback at the
beginning of our series saying we were describingavoidant much more than schizoid
by showcasing the psychodynamicconceptualization of schizoid.
And given our discussion here,that makes sense.
(01:23:24):
Exactly. There's so many different perspectivesin psychology and different people
argue different things. Butin my opinion, I would
differentiate schizoid and avoidantway more clearly.
Yeah.
I do think schizoid should encompass allof the psychoanalytic processes of
schizoid. Like maybe keep Kretschmer's continuumof that sensitivity regarding how
(01:23:48):
far the turtle comes in and out of its shell.Plus there's like different kinds of
turtles and some are more sociableor sensitive than others.
Sure.
So maybe like, I don't know,throw out the DSM
schizoid description becauseit kind of sucks.
Yes. You've been saying that this whole series.Yes. And I agree. It's not great.
Yeah. But I'm hoping you can tell me a littlemore. I know you have more to say.
(01:24:12):
Always. So then then I describe avoidant asa psychoanalytic, anxious avoidant or
phobic personality. So it's not quite a turtle.It's a hair, a bunny. Like they're
always on guard against threat. They runreally fast away from danger.
But they also hide in their like lovely,cozy bunny homes with other bunnies
(01:24:34):
because they really do want connection. Uh-huh.So they're sociable but fearful.
They actually scope out a boltlocation where they can
easily and quickly run to whenthey're feeling danger.
Uh-huh. I can see this. I can see what you'rethinking about here. Yeah. So you're
(01:24:54):
saying two different species who are fearfulin some type of way but for different
reasons and who cope with itlike way differently.
So basically both personalities move awayfrom others. But schizoid fears,
engulfment or intrusion and the avoidantfears humiliation.
(01:25:16):
Yeah. But what do you think, Doc Bock?
Mm-hmm. Well, I mean, firstly, I like whatyou have to say here. I think you might
be onto something like maybe puttingit in a different
category from psychodynamic. Like Ithink that's a possibility.
But then there's another part of me that ishonestly really not quite sure what to
(01:25:36):
think about avoidant personalitydisorder. I have
a lot of conflicting thoughtsand opinions here.
So the piece that continually sticks out tome is the late origins of it. Like I'm
really skeptical about it being so lateand being in the 1960s versus other
(01:25:56):
personality disorders that haveway, way, way more
research and time to make sure thatthey're actually legit.
And with that, I think we have to look atthe cultural and socio political factors
that maybe contributed to Milan'sseeing this like
hypersensitive trait being a fullblown personality disorder.
(01:26:20):
Okay. So this is an interesting train of thought.So you think perhaps avoidant as
a trait that could be part of multipletypes of personalities.
That's what I'm wondering. I'm curious aboutit. I'm not sold on it yet, but I want
to kind of explore it more as I learnmore and research more about it.
(01:26:41):
But I just I can't help but consider the contexthere. So like 1960s, right? Let's
remember what that time was like.I wasn't born yet.
But in the 1960s, World War IIwas not that long ago.
Boomers are born or coming of age. JFK wasassassinated in 1963. And in America,
(01:27:04):
which Milan was an American psychologist,that was the height of the civil rights
movement. And then the war in Vietnam escalated.Nixon, a very, very fearful
personality, was elected as presidentin 1969. Multiple
theorists have said he's a paranoidpersonality structure.
Anyway, even though I wasn't there in the1960s to be able to say from what I know
(01:27:28):
about it, it was a time ofa lot of anxiety and
a lot of upheaval and politicalupheaval as well.
So one of my questions is, is it possiblethat Milan was capturing a rabbit like
fear based personality trait that wasso prevalent in that timeframe?
(01:27:50):
I think that's very possible. It makes me wondertoo if Milan was maybe an avoidant
personality, because researchers love toresearch their own internal dynamics.
Don't they?
I think it's also possible that Milan hada hole in his theory where he needed to
find a dichotomous categorization for detachedpersonalities. So he came up with
(01:28:13):
avoidant to fill that hole,or maybe just saw
an opportunity to make hismark on the field.
Yeah, very possible. He perhapsdid have more of an
egotistical streak, as unfortunatelymany shrinks often do.
But I'm also wondering ifthis shame-filled,
hypersensitive to rejection trait can bea part of other personalities.
(01:28:37):
So for example, one could argue that borderlinepersonality disorder has a strong
avoidant flavor, right? The go away, the push-pull,but then they flip that switch
to dependent, like, "Come here, come here,come here. I love you. Don't leave me."
I've actually seen that pattern on MCMI profilesa lot with borderline personality
(01:29:00):
disorder, so that's interesting. Along thelines of the MCMI, so that's Milan's
measure of personality, there's high overlapbetween schizoid and avoidant scales.
And I also can't help but wonder if maybeavoidant could overlap with a
negativistic or passive-aggressivepersonality too.
Yes, okay, so I see what you're saying here.Yeah, and that made me think on the
(01:29:25):
MCMIs that I have seen, sometimesthat negativistic
trait is also elevated, or thatpassive-aggressive trait.
So there's some overlap here among thesepersonalities, at least in regard to
Milan's theory and his personalitymeasures.
And then I also think of avoidant types beingpassive-aggressive and even bitter
(01:29:49):
because they're trying tohide their shame.
But anyway, I'm just not sure about thisone. I feel like I have more questions
than I have answers about avoidant personalitydisorder, especially that late
recognition. That reallysticks out to me.
But I mean, that said, I have diagnosed itclinically, and I've seen presentations
(01:30:13):
that "check the DSM boxes" and have confidentlymade that diagnosis as a result.
But then I think of something else, and that'sthat avoidant personality disorder
is often taught, and it was taught to me inschool as an extreme version of social
anxiety disorder or social phobia, butit's to the extreme, right?
