Episode Transcript
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(00:00):
Welcome to the Personality Couch podcast,
where we discuss all thingspersonality and
clinical practice.
I'm your host, Doc Bok, and I'm herewith my co-host, Doc Fish.
And today we are wrapping up our
Schizotypal personality seriesby discussing the three
most unstable personalities, which spoileralert, includes Schizotypal.
(00:24):
So the questions we're answering this
episode are (00:25):
what makes some
personality disorders
more severe than others?
Why does some personality seem to fall apartmore easily into quasi-psychosis?
And what are the three most unstablepersonality structures?
Let's jump in.
All right, so let's startby going way back
(00:46):
in time to our earliest psychoanalyticshrinks.
We had a heavy emphasison personality and
its overall influence on thepsyche, emotions,
behaviors, etc.
And we put personalities intotwo main buckets,
sane and insane, or nuts andnot nuts, basically.
And then we started using different languagelike neurosis versus psychosis.
(01:12):
In other words, is the person seeking
treatment having a response tosevere anxiety, or are
they not in touch with reality at all?
And of course, people do not fit neatlyinto binary categories.
So we later had to create a new category, theborderline gray area between neurosis
(01:34):
and psychosis.
According to Nancy McWilliams,this borderline
space meant, "too saneto be considered
crazy and too crazy to beconsidered sane."
So these were the individualswho were not
responding well to outpatienttreatment, but
didn't quite meet the criteria forhospitalization at the time.
(01:56):
So something was differentabout these types.
Right, indeed.
Yeah.
So these in-between types are the
personalities that sit in the middlesomewhere, but that
are more prone to falling apart.
So overall, that leaves us with three maincategories in which personalities fit.
Neurotic, borderline (02:16):
that gray middle
area, and psychotic.
But in order to understand the borderline area,we have to understand what neurotic
and psychotic mean.
So let's break down each, startingwith neurotic.
So the neurotic personality encompasses
many different personalitystyles that span the
(02:37):
DSM.
This type of personality is in touch with
reality, and they have a stablesense of self,
but they are overly rigid and inflexible
because of their need to controlto try to soothe
their anxiety, they struggle to beflexible and adapt to stressors.
Right, and most of their psychologicaldefenses
(02:58):
are a reaction to this higherlevel of anxiety.
And that anxiety stems from fear of their
own impulses and internal unconsciousconflicts
that result in overactive defenses.
If this personality type was an icecream, it would be freezer burned.
Ooh, too rigid, too frozen,and immovable.
(03:23):
So the personality flavorsare muted by the ice.
But at the end of the day,it is still ice
cream, but it's not going tobe like everyone's
favorite flavor.
You might burn your taste buds.
There's a little too much anxietyand rigid energy.
Yeah, yeah, it's probably not going to beyour favorite ice cream, in other words.
And neurotic personalitiesare probably not
(03:44):
going to be your favorite personeither because
that anxiety is all consuming and it canbe really grating on others.
So just like freezer burnedice cream grates
on the taste buds and createsan unpleasant
experience, same type of thing, right?
But it's still technically ice cream andit's technically structurally sound.
It's just too frozen, likealmost like it's
(04:06):
taking its job of beingice cream a little
too seriously.
So fun fact, ice cream shouldbe around 36
degrees so that you canactually taste the
flavor.
Otherwise it's too cold andfreezes your taste
buds and you just don't getthe full experience.
Huh?
I kind of view neuroticpersonalities like
that, like too cold, likeit hurts your tongue
(04:28):
cold.
That is so interesting.
I'm wondering if somebody here worked in
an ice cream shop and knowsa thing or two.
Ice cream is lovely, but we'renot camping on me.
We're going to move back to personality.
So on the other end of the spectrum, wehave the psychotic personality.
(04:48):
So while any personality can disintegrate intopsychosis, some are more prone to it
than others.
As we stated previously, psychotic
personalities are out of touchwith the reality and they
may not even be sure that they exist, let
alone have an integratedand cohesive sense
of self.
