Personality Disorders: Child's Defense Against Madness (Schizotypy and Neoteny)

So we are beginning to see that schizotypy is a regression to childhood, a regression to extremely early childhood where boundaries are not formed yet or are very fuzzy and unclear.

And when there is a massive confusion between external and internal object, there's no real perception of the world out there as a separate entity, as a separate environment.

But there is a kind of flow and flux between internal and external so that the boundaries, the fuzzy boundaries are made even fuzzier and the person either absorbs the world in a process called hyperreflexivity or confuses internal and external objects in a process called psychosis or confuses external for internal objects in a process called narcissism.

So this is a very early stage.

Interestingly, this regression to pre-self childhood where there's no constellated self, where there's this confusion of internal and external objects, fuzzy boundaries, this regression enhances creativity and imagination as our civilization places emphasis and value added on creativity, creative efforts, works of art, imagination, the need to deploy creativity in a variety of daily settings.

As creativity becomes the predominant mode of relating to the environment and managing one's life, the more creativity becomes the pivot of modern life and postmodern society, the more we are incentivized as individuals to regress to childhood because children are much more creative and imaginative than others.

By regressing to a pre-self state, by blurring our boundaries, making them fuzzy, by beginning to confuse internal and external objects, we become much more creative. We let loose our imagination and then we are better able, better adapted to cope in a postmodern environment.

So our civilization incentivizes us to become children and people infantilize their behaviors. We see people still cohabiting with their parents well into their 30s, marriage is delayed, childbearing and childrearing are delayed or cancelled altogether. People refuse to grow up, they refuse to assume adult accountability, responsibility and chores. They insist to remain children because remaining children is increasingly more adaptive, it's increasingly a very good reasonable choice.

So they choose neoteny, they try to baby fight, they try to infantilize themselves, they choose neoteny and on the other hand they choose schizotypy even if they are not schizotypal, even if they don't have pathological schizotypy. Schizotypy becomes a lifestyle choice, becomes a personal style, becomes a kind of conformity asset, becomes a form of virtual signaling.

So schizotypy is involved, it's in fashion.

To remind you, schizotypy is a set of characteristics, personalities, personality characteristics and experiences which involves dissociation, imaginative states, creativity and so on and so forth.

In schizotypy we have a continuum, we have a spectrum.

Prior to the conception of schizotypy we used to think that people are either or, either they're totally normal or they're totally schizotypal or schizophrenic. So they were either psychotic or they were normal or neurotic. So they were like categorical divisions and that is the fault of Krechlin and of Sigmund Freud.

Later on we began to have a kind of more nuanced approach, starting I would say in the 60s. We began to have a more nuanced approach.

There were outliers and dissidents and free thinkers like R.D. Laing, which were way out of the mainstream, but there were people who were mainstream scholars such as Hans Eysenck, Eysenck for example suggested the trait of psychoticism. He said that there are three traits that define every person and they are psychoticism, extroversion and eroticism. So he had a model of personality and one of the elements was psychoticism and it was very similar to the intelligence constraint factor in his three-factor model of personality.

Psychoticism was an agglomerate, was a constellation of traits. It included for example impulsivity and sensation seeking, what we call today novelty seeking and these were divided to even more specific traits. For example you could have narrow impulsivity which is unthinking responsivity. You can have risk-taking, you can have non-planning, you can have liveliness, you can have reactance etc.

So psychoticism was not one trait but a family of traits. Sensation seeking was one of them. Eysenck was the one who introduced the idea which was later verified and confirmed in quite a few studies that psychoticism must be somehow connected to creativity.

I will not go into the reasons right now although it's a fascinating topic in itself and I advise you to watch my video on the connection between art and narcissism.

But here we have a situation where we started 130-140 years ago believing that people are either healthy or psychotic and then within the healthy group we started to think of people who are totally healthy and people who are neurotic but they are still not psychotic.

And then there were all kinds of middle-of-the-way scholars who tried to find interstitial the seams between psychosis and normality. So for example Kernberg came with the idea of borderline personality disorder is on the verge of psychosis but is not psychotic. And then there was Eisen who said that actually psychoticism is an element of every personality. It depends on the weight of the psychoticism but it's an element of every personality and it is the found of creativity.

