Personality Couch

In this episode of the Personality Couch Podcast, we (licensed clinical psychologists Doc Bok and Doc Fish) explore the 3 most unstable personality disorders: schizotypal, borderline, and paranoid. All 3 types are at risk of psychosis. We first discuss historical personality classifications of neurotic, psychotic, and borderline, highlighting that the borderline space between neurotic and psychotic is the most prone to instability. This borderline space is where schizotypal, borderline, and paranoid personalities sit. We discuss the risky traits of each personality, including cognitive slippage, emotional instability, and extreme rigidity. We also discuss some of our thoughts and experiences in diagnosing these rather tricky disorders! 🆘Are you a clinician stuck on a case? To schedule a consultation, please visit the practice website! 👉https://www.questpsych.org/ Chapters 00:00 Intro & Psychodynamic Personality Organization       02:31 Neurotic Personality Organization       04:47 Psychotic Personality Organization       05:48 Borderline Personality Organization 07:57 Schizotypal Personality & Instability       08:57 Why Personalities Are Unstable (according to Millon)       13:55 Personalities that Coexist with Schizotypal 16:30 Borderline Personality & Instability       21:16 Personalities that Coexist with Borderline  23:18 Paranoid Personality & Instability       26:52 Personalities that Coexist with Paranoid 30:18 Our Experiences with Diagnosing Unstable Personalities 33:39 Summary & Conclusion

In this episode of The Personality Couch Podcast, we (licensed clinical psychologists Doc Bok and Doc Fish) unpack the 6 subtypes of schizotypal personality disorder, according to Dr. Theodore Millon. We outline Millon’s take on “structurally defective structures” as being at risk of falling apart into psychosis at all levels of functioning, with the most severe levels of schizotypal deteriorating into schizophrenia. We then discuss the characteristics of mild, moderate, and severe subtypes, specifically: Disengaged Eccentrics, Apprehensive Eccentrics, the Insipid Schizotypal, the Timorous Schizotypal, the Immobile Schizophrenic, and the Disorganized Schizophrenic.  🆘Are you a clinician stuck on a case? To schedule a consultation, please visit the practice website! 👉https://www.questpsych.org/ Chapters 00:00 Intro & History of Schizotypal Subtypes 02:45 Theodore Millon’s Theory on Schizotypal Personality 07:00 The Mild Eccentric Level        08:21 Disengaged Eccentrics       09:39 Apprehensive Eccentrics 10:48 The Moderate Schizotypal Level       11:57 Insipid Schizotypal       18:17 Timorous Schizotypal 21:26 The Severe Schizophrenic Level        22:56 Immobile Schizophrenic        26:08 Disorganized Schizophrenic 29:05 Summary & Conclusion 

In this episode of the Personality Couch Podcast, we (licensed clinical psychologists Doc Bok and Doc Fish) dive into the origins, diagnostic criteria, and oddities associated with schizotypal personality disorder and what it means to be almost psychotic, but not quite. We unpack idiosyncrasies and “cognitive slippage” of schizotypals that include odd speech patterns, suspiciousness, emotional expression, and social anxiety. This episode also highlights the importance of cultural context in diagnosis and not overpathologizing trends or religious norms. We also explore the overlap with and risk of schizophrenia in schizotypals, along with long-term implications of living in a quasi-psychotic cognitive space. 🆘Are you a clinician stuck on a case? To schedule a consultation, please visit the practice website! 👉https://www.questpsych.org/ Chapters 00:00 Intro & History of Schizotypal Personality  01:15 DSM Criteria Schizotypal Personality       02:59 Ideas of Reference      05:35 Odd Beliefs and Magical Thinking               08:18 Exploring Cultural Oddities vs Psychosis      11:05 Unusual Perceptual Experiences      12:44 Odd Thinking & Speech      17:45 Suspiciousness and Paranoia      18:34 Emotional Expression, Behavior, and Appearance      20:13 Lack of Close Relationships and Anxiety 23:42 Schizotypal Differential Diagnosis 24:46 Schizotypals’ Relationship to Schizophrenia 29:33 Summary and Conclusion

In this episode of The Personality Couch, we (licensed clinical psychologists Doc Bok and Doc Fish) explore the origins and nuances of schizotypal personality disorder, its genetic links to schizophrenia, and the clinical observations that define it. We discuss the evolution of the term 'schizotypal' in the DSM, the implications of schizotypy, and how environmental factors and social learning influence its development. We also uncover observable traits of schizotypal individuals, their social interactions, and self-concept, providing a comprehensive overview of this intriguing personality disorder that is not quite psychotic, but close. 🆘Are you a clinician stuck on a case? To schedule a consultation, please visit the practice website! 👉https://www.questpsych.org/ Chapters 00:00 Intro & History of Schizotypal Personality  01:34 Genetic Research on Schizotypal 05:17 Clinical Research on Schizotypal 08:47 Schizotypal in the DSM 09:29 Schizotypy and Borderline Personality Organization 12:17 Schizotypy Defined 14:32 Schizotaxia Defined 17:39 Schizotypic Endophenotypes Explained 19:57 When Schizotypy Manifests 21:28 Observable Traits of Schizotypal Personality Disorder 30:44 Summary and Conclusion 

In this episode of The Personality Couch, we (licensed clinical psychologists Doc Bok and Doc Fish) compare and contrast schizoid and schizotypal personality disorders, as well as schizophrenia. We define key terms, explore the overlap and differences among these disorders, and introduce the concept of schizotypy as a genetic predisposition towards schizophrenia. We further discuss the concept of schizotaxia, or “cognitive slippage” and the impact of birth trauma on schizo development. We also share our opinions about where schizoid fits on this continuum and if they are schizotypes or not.  🆘Are you a clinician stuck on a case? To schedule a consultation, please visit the practice website! 👉https://www.questpsych.org/ Chapters 00:00 Introduction & Defining Terms           01:14 Schizoid Personality Defined           01:49 Schizotypal Personality Defined           06:30 Schizophrenia Defined 09:05 Overlap of Schizoid, Schizotypal, & Schizophrenia 12:48 Differences Among Schizoid, Schizotypal, & Schizophrenia 14:34 Meehl’s Model of Schizotypy & Genetics           16:29 Schizotypy Defined 20:00 Premature Birth & Low Birth Weight in Schizo Disorders 22:39 Schizoids’ Unique Relationship to Schizotypy 28:34 Summary & Conclusion