Their main crisis is fear of death due to
(05:11):
difficulties trusting what isoutside of themselves
and what is inside.
So there's difficulty with existenceand a sense of separateness.
If psychotic personalities were an icecream, they would be melted.
They've lost their structural integrityand are a bit of a soupy mess.
They have fallen out ofreality and it can
(05:32):
be really hard, if not impossible,to spring
back into a cohesive ice cream state.
The psychotic personality's structural
integrity is compromised, puttingthe personality at
risk for falling out of reality again.
And that brings us to that ohso tricky borderline
space in the middle between neuroticand psychotic.
(05:55):
So borderline personality structures are
not just a personality disorderof borderline.
Same word, different meaning right now.
So these personalities cycle in and outof reality and non-reality.
With that comes an unstablesense of who they
are and overall confusion abouttheir identity.
So unlike the psychotic personality,borderline
(06:17):
personality organizations knowthat they exist.
However, they have a hardtime functioning
in relationships, which istheir main crisis
point, like attachment and the separation
individuation process thatoften involves shame.
Yes, yes.
And they do have a hardtime knowing where
they end and the next personbegins, causing
(06:39):
them to become disorientedor to potentially
have a push-pull dynamic intheir relationships.
So if borderline structures were an icecream, they would be melting.
So they're technically still ice cream,but the structure is falling apart.
So think of like a scoopof ice cream on a
hot sunny day and it's startingto drip onto
(07:00):
your shoes, onto the sidewalk.
Borderline structures are in thisever melting state.
And as you might've guessed, this putsthem at increased risk for psychosis.
Yes.
And they do cycle in and out of reality,
oftentimes having brief psychoticepisodes where they
frequently flirt with the psychosis line.
(07:20):
So they sit in this unstable placeof like melting as a default.
And this borderline space is wherewe're camping out today.
So the personalities that are melting,
falling apart into psychosis,who by nature of their
personality live in that quasi-psychoticspace, making them inherently unstable.
(07:41):
The three structures that live in this
borderline space by default areschizotypal personality
disorder, borderline personality disorder,and paranoid personality disorder.
Yep.
And since we're in the schizotypal series,we'll start with schizotypal.
Okay.
I'll give you a quick recap ofwhat this personality is.
(08:04):
So according to the DSM,there has to be a
pattern of oddities, cognitive or sensory
distortions and social deficits.
This includes things likeexcessive social
anxiety, social isolationand withdrawal, among
other odd behaviors.
Schizotypal individuals are eccentric in
their thoughts and they haveunusual sensory and
(08:25):
bodily experiences, increased suspiciousnessand ideas of reference.
This means that they oftenread into benign or
neutral events as having personalsignificance.
Their oddities and slight disconnect from
reality are evidence ofcognitive slippage
and it puts schizotypals inthe pre-psychotic
(08:46):
or quasi-psychotic camp, butthey're not fully
psychotic.
But let's break that downa little bit more.
Doc Fish, we've talked about cognitive
slippage in this series as a signof instability, but
what actually makes schizotypalpersonalities unstable?
Oh boy.
So to answer this question,we actually first
(09:07):
need to introduce Millon'sevolutionary theory,
which basically just says like we have threepolarities involved in survival.
The first polarity involves existence.
And so that is a continuum with a focuson either pleasure or pain.
The second is adaptation involving a focuson like being passive or active.
(09:29):
And then the third is replication involvinga focus on the self or other.
Okay.
Yeah.
All right.
So according to Millon, allpersonalities have
some type of relationshipto these three means
of survival and the personalities fallalong this continuum for each.
Is that right?
(09:50):
Exactly.
Exactly.
They all have survival motives, but they
look different for each personor personality.
Now hopefully they're more balanced, but
the more extreme someone ison either end, you
get into more maladaptive territory.
So for example, if someoneis too self-focused,
like narcissism, it probablynegatively impacts
(10:13):
their relationship somehow.
Well someone who is too other focused or
dependent maybe can have difficultywith their sense
of self.