To understand where all this is going we need to time travel. We need to go back in time to Emile Kripelin.

Emile Kripelin was a towering figure in very very very very early psychology in the early childhood of psychology. He was among the first to try to medicalize psychology and the way he did it was very similar to Carl Linnaeus.

He began to compile lists, he began to classify different forms of psychotic illness. So he came up with dementia precox which today we call schizophrenia, manic depression in depressive insanity which today we call bipolar disorder and other non-psychotic states.

Kripelin is the real father of the DSM because the DSM until the most recent edition and even in the most recent edition has a categorical list-oriented list-based view of human mental illness.

So the DSM is seriously heavily concerned with compiling lists of traits, lists of behaviors, classifying, categorizing, differential diagnosis between diagnosis etc etc. That's all Kripelin's work. It's the Kripelin way of regarding mental illness.

At the same time there was another guy, Eugen Bleuler which I consider even greater than Sigmund Freud, an obscure forgotten figure because Freud was much better at public relations.

So Eugen Bleuler, who literally was the father of most modern, most language used in modern psychiatry. He coined the words schizophrenia, he coined the word autism.

I mean Bleuler was a giant, was a genius. Bleuler did not agree with Kripelin. He said that the separation between sanity and madness, it's a degree, it's a question of degree. He said that madness, psychosis was just an extreme expression of thoughts and behaviors that are present in varying degrees throughout the population.

He said everyone is a little mad and then a little more mad and then we have mad people.

So he said psychosis is simply taking things to extreme but all the elements of psychosis exist in healthy people. That was the spectrum approach which is now gradually being adopted in the Diagnostic and Statistical Manual edition five when it comes to personality disorders.

Everything is on a spectrum and then you had Iseng and you had Gordon Claridge and they had adopted Bleuler's approach and they tried to construct a personality theory which was dimensional, where cognitive and behavioral variations are spread, are smeared across a whole spectrum.

So we can find psychotic elements, narcissistic elements, neurotic elements in totally otherwise healthy people.

Claridge was the one who named his concept of schizotypal spectrum. It's his invention, he coined the word.

He studied unusual experiences in the general healthy population and then he clustered the symptoms and then he compared the symptoms to people diagnosed with schizophrenia and Claridge came up with the view that the personality disorder, the personality trait of psychoticism in its extreme form psychosis is much more complex than anyone had thought and he said there were four factors.

Number one, unusual experiences, the disposition to have unusual perceptual and other cognitive experiences such as hallucinations, magical or superstitious belief and interpretation of events, for example delusions.

Number two, cognitive disorganization, a tendency for thoughts to become derailed, disorganized or tangential. It's known as a formal thought disorder or word salad. Word salad is typical of psychotics not of narcissism.

A third element in psychosis or schizotypal, the range, the spectrum of psychoticism. A third element is introverted anhedonia, a tendency to be introverted, a tendency to be emotionally flat, a tendency to have a social behavior, schizoid actually associated with the deficiency in the ability to feel pleasure from social and physical stimulation including sex.

The fourth element is impulsive nonconformity. The disposition defines reactants, the disposition to have unstable moods and behaviors, particularly with regard to rules, authority and social conventions.

Okay, this was Claridge's view of psychoticism and you're already beginning to see the convergence between many elements of schizotyping and many elements of narcissism and psychopathy.

And as we said, as I said in previous videos, the narcissist does not have a self, he does not have an ego and in this sense, he is a schizoid, he is on the schizotyping spectrum.

And as Kernberg has suggested 40 years ago, he is on the verge of psychosis, the narcissist. We will come in a minute to the psychopath.

Similarly, psychopathy is much more nuanced than one of the experts online would have us believe, it's much more nuanced.

So let's summarise up to here and then continue.

Neoteny is an evolutionary adaptation whereby members of a species become adopt or retain childlike traits, behaviours, cognitions, emotions and physical properties well into adulthood. It's an adaptation because it allows them to extract benefits from the environment. That's neoteny.

Schizotyping is a form of neoteny. Schizotyping is the psychological equivalent of neoteny because it's a regression to a very early childhood state where there was no self, where there were no boundaries and there was no distinction between external and internal objects. This is where we are right now.