(01:30:36):
So then it kind of becomes integratedwith the personality, so it becomes
all-pervasive and all-encompassing, significantlyaffecting relationships.
So we call this egosyntonic, right? The anxietyis one with the personality. But
I'm wondering if certain structures maybeare prone to these avoidant traits, but
(01:31:01):
perhaps any personality can havethem. I don't know.
Okay, so you're saying that the anxiety isegosyntonic, so it's turned in versus
like egodistonic, like a disc, I think of,like you throw it out. So you can just
have anxiety on the outside, but the
avoidant is anxiety that's withinthe personality.
(01:31:23):
Yes.
Okay, so that makes me think of obsessivecompulsive personality disorder, so that
technically is OCD intertwinedwith the personality.
Mm-hmm, turned inward.
Mm-hmm. We also used to have depressivepersonality disorder in previous DSM's
appendices. Milan also has melancholic, butthat's depression that's egosyntonic.
(01:31:48):
It's in. It's not like outside. It'swithin the personality.
So it would make sense that we maybecould have an egosyntonic, anxious
personality. But also, avoidant traits couldjust be that. Like I'm thinking it
makes sense as humans, I don't think mostof us like to be rejected or humiliated.
(01:32:09):
Yeah.
So there could be a social thread throughoutmany personalities with that. I really
think it's worth focusing on like the rootof where personalities stem from.
Yeah, I agree with you. I think you bring upsome really, really interesting points
here, Doc Fish. Yeah. So then my questionis like, okay, is this avoidant
(01:32:30):
personality trait a common thread in all ofus that can get a bit extreme, right?
Mm-hmm.
So that's what's making me question it. Like,and then the time period in which it
was coined. Like, think about if we coineda new personality disorder right now.
Right now. In 2025, when we're recordingthis podcast in this post-pandemic
(01:32:52):
landscape, one that highlighted hypersensitivityand anxiety, later researchers
would probably raise an eyebrowat us, right?
Because taking a sample of the clinical populationnow is very different than in
years past. Like we're on guardright now. We're
hypervigilant, we're despondent,we're polarized.
(01:33:15):
Like I like to think of it, if we take a randomladleful of personalities from the
personality soup, it's goingto come up with more
anxiety, fear, and hypervigilancethan in other decades.
Like my question is, wouldthis personality
disorder that we coined today withstandthe test of time?
(01:33:35):
Ooh, okay. Like where you're headed with this.So one thought I had is in like when
those theorists were going back and forthin the journal and arguing, one argument
was the sample size of the avoidant personalitydisorders. It was small. It was
like in the 80s. So we're taking a ladle.
Oh, yeah.
That is really small. Yes.
(01:33:58):
It is. So there's that. Then I'm also thinkingmaybe about how histrionic came from
a time period of high female restriction.And so now maybe
avoidant comes from an anxioussocio-political time period.
Right, right. But with histrionic, even thoughthe name sucks, we'll get to that
(01:34:21):
one in another in anotherseries. That one
historically there we've beenable to test. Yeah.
Yeah. I think it was just so much moreprevalent because of the time period.
Exactly. Exactly. Similar to paranoid personality,which has arguably been more
present since the pandemic, but like coininga personality disorder without a whole
(01:34:46):
lot of research and without the historicalresearch and just taking a very
polarized time in history ofupheaval and anxiety.
I'm actually suspicious about this personalitydisorder, similar to if we coined a
new personality disorder rightnow in this exact moment,
given everything that's happenedin our world recently.
(01:35:09):
But that said, I am open to new data. We dohave an avoidant personality disorder
series in the works. So perhapsmy viewpoint will
change as I learn more. I'm alwaysopen to learning more.
But I also am really curious what our listenersand viewers think. So we presented
the data and the researchas well as our own
opinions. But I want to hearyour thoughts.
(01:35:31):
Doc Fish wants to hear your thoughts. Likelet us know in the comments, is avoidant
personality disorder different fromschizoid or is it part
of it? Should it even be a thing?Should it just be a trait?
Should we consider cultural things or not
in the making of this diagnosis?Let us know.
And I did want to bring up that regardlessof label, so no matter what you named
(01:35:56):
it, you're an individual with individualtreatment and growth needs. So your
journey does not depend on what psychologistsor psychiatrists argue about.
It's so true. That's so true. Yeah, regardlessof what we call it, your experience
and your symptoms are important.Like never mind the
shrinks arguing in the backgroundover here. Right?
(01:36:18):
They're always going to.
Always, always very opinionated. Anywho, wewent deep as usual and I honestly have
more questions than answers about schizoidversus avoidant. If they should be the
same thing under schizoid or differentthings or traits. I don't even know.
So personality is super complicated and weshrinks have disagreed about it for like
(01:36:42):
ever, which is why we made thispodcast dedicated to
talking about the deep end ofthe personality pool.
And don't forget to let us know if there'ssomething in that deep end of the
personality pool that you wantto know more about.
Absolutely. Absolutely. We'll do the heavylifting. Okay. So on that note, that's a
wrap. Thank you for joining us today onthis episode of the personality couch.
(01:37:05):
Make sure to check out our blogs thatcoincide with these episodes at
www.personality couch.com. And as always,don't forget to give us a thumbs up or
rate and review us on yourfavorite podcast app.
And on YouTube, hit that bell so you don'tmiss a single episode of our schizoid
personality series. Be well, be kind and
(01:37:26):
we'll see you next time on thepersonality couch.
This podcast is for informational purposesonly and does not constitute a
professional relationship.If you're in need of
professional help, please seek out appropriateresources in your area.
Information about clinical trends or diagnosesare discussed in broad and universal
terms and do not refer to anyspecific person or case.
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