Being balanced is key, butanyway, I made a
visual that I'll put in theblog this week.
Yes, it is a little tricky to understand, butthe visuals do help and I'll link our
website in the show notes.
Awesome.
(10:34):
Okay.
So back to your question of what makesschizotypals unstable.
It's because there is a weak focus in allof the areas involved in survival.
So schizotypals are not grounded in any
survival motive, being fragilein focus and intensity,
kind of like a leaf floating around withno purpose or effectiveness.
(10:57):
And this leads to disconnect from social
norms and then results in eccentricityand just
inappropriateness in general.
So they're usually undirected and diffuse
and just random, havingexcessive fluidity
in their personality structure.
They are quite literally in their own
world, like functioning ata frequency that the
(11:19):
rest of us really don't understand.
Yeah.
Okay.
But let me get this straight.
So the structure of the schizotypal
personality is unstable becauseits survival motives are
muted and easily reverse course.
Like they're so disconnected thatit's no longer adaptive.
So schiz means to split.
(11:41):
For the schizoid, they disconnectinto fantasy
in order to survive, but theschizotypal takes
this a step further and disconnectscompletely with no grounding.
So their boundaries aretoo loose, meaning
they are often drifters onthe periphery of
society like a leaf, like you said.
Yeah.
And an interesting piece of research is
(12:02):
that on the big five, schizotypalsoften score
higher in openness than schizoid becausetheir boundaries are too loose.
They're too open.
And then like we've beensaying, they just
drift like a leaf sometimesright into psychosis
before drifting back into reality, whichis really interesting, right?
(12:24):
Mm-hmm.
Okay.
But briefly, what does their almostpsychotic-ness look like?
Right.
As we've been talking aboutin this series,
cognitive slippage is abig indicator that
we're on our way to psychosis.
This can look like bodily illusions or
sensations of being disconnectedfrom the body or that
(12:45):
feeling like their body's not theirs.
So it's not fully psychoticdelusions, but
they're illusions that tell us that their
sense of grounding is off.
Yeah.
Ideas of reference is another big one.
So believing that everyday events that areactually neutral are specific to you.
So for example, like, "Oh,they're talking
about me over there becausethey just looked
(13:06):
at me."
But later these ideas can be challenged.
So it's not quite a delusion, but
something is off in how they interpretthe world and
how they feel like they are physicallypresent in their bodies.
Right.
Yeah.
And they might be very superstitiousor preoccupied
with the paranormal or likeotherworldly phenomena
(13:26):
that are outside the normsof their subculture.
So again, it's that fringereality stuff or
like magical thinking or telepathyamong many,
many other things that it could be.
But it's that disconnect fromthe self and the
world that leads them to thisquasi-psychotic
place.
And they are just a little odd, like a littleoff, but they're not dangerous.
(13:51):
Mm-hmm.
Now, Millon also notes thatfor structurally
defective personalities, thereis almost always
another non-structurally defective personalitydisorder that goes along with it.
Huh.
Makes it more confusing.
So for the schizotypal, schizoidand avoidant
personalities are usually theones that disintegrate
(14:13):
and fall apart into schizotypal.
That is really interesting.
I have definitely seen thatin psych testing
results where there's anunstable structure
with a pop of color in another personalitydisorder category.
But I think also what you'resaying is that
personality disorders candisintegrate into
one of these unstable structures, which
(14:35):
puts them at risk for furtherdeterioration and
possible psychosis.
Yes.
So the structurally defective personality
disorders usually startwith and stem from
like another like regular personalitydisorder.
It's the structure that falls apart, likethe architecture of the psyche.
(14:55):
That is so interesting.
Okay, so if I were to take a Polaroid
snapshot of someone's psyche,and maybe I'm seeing
the schizotypal traits, cognitiveslippage,
oddities, et cetera, it'spossible that it
could be a pure schizotypalpersonality and
that maybe the psyche originatedfrom that
unstable point.
(15:17):
But it's also possible that the
deterioration came from anotherorigin point, potentially
schizoid or avoidant if the personalitystarts to fracture.