And when we discuss schizotyping, we need to think of Claridge's observations that schizotyping involves unusual experiences, cognitive disorganization, introverted anhedonia and impulsive nonconformity.

Okay. When we study personality, we usually apply what we call factor models. Factor models are models which describe personalities in terms of factors, in terms of components, ingredients, to use a cooking analogy.

So the most widespread model is known as the five-factor model.

But there are other models. I mentioned intelligence. I mentioned Isengs. There are many models with factors. We use the five-factor model because it had been validated by many studies and it seems to be the most powerful way we have to capture the essence of personality via its interacting components.

And so when we take Claridge's breakdown of psychoticism or schizotyping and we combine it with a five-factor model, we get some very interesting results.

For example, Claridge said that unusual experiences are an integral part of schizotyping.

And it seems that the five-factor model combines it with high neuroticism and with openness to experience.

Now, openness to experience could take the form of risk-taking, adrenalin-junkly, novelty-seeking, which are very common features of psychopaths. Unusual experience in combination with positive affectivity predicts religiosity and spirituality.

In this sense, religiosity, religion, the belief in God, belief in spirits, in angels, all these, they are indicative of a tendency towards psychosis. And in many respects, this is a form of delusional disorder, culturally accepted, socially tolerated, delusional disorder, but mental illness, all the same. Religion is a mental illness, end of story.

So when we combine unusual experiences with neuroticism, openness to experience from the five-factor model, this is what we get.

What about introverted anhedonia?

When we combine this element of psychoticism with a five-factor model, we see that it is linked to neuroticism and low extroversion.

This fits well with the schizoid narcissist or with the schizoid phase in overt classic grandiose narcissism. And of course, it fits perfectly with covert narcissism.

The cognitive disorganization factor is linked to low conscientiousness.

And if you take all the five factors and combine them with Claridge, you get a fully dimensional model of schizotyping.

And it's truth-positive that there is a continuum between normal personalities and schizotypal personalities, schizotyping.

Schizotyping has been linked to other questionnaires, other tests like temperament and character inventory, etc.

Now, in the temperament and character inventory, there is something called self-transcendence. It's a trait associated with openness to spiritual ideas and experiences. And it has moderate positive association correlation with schizotyping, particularly with unusual experiences.

So here's another test, another measure, which confirms that religion and religiosity are schizotypal. They are towards the end of the pathological side of schizotyping where psychosis resides and happens.

Kloninger described the specific combination of self-transcendence, low cooperativeness and low self-directedness as schizotypal personality style.

And additional research proved that this specific combination of traits is associated with a high risk of schizotyping, in other words, with a high risk for psychosis.

But wait a minute. When we say high self-transcendence, low cooperativeness, low self-directedness, low conscientiousness, what are we talking about? Isn't this a very good description of psychopathy?

Yes, sirree. It's a good description of psychopathy.

Low cooperativeness, self-directedness, combined with high self-transcendence result in openness to odd and unusual ideas and behaviors associated intimately with a distorted perception of reality, with an impaired reality testing.

And here is the interesting thing.

Studies have shown that when you take schizotyping to a certain point on the spectrum, what you get is increased psychopathy but lower narcissism. Amazing.

In other words, we are beginning to see two types of psychopaths. One psychopath, who is grandiose, and his grandiosity propels him and impels him to behave contumaciously, defiantly, impulsively, recklessly. That would be the primary psychopath.

But if we take the psychopath and move him across the spectrum of schizotyping, towards the psychotic end, we get a secondary psychopath. That's a psychopath with access to emotions and empathy and a psychopath that is very low on narcissism. It's not a grandiose psychopath. That would be, for example, the borderline. Borderlines have grandiosity, but the grandiosity is not the pronounced feature of borderline. The pronounced feature of borderline is being on the verge of psychosis. Borderlines often have psychotic micro-episodes.

And all the schizotypy features, including decompensation acting out in a transition to secondary psychopathy.

This emotional dysregulation, etc., they drive the borderline towards the psychotic end of the schizotypy spectrum, where we also find the secondary psychopath.

Now we're beginning to understand how borderlines transition into secondary psychopathy. They are one and the same, actually, when you combine the schizotypy model with the five-factor model or with other inventories, such as the temperament and character inventory.

