8.3 Schizotypal PD

Pervasive pattern of S and I deficit

social, interpersonal

Prominent Features
-eccentric beliefs (inc. M thinking,
S)
-I speech
-unusual A
-inappropriate A (inc. anhedonia)
-S anxiety
-perceptual D/disturbances

magical, superstitions, idiosyncratic, appearance, affect, social, distortions

SELF IMAGE
I, F and
D

“more D than alive”
- Also as “I/P”

insubstantial, foreign, disembodied, dead, insightful, perceptive

RELATIONSHIPS
R have any outside of
immediate F; uses F/I to
ward off loneliness

rarely, family, fantasy, imagination

ISSUES WITH AUTHORITY

Authority figures= U & S; interactions E bizarre behavior

untrustworthy, scary, escalate

BEHAVIOR

S A
“slightly L of center” logic
-unable to differentiate salient from T
-likely to attribute special S to incidentals
-often digresses off T

socially awkward, left, tangential, significance, significance, topic

AFFECT
D, A, S, joyless OR F, agitated, ill at ease

dull, apathetic, sluggish, fearful

DEFENSES
(inadequate and insufficient)
* Preoccupation with P
* F/imagination
* magical/I theories that give the illusion of
P and C (S)

SELF-
CREATED WORLD (ALTERED REALITY)

P > authenticity
Distance > closeness

past, Fantasy, illogical, predictability, control, superpowers, Predictability, 

Common beliefs:
-transcending reality lifts spirits above clouds -others are S-minded/pedestrian in thinking (smallest thought can transport me to another level of consciousness)
-I can make the people around me F better or worse
-I push away N. I invite the loving universe into my soul

simple, feel, negativity

SUBSTANCE USE DISORDERS &
StPD 

Protective Factors: Social oddities make establishing C to obtain drugs

connections, 

SUBSTANCE USE DISORDERS &
StPD 

Risk Factors: Any use can result in D
-Vulnerable to E, abuse & violence in drug
dealings
-Prone to use substances to manage A
build C
-Drugs facilitate escape from feeling O or
disenfranchised
-Abstinence carries burden of I loss and
heightened anxiety

destabilization, exploitation, anxiety, connections, odd, interpersonal

Drugs of choice for StPD
— P
-facilitate fantasy, E, provide access to P
(also congruent with desire to transcend
to higher levels of C
(L, P, W)

— A
-A
-disinhibition D

Psychedelics, escape, paranormal, consciousness, LSD, peyote, weed, alcohol, accessible, desirable

TREATMENT ISSUES FOR
INDIVIDUALS WITH StPD
 RECOMMENDATIONS:
* Make efforts to enter StPD secret W (E & I)
* Directive but not O
* Clinician as “auxiliary ego” (R testing, reinforce S of internal feelings from external circumstances)
* S skill building: stick to the point, practice
recognizing salient themes, topics)
*Consider possible psychotic processes (Axis #?)
* Medical and M evaluations
* Seek out opportunities for clients to engage in positive S interactions (look for accepting group environments)

world, empathy, interest, overcontrolling, reality, separateness, Social, 1, medication, social

TREATMENT ISSUES FOR
INDIVIDUALS WITH StPD
Things to Avoid
* Clinician  P & paternalism
* Clinician B or O
* C or pressure to “drop the denial”
* Underestimate the L associated with abstinence
* Rigid or U expectations (including
abstinence)
* Disavowal of their attraction to T, special powers, witchcraft, wiccan (instead look for spiritual,
philosophical substitutions: meditation,book clubs, spiritual organizations)

protectiveness, boredom, overwhelm, Confrontation, losses, unrealistic, transcendence