You got it.
Yeah.
So like when we're lookingat schizotypal,
we see ruins or rubble, likea structure that
is actively falling apart.
(15:37):
It can be hard to know what structure thatused to be, like was it a house?
Was it a store?
But essentially the building that
schizotypal used to be was likelyschizoid or avoidant,
though it is possible it started as a pureschizotypal personality that is debated.
Yeah.
Yeah.
That's another interesting thing too.
(15:57):
So it actually reminds me of childhoodschizophrenia, right?
As an example of startingoff in this falling
apart space, that it's rare,but it does happen
just like childhood schizophrenia, not
commonly diagnosed, but it technicallyis a thing.
And it sounds like researchershere are mixed
(16:19):
onto whether or not the personalitycan start
from that unstable place.
But alas, we do have to move on.
We have two more categories.
Sure.
So let's move to borderline personality
disorder as a second of theunstable structures.
And before we get into thedetails, I just
(16:40):
have to say once again thatwe are terrible
at naming things as shrinks.
Oh boy, aren't we?
Yes.
Yes.
So I'm just going to takea rant real quick.
Why in the world would wecall a personality
disorder the same name as alevel of personality
organization?
Like, how confusing is that?
And it's such a nondescript way to label
(17:01):
the unique pain and instabilityrepresented
in this condition.
But I digress.
We are indeed talking about borderline
personality disorder, which is inherentlyat the borderline
level of personality organization.
So it is a personality that's unstableand falling apart.
(17:22):
Mm-hmm.
A quick overview of borderlinepersonality disorder.
This is characterized by instability and
sense of self, mood, andrelationships, and
just overall sense of emptinesson the inside.
So the empty spot is easilytriggered by a
huge fear of abandonment,which then leads
to impulsive behavior and even self-harmor parasuicidal behavior.
(17:47):
Yeah.
And interestingly, any ofthe three unstable
structures, among others, canengage in parasuicidal
behavior or possible attempts.
And sometimes such attemptsand gestures can
give us clues about the healthof the psyche.
But Doc Fish, what does their almostpsychotic-ness look like?
(18:08):
I've seen this in regard to considering ormaking impulsive major life changes.
So it might be moving toa different state,
quitting their job, leavinga relationship.
It could also look like preoccupationthat a
friend is out to harm themor their coworkers
are just talking about them behind theirback and plotting against them.
Sometimes it can also bebrief dissociative
(18:30):
episodes, ranging from justwasting the day
away in bed and not existing to self-harming,like without feeling pain.
Mm-hmm.
Yeah.
And I've also seen it aslike some fleeting
paranoia about others beingout to get them
leading to impulsive andreckless decisions.
And interestingly, I'vealso heard of some
(18:52):
borderline personalities havingbrief psychotic
episodes where they have full-ondelusions or
hallucinations, but they comeback to reality
quickly and are aware of their brief stay
in psychosis, which is justlike that blows
my mind, right, to step out of realityand have awareness of it.
That's typically not a thing.
(19:13):
But borderlines are, as far as the
personality goes, borderlinepersonalities are usually
extremely aware of their psychic painto a fault, I would say.
Oh, absolutely.
Yeah.
So here it's their emotionalinstability and
conflictual needs that putthem at risk for
(19:34):
potential psychosis versus schizotypal.
It's their cognitive slippage and detachmentfrom the social world.
Mm-hmm.
And in regard to the survivalmotivations in
Millon's theory, borderlineshave an average
focus on each.
So there's average focus on pleasure pain,passive active, and self-other.
(19:57):
Sounds amazing, right?
Yeah.
Except the thing with borderline is thatthere is a conflict within each domain.
Okay.
Tell me more about that.
Yeah.
So there's average focus in each survival
category, but each one isalways in conflict,
making it unstable.
They keep switching backand forth between
(20:19):
the different survival polarities,which is
often why we tend to experience the push-pulldynamics in borderline personalities.
Yeah.
So come here, go away.