This is very interesting because it's the first time we begin to see how all personality disorders converge within a single spectrum, which is a spectrum of schizotypy.

And I'm suggesting that schizotypy's main feature is main two features.

And this is my standard model of personality disorders, which is actually an enhancement of the schizotypy model. I claim that schizotypy relies on two pillars, a lack of constellated and integrated self, no ego, and a blurring of internal and external objects because of failure in boundary formation.

I refer you to the article by Lonsdale, Biukas, Laszlo, and others, December 2018. In the academic journal Psychological Reports, the article is titled, Schizotypal Traits in the Dark Triad from an Ecological Perspective.

Schizotypal Traits in the Dark Triad from an Ecological Perspective. So we are beginning to converge. We're beginning to converge, and we are beginning to see how secondary psychopathy, how covert narcissism, how narcissism itself, emerge on different points along the schizotypy spectrum, along the schiztypy range.

Increased borderline personality traits go hand in hand with increased psychopathy in a single particular point on the schizotypy range.

When we reach this point, suddenly there are borderline traits coupled with psychopathic traits.

Okay. There is evidence that schizotypy correlates with differentially enhanced and impaired aspects of cognitive function.

Cognitive deficits impaired reality testing.

I keep telling you that the narcissist is no longer with us. His reality testing is short. He has no access to reality.

What he does instead, he internalizes reality.

For example, he internalizes external objects in order to control them because he's terrified of losing control, being abandoned, etc. And because he has no ego and no self to guide, you need an ego. You need a self to guide, to discipline, to moderate, to modulate, to curate. There's no ego there. There's no self.

So these internal objects are in constant conflict, constant fight. They are polarized.

So these findings that the schizotypy correlates with cognitive dysfunctions and an impaired cognitive style, impaired reality testing, they indicate that schizotypy is positively correlated, positively associated with enhanced global processing over local processing, lower latent inhibition, attention and memory deficits, enhanced creativity and imagination, and enhanced associative thinking.

Now it's easy to understand why, for example, borderlines, narcissists, and even many psychopaths prefer fantasy to reality.

The fantasy defense mechanism is predominant in borderline and narcissistic personality disorders, but why?

We could have asked ourselves, we can ask, you know, there are like dozens of defense mechanisms, for example, intellectualization, rationalization, I mean, you name it, projection.

Why does the narcissist prefer fantasy?

Because of what I just said, they have lower latent inhibition, which leads to impulsiveness and dysempathy, lack of empathy. They have attention, not lack of empathy, but dysempathy.

When their impulses take over, they are less empathic. They have attention and memory deficits, but they have an enhanced creativity and imagination and enhanced associative thinking.

And these are the ingredients that go into making the fantasy cake. Fantasy requires creativity, imagination, and associative thinking. Fantasy also requires a disrupted interface with reality, memory deficits, cognitive deficits, attention deficits. Fantasy and creativity rely on partial access to reality. They are compensatory.

Where your access to reality is impaired, your judgment of reality is wrong, erroneous very often. Where you don't process information and data, where you filter them, or repress them, or reframe them, you need fantasy. Fantasy kicks in to fill in the gaps.

One very well-known fantasy mechanism is confabulation.

So fantasy compensates for all these elements of schizotypy.

Now, some of the features in schizotypy can be diagnosed in mental illness. They're observable and discernible in mental illness, but schizotypy is not about mental illness. It's a personality theory. It's a theory of the entire personality.

And it actually says that everyone is schizotypal to this or to that extent.

Schizotypy could be beneficial. Creativity, artistic achievement, rely on schizotypy, unusual experiences, cognitive disorganization. Jackson came up with the concept of benign schizotypy. He said that certain classes of religious experience are forms of benign schizotypy because they solve problems. They have adaptive value. They make you feel good. They make you feel egosyntonic. They motivate you to act in certain ways and inhibit you in other ways which are long-term beneficial. They secure beneficial outcomes for the environment. They prevent you from ending up in jail.

So he said that benign schizotypy, even when it manifests in a delusional way like religion, has adaptive value. It's a positive adaptation.

So schizotypy is not a bad thing. It's not a curse word. It's not like narcissism. And narcissism is not a bad thing. We have healthy narcissism.

