Reader Question: My boyfriend was diagnosed schizotypal. What is that, really?

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Whatever you may think the official definition is, psychiatrists tend to use the term in only one of two ways: either incorrectly, as “almost schizophrenic, but still can hold a job and doesn’t hallucinate;” or as a pejorative label describing one who believes in all sorts of fantastical things– aliens, esp, conspiracies, 911 was done by Bush, etc– but believes them in a logical way (e.g. not “aliens came to my house and we played cards.”)

If it’s the latter, then the psychiatrist isn’t making a diagnosis, he’s describing his observations about a “patient’s” character.

Can this kind of schizotypal be “treated” with therapy?  The person has to decide why he’s so invested in these ideas (e.g. believing in conspiracies is a way of reassuring oneself that, after all, there is someone in charge, and that none of this is haphazard. It also means of there is some gigantic catastrophe, someone will be able to take care of us; and also means that any failures in your life aren’t fully your fault, because you’re not a member of TPTB, so you’re being kept down. Etc.)

What about when the psychiatrist means it as  “almost schizophrenic?”  It means you need a new psychiatrist.  (Similarly, antisocial is wrongly used to mean shy.)  Almost schizophrenic– illogical, prone to delusions/hallucinations is a different, more severe matter, that probably will need meds, depending on how old the guy is. <30 means it could get worse; >30 means this is probably as bad as it will ever get.

Going out on a limb here: is marijuana involved?  Clinicians like to think that drugs exacerbate pre-existing conditions, but how can anyone tell?   Clinicians like diagnoses: crack didn’t cause depression, you were depressed and used crack.  Either way, no amount of therapy or Zyprexa can counteract the effects of daily weed.

So the clinician labeled him schizotypal, it suggests to me that the symptoms were present but vague… and that he smoked a lot of marijuana. Start with that. 

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3 Responses to Reader Question: My boyfriend was diagnosed schizotypal. What is that, really?

  1. Rookie says:

    Love the comment about antisocial… a supervisor of mine told me she once fed a report back to her client who replied “what, antisocial personality traits? But i LOVE parties!.”

    I’m a big fan of personality theory, it explains so much about a person and their ‘tactics’ to get their human/social needs, but schizotpal personality cofuses the hell out of me. It sounds like “angry wierd homeless bag lady” or “wierd introverted market stall owner at a mind/body/spirit fair.” But the whole construct seems to include into some very normal people I know, who’re into herbalism and low grade mystic bullshit. I hate that stuff and would readily consider it way out, but that’s my subjective view; society as a whole is probably more open to what I see as alternative crap. Who would I be on that basis to turn my opinion into a diagnosis?

  2. pw says:

    Why did you make leap to marijuana?

  3. Blended Splendid says:

    I have a close friend who is classic Schizotypal. He has almost every attribute. The only reason we became friends is because I’m so pushy. He “became” that way in late adolescence, he has an emotionally distant parent, obsesses over part of his appearance, needs to be alone a lot, can’t function in social situations, is paranoid about people and what they think, he thinks he knows what they are thinking and it’s always negative stuff about him, his magical thinking is off the charts. According to him, he’s been preventing plane crashes and natural disasters for years. My friendship with him is constantly challenged because he always thinks he should be “walking on egg shells”. He thinks I’m mad when I’m not, thinks I’m thinking things I’m not and he’ll leave in the middle of a nice conversation because he badly misinterprets me. He’s incredibly kind and compassionate and talented but he has these other massive issues. I don’t know how to help him because he’s too Schizotypal to walk into a Doctor’s office and explain what’s going on with him.
    I think in Magical Thinking too, but I struggle to believe it. It’s more like I want to believe that wishing and dreaming will bring something good. But my friend believes things with no mental barrier. That’s the difference. If you aren’t Schizotypal, you may think that crystals and burning white sage will alter the spiritual plane or something, but you aren’t there like a Schizotypal person. For them, it is undeniably real with or without drugs! Doctors may play around with the word Schizotypal to describe someone, but some people really are on the Schizophrenia Spectrum. I just wish there was still a place for my Artsy/Musician/Shaman/Monastic type friend in this modern world. Right now, he acts homeless even though he’s a trustfund kid! He’s really interesting!