I love you.
Don't leave me.
Go away.
I don't need you.
Like they're constantly changingpositions in relationships.
Mm-hmm.
And there is an intense, extremeinconsistency
(20:40):
and ambivalence resulting inemotional lability,
unpredictable behaviors, and thoughts and
feelings about others that arejust always changing.
Mm-hmm.
Yeah.
And they're inconsistent too.
Mm-hmm. Yeah.
Which makes a lot of sense because then theyseem wishy-washy a lot of the time.
So constantly changing that position and
(21:01):
their view in the relationshipsand their emotions
and even in how they view themselves.
So it is an ever-changing roller coaster
depending on where they areat in that moment.
Exactly.
Also for the structurally defective
borderline personality, the otherpersonalities that
often co-exist with it includemelancholic,
(21:24):
dependent, avoidant, histrionic,narcissistic,
and antisocial.
Wow.
Okay.
So there's a lot of personalitiesthat can
co-exist with borderline personalityor possibly
even personalities that can disintegrateinto borderline personality.
So this spans clusters B and C personalitydisorders in the DSM.
(21:47):
Interestingly, no cluster A where schizoid,schizotypal, and paranoid live.
And I bet it's because theyhave their own
disintegration lines, onewe already talked
about and one is up next.
Exactly.
And I think this is probably one reasonwhy borderlines can look so different.
Yes, that's a great point.
(22:10):
And if you've met one borderline, youcertainly have not met them all.
Mm-hmm.
So for example, you can have a more
depressive personality co-existingwith borderline or
a more dependent clingy flavor or even an avoidantflavor that is socially anxious.
Aha.
And then we also have the histrionicpersonality.
(22:32):
So big emotions, attentionseeking behavior,
which some argue is most likelythe DSM version
of borderline personality.
Mm-hmm.
And we can see narcissism too.
So with high self absorption and often
looking to fill their ownneeds above others.
Mm-hmm.
And then of course, antisocial or a more
dangerous, edgy flavor of borderlinethat maybe lives
(22:55):
on the knife's edge, perhaps running from
the law or believing, youknow, laws or rules
don't apply to them.
Yeah, very interesting.
So there's all kinds of flavorsof BPD, like
looking very different fromperson to person.
But having that instability is the commonfactor in all of them, right?
(23:16):
But let's move to the last unstabletype, the paranoid.
Okay.
Quick overview of paranoidpersonality disorder.
There's chronic mistrustand suspiciousness
with beliefs that others arejust malevolent.
Like they suspect others are out to harm
them, are preoccupied withothers' loyalty and
(23:36):
trustworthiness and avoid confiding in
others so it's not used againstthem maliciously.
Yep.
And as such, they interpret neutralremarks as threatening.
They hold grudges and arehypervigilant to
perceived attacks and theyare quick to counter
attack.
And interestingly, anothertrait that they
(23:56):
have is often an unjustified suspicion of
their partner's fidelity.
But the hallmark characteristichere is their
fear, mistrust and suspicionleading to chronic
personality based paranoia about theworld being out to get them.
This one is particularlyinteresting and of
(24:18):
the different personalitiesthat carries a
high risk for dangerous behaviors due tothis personality being too rigid.
So Millon doesn't focus onthe intensity of
the motives here, but theinflexibility of
the paranoid's survival aims and motives.
Yeah.
So it's less about havinga weak average or
(24:41):
strong relationship to thesesurvival aims
and motives, but more soabout how rigidly
the paranoid adheres to theirdifferent motives.
They are immovable and frozen,not able to
adapt, which is interestingbecause there's
actually some neurotic energy here.
Yeah.
And paranoids are arguably the most fearfulof the personality disorders.
(25:05):
So you take their neurosis maybe and you
freeze it in with their disorderdefense mechanisms
and we just have a recipe for reallyunhealthy personality.
Absolutely.
Yeah.
And in some ways it means they operate
opposite of borderline personalitybecause borderlines
are constantly back and forth about theirsurvival aims and motives.