Schizotypy, there's been a debate about the extent of schizotypy in healthy populations. And so there are basically three approaches, quasi-dimensionala debate about the extent of schizotypy in healthy populations. And so there are basically three approaches, quasi-dimensional, quasi-dimensional, dimensional, and fully dimensional. And schiztymphy reflects cognitive biological vulnerability to psychosis because of regression to early childhood when we had no ego defense.

As children, we had no ego defenses. There is no self there. And because there's no self, the entire inner internal environment is dysregulated. And it's difficult to tell the difference between out there and in here. It's difficult to reconcile internal objects. It's difficult to force them to collaborate.

So schizotypy reflects vulnerability to psychosis because of the level of chaos and disorganization inside.

But there is a debate whether everyone on earth alive has some modicum, some measure of disorganization and chaos. But it is so low that it is latent and dormant and never expressed and never manifested, only when it is triggered by appropriate environmental events, conditions, stressors, substances like drugs, only then the disorganization and chaos manifest and express.

And so susceptibility to stress, for example, would condition some people to express their schizotypy much more than other people.

And we need to think. That's why I'm suggesting to reconceive personality disorders as post-traumatic conditions.

Because in post trauma, there is intolerance of stress of any kind. Stress immediately triggers decompensation, immediately triggers acting out, immediately triggers schizotypy or schizotypal reactions.

I said that there are three models, and we'll start with the first and oldest one, which is the quasi-dimensional model.

The quasi-dimensional model was proposed by Bleuler, of course, who coined the word schizophrenia. Bleuler said that there are two types of continuity between normality and psychosis. There is continuity between the sick person and his or her relatives.

So Bleuler was the first to introduce a relational approach to mental illness, to mental health. He said that schizotypy manifests, is expressed in the relationships between the sick, the ill person, the mentally ill person and his or her relatives.

And another dimension is between the patient's pre-morbid and post-morbid personalities. Personality before the illness, the personality after the illness, after the onset of, for example, psychosis, after the onset of personality disorder.

He said, if one observes the relatives of our patients, one often finds in them peculiarities which are qualitatively identical with those of the patients themselves.

So then the disease appears to be only a quantitative increase of the anomalies seen in the parents and the siblings.

And this is exactly how we conceive of personality disorders.

We say that many personality disorders, not all, but many personality disorders are the outcomes of early childhood environment, of abuse, of trauma, of parentifying, of breach of boundaries, of idolizing, of not allowing separation, individuation, of a dead mother, narcissistic, selfish, absent, etc.

This observation is as old as Bleuler. He suggested that human environment conditions people to become ill, and therefore, illness is a contextual, relational, environmental thing.

I can't tell you how revolutionary this thinking was at his time.

On the second point, the relationship between the personality before the illness and after the illness, Bleuler mentions peculiarities that are displayed by the patient before admission to hospital. And he said these peculiarities are premonitions. They are premonitory symptoms of the disease. They are red alerts, they are warning signs.

They are, at the very least, are indications of a predisposition to develop the illness.

And again, Bleuler was a pioneer because he had hinted at genetics when there was no genetics. He said there must be something in these patients which predisposes them to become ill.

And so, despite these observations of continuity, Bleuler didn't dare to go all the way. He remained committed to the disease model of psychosis and schizophrenia, and he invoked the concept of latent schizophrenia.

He wrote, in the latent form of schizophrenia, we can see in a nutshell, all the symptoms and all the combinations of symptoms which are present in the manifest types of the disease.

The quasi-dimensional view of schizotypy as propounded by Rado, Miehl, MEEHHL, and others, they say that schizotypal symptoms represent less explicitly expressed manifestations of the underlying disease process, which is schizophrenia.

Rado proposed the term schizotype to describe the person whose genetic makeup gave him or her a lifelong propensity, proclivity predisposition to schizophrenia.

The quasi-dimensional model is called quasi-dimensional because the only dimension it postulates is gradations, gradations of severity, gradations of explicitness, gradations of manifestation in relation to the symptoms of a disease process.

So, the spectrum is a spectrum of quantity, not of quality.

Enter the dimensional approach.

Dimensional approach was a derivative of an innovation at the time in psychology, personality theory. As Western civilization and society became more and more individualized after the 1920s and 1930s, there was a reorientation of psychology from relationships, from context, from environment to the individual, the indivisible, the atom, the personality.

And this was called the personality theory.

And so personality theory and the dimensional approach to schizotyping suggested that full-blown psychotic illness is only the most extreme end of schizotyping spectrum.

There is a natural continuum between people with low and high level of schizotyping. The model is associated with the work of Hans J. Eysenck, the aforementioned Hans J. Eysenck. He regarded the person exhibiting the full-blown manifestations of psychosis as simply someone occupying the extreme upper end of his psychoticism trait or dimension.

And so, it seems that there is some support for the dimensional model of schizotyping because it seems a schizophrenia, schizoaffective disorder, schizoid personality disorder, schizotypal personality disorder.

And I would add cluster B personality disorders because they are all centered around the schizoid core.

If you take all this, there seems to be intimate connections of gradation in quantity and in quality. In other words, both the number of manifestations increase, increases, and the intensity of the expressed trait or behavior increases, both quality and quantity.

The reason I'm adding cluster B and claiming that cluster B has a schizoid core is because there is a whole school of extremely prominent scholars, the scholars which are the authority on the self, scholars like Winnicott, like Spitz, like Gannon, like Fairburn, like others. And these scholars were the ones who had suggested that schizoid personality is at the core of cluster B personalities and others, not only cluster B.

So, I'm standing on the shoulders of giants and following the footsteps of giants when I say that the schizotyping spectrum should definitely include cluster B personality disorders.

And indeed, when we combine it with a five-factor model, we get borderline personality disorder, narcissistic personality disorder, and antisocial personality disorder, aka psychopathy in its extreme form.

So, this leads me to the fully dimensional approach.

Claridge called his model the fully dimensional approach, fully dimensional model.

According to him, schizotyping is a dimension of personality normally distributed throughout the population. And in this, he agrees with Eysenck. There's no big innovation here.

But he says, schizophrenia is a breakdown process. It's totally distinct from the continuously distributed trait of schizotyping. In other words, he said, you're all wrong, schizophrenia is not a member of the family of schizotyping, schizotyping illnesses or schizotyping disorders. I am of this view.

I think that schizoaffective disorders, schizoid personality disorders, schizotypal personality disorder, borderline personality disorder, narcissistic personality disorder, histrionic, to a larger extent antisocial, and so on. They are all centered around the schizoid core, but these personality disorders are positive adaptations to the schizoid core, and they prevent schizophrenia.

The only thing standing between a personality disordered person and psychosis is his disorder. The disorder, the personality disorder, protects the patient from becoming psychotic, protects the patient, defends the patient against schizophrenia.

If the patient were to come into contact with his or her schizoid core, they would have been rendered psychotic or schizophrenic.

The personality disorder is an adaptation intended to prevent precisely this development.

So, schizophrenia in his encourages model is a breakdown, and he said in itself, schizophrenia has a graded continuum, and he said, okay, we can place schizotypal personality disorder on one end and schizophrenia on the other, but we should not confuse the two spectra. We should not confuse the two issues.

There is schizotyping, which is normal, distributed in all the population, and its abnormal manifestations are various personality disorders, schizoaffective disorders, and then we have separately a continuum of schizophrenia at one end of which is schizotypal personality disorder, and at the other is schizophrenia, and that's the model I adhere to. It's fully dimensional because not only is the personality trait of schizotyping continuously graded, but the independent continuum of the breakdown processes is also graded. It's all non-categorical.

The fully dimensional approach argues that full blown psychosis is not just high schizotyping, but must involve other factors that make it qualitatively different, pathological. There's a differential diagnosis, and I fully agree.

Narcissists, vaudelites, psychopaths, histrionics, paranoid, schizoids, schiztypals, they're all on the schizotyping model. When their traits intermix with schizotyping, there is also personality disorders, and personality disorders are the defenses which evolved over time, mainly in childhood, to isolate the patient, to isolate the person from ultimate schizophrenia and psychosis. They are anti-psychotic medication personality disorders, they are anti-psychotic defenses, and now we understand why the patient is so invested in his personality disorder, why it's almost impossible to heal and cure and reverse personality disorders, with the exception perhaps of borderline independent personality disorders. Why?

Because it's the only thing separating the patient from total unmitigated, all-encompassing, all-pervasive raving madness.