(25:27):
But in contrast, paranoids are frozenin them and immovable.
So you have all the extreme relationships
here in reference to thepersonalities means
of survival.
Paranoids are so afraidof annihilation
that they are fixated onsurviving, causing
them to freeze.
(25:47):
Exactly.
Their psychic structure is fixed andunyielding and obstinate.
Whatever they learned anddeveloped in life
is hidden and unchangeableand it's just not
influenced by life circumstancesor external experiences.
So their character is unbending with no
variation because there's anunwillingness to do that.
(26:09):
To change even with good reason to do so.
Yeah.
So their attitudes, their emotions and
thoughts about themselves andothers are all rigidly
enclosed and compartmentalized,which then
means that their behaviorsare fixed as well.
So they're unrelenting in the constricted
(26:29):
way that they perceive andrelate to the world
and they will not adapt toexternal realities.
Right on.
Yeah.
And so then even with newinformation, they
rigidly adhere to theirway of viewing the
world which they see as a hostileand threatening place.
And then for the structurally defective
(26:50):
paranoid personality, the otherpersonality disorders
that often coexist include avoidant,negativistic,
compulsive, narcissistic, antisocialand sadistic.
Another interesting point.
Yeah.
Avoidant personality, accordingto Millon, can
show up with any of the unstablestructures.
(27:14):
Super fascinating, right?
So does make me wonder ifit's because Millon
coined the term avoidant andit doesn't actually
fit neatly into categories or I don'tknow, maybe there's something there.
Possibly.
I'm still not convinced thatavoidant is its
own like fully separate personality,but I'm
not sure, but I won't go there right now.
(27:36):
I know.
I'm not sure about that one either.
I'm still, I'm still mixed about that.
But anyway, we have more dangerous
personalities here too within theparanoid personality.
So you mentioned sadistic.
So that's taking pleasurefrom pain, which
is arguably one of the mostsevere personality
structures that you can have.
(27:57):
And then there's antisocial,which is rule
breaking, norm breaking, not caring about
social mores or what people think.
Compulsive is pretty interesting too, as
they overlap with paranoidin their rigidity,
though compulsives are rigid about outside
rules and they do want to pleaseothers typically.
(28:18):
So that's a pretty long fallfor the psyche to
go to paranoid, but it definitelycan happen.
That is an interesting thought.
Yeah.
That's a fall.
That's quite the fall, but it can happen.
Yeah.
Anyway, we won't get into all of that.
What does their almost psychotic-nesslook like?
Sure.
Paranoids dip into psychosis is actually
(28:40):
super tricky to see becausetheir delusions are
systematic, meaning they're absolutelylogical and comprehensive.
They're just irrational and untrue.
Huh.
So most times I've seen paranoid like
briefly fall into episodes ofpsychosis where they
are just super convincedthat someone's out
(29:01):
to get them with malevolentintent despite
no evidence or even evidenceto the contrary.
Anecdotally, it does seem that this might
be triggered by unconsciousfeelings of guilt
that they can't handle.
So they project it onto another person.
So like, I'm not the bad guy.
You are.
(29:21):
Mm-hmm.
And in paranoids, paranoiais all encompassing
and pervasive and they structuretheir entire
life around outwitting perceived enemies sothe enemy doesn't take them out first.
And I've seen that come outas blurred lines
between the self and theother, also similar
to borderline.
(29:42):
But for the paranoid, this can look like
having illusions of enemiesout of the corner of
their eye or nursing oldgrudges from years
gone by and believing thatthose people are
somehow still against you,believing they've
maybe even reached out to you,but not realizing
it was only a thought in your mind.
(30:03):
Like it never really happened.
So again, blurring reality and non-realitydue to the paranoia.
Interestingly, it is their paranoia that
takes them into that possiblepsychosis place.
Mm-hmm.
So because these three personalitiesat the
disorder level live in thatquasi-psychotic
(30:24):
space, they can sometimes be hard todifferentiate in treatment.
Oh, yeah.
Especially because they usually coexist
with a non-structurally defectivepersonality.
I think in theory, schizotypals should be
the easiest to identify becauseof the social
oddities.
However, I've also seen more quiet
presentations of borderline personalitydisorder that maybe
(30:47):
has a schizoid layer.
This can be super challengingto know like
what personality is actuallydriving the bus.
Yes.
And this is where I say personalitiesare like gobstoppers, right?
What is at the core of the gobstopper?
You have all these other flavors aroundand around and around the layers.
(31:08):
And that's why I love psych testing.
And specifically in psychtesting, I always
use Millon's MCMI for thisreason because it
actually breaks down thedifferent layers of
the personality gobstopperand then including
the three unstable structures andtheir related skills.
So it can tell us a lot more about the colorsand the textures of the personality.
(31:32):
And again, what that personality core is,but even still, it can be challenging.
So some of my trickiest cases have been a
differential diagnosis betweenparanoid and
borderline and sometimes even betweenschizotypal in borderline too.
Definitely.
So as the structure of a psyche falls
(31:52):
apart, it's harder to figureout what it used to
be.
So again, if you see a collapsedbuilding,
it's hard to know if itused to be a house
or a cabin or a garage.
You really have to dig andtry to find data
from the very beginning, likefrom childhood,
from other people's perspectives, essentiallyfrom the original motives.
(32:13):
I love that analogy.
Yeah, that's spot on.
Yeah.
So for example, if an individualis currently
struggling with wanting toattach to others,
but being fearful of doingso, having some
paranoid ideation, which couldfit into borderline
or paranoid, it's helpfulto look at history.
Yeah.
So in youth, were they more dependent andexperiencing separation anxiety?
(32:37):
Probably borderline there.
Yeah.
Or were they scared of whatothers thought
of them and like fearing that others were
out to get them and bully them?
Uh-huh.
Now this sounds more paranoid,but it takes
a lot of time with the personto know what
makes them tick and also their backstory,
their history, others' perspectives,family
(32:58):
history as well, what runs in the family.
And I've also found that certain
personalities lie a lot to hidetheir pathology, which is
why external data from othersources is super
helpful in personality differentialdiagnosis.
Yeah.
And sometimes it's not even lying.
It's just their skewed reality.
Like denial or projection,like is not
(33:21):
lying on purpose, whichis why we can have
empathy for all persons.
Everything stems from pain andhurt and protections.
And people can be challengingand we can have empathy.
Like we can have those doubledipped feelings.
Absolutely.
Yeah.
Oh goodness.
All right.
So we've covered the three unstable
(33:42):
personalities of schizotypal, borderlineand paranoid who
all live in this quasi psychoticspace and
are at risk of further fallingapart, similar
to melting ice cream.
Their instability stems fromtheir unhelpful
relationship with survivalmotives and aims
putting them at risk for further
(34:03):
deterioration, from cognitive slippageof the schizotypal
to emotional instability of the borderline,to rigid paranoia of the paranoid.
Their psychic architectureis falling apart.
Yes.
This is super interesting stuff.
And I will say too, if ourlisteners and viewers
(34:23):
have found schizotypal andschizoid interesting,
we also think that you'll like avoidant
personality, which is coming up nextas there's a significant
overlap with this personality.
So I'm really excited for that series to
launch very soon, but for today,that's a wrap.
So thank you for joining us on thisepisode of the personality couch.
(34:46):
Make sure to check out ourblogs that coincide
with these episodes at www.personalitycouch.com.
And as always, don't forget to give us a
thumbs up or rate and reviewus on your favorite
podcast app and on YouTube, hit that bell soyou don't miss a single episode of our
upcoming series on avoidantpersonalities.
Be well, be kind, and we'll see you nexttime on the personality couch.
(35:11):
This podcast is for informationalpurposes
only and does not constitutea professional
relationship.
If you're in need of professional help,
please seek out appropriate resourcesin your area.
Information about clinical trends or
diagnoses are discussed in broadand universal terms
and do not refer to any specificperson or case.