Disclaimer
We recognise that the system of personality disorder diagnosis can be considered controversial. It is completely your choice which term, if any, you want to use, knowing that your doctor or care team may use another.
The terms used on Counselling Directory are those that are generally used in the UK, currently. We refer to these terms throughout, with the hope of reaching and supporting as many people as possible.
What is schizotypal personality disorder?
Schizotypal personality disorder (STPD) is a type of personality disorder which affects a person’s relationships and behaviours. People with this condition typically struggle to form relationships with people and may find it harder to understand how their behaviours impact others.
Known as a ‘Cluster A’ personality disorder, schizotypal personality disorder is characterised by distorted and/or eccentric thinking and behaviours, and social discomfort.
People with STPD can be suspicious of other people’s intentions. Because of this, those with the disorder tend to trust few people and often view the world as an isolated place. They also tend to feel extreme anxiety in social situations, avoiding them where possible, and may act inappropriately, or not react at all, during conversations.
How does STPD differ from schizophrenia?
Schizotypal personality disorder is part of the schizophrenia spectrum of disorders. STPD shares similar symptoms of schizophrenia, but they are different conditions.
Whilst both conditions experience distortions in reality and may display ‘odd’ behaviours, people with STPD typically act, dress or speak in ways that are outside of societal ‘norms.’ People with schizophrenia, however, tend to experience psychotic symptoms such as disordered thinking, hallucinations and delusions.
Those with schizotypal personality disorder often believe they have extrasensory abilities, or a ‘sixth sense’, can see into the future and can read other people's minds. They also describe supernatural experiences, such as out-of-body experiences and recurrent coincidences, commonly known as déjá-vu.
Schizoid vs schizotypal personality disorder
People with schizoid personality disorder typically have little interest in forming relationships. As a result, they tend to prefer solitary activities and may come across as emotionally detached. People with schizotypal personality disorder, on the other hand, may long for close relationships, but struggle with social interaction.
In this video, psychotherapist Monica Videira explains what schizotypal personality disorder is, the common signs to look out for and busts some myths.
What are the symptoms of schizotypal personality disorder?
Individuals with STPD typically behave in ways that many people would describe as ‘eccentric.’ Other signs include:
- having odd beliefs, behaviour and fantasies
- difficult-to-follow speech
- unusual perceptual experiences
- excessive social anxiety
- difficulty forming relationships
- suspicion and paranoia
- difficulty responding to social cues
- seeming emotionally distant
Although paranoia is a symptom of schizotypal personality disorder, this is not the same as paranoid personality disorder. Also categorised as ‘Cluster A,’ paranoid personality disorder typically leads people to believe that others are trying to hurt them, whilst people with schizotypal personality disorder prefer to avoid social situations.
It’s important to remember that our personalities are unique to us and make us individual. However, if you recognise any of the above symptoms in yourself (or someone you know) and it’s having an impact on your daily life, including your ability to form close relationships, you may wish to seek some support.
The complexities around their similar symptoms and associations with schizophrenia mean that Cluster A personality disorders, in particular, are often less frequently diagnosed, so it's important to seek support.
Who is more likely to be diagnosed with STPD?
People with schizotypal personality disorder are more likely to be diagnosed in early adulthood. There are a number of factors that might influence the likelihood of someone being diagnosed with schizotypal personality disorder. These can include:
- Genetics. Schizotypal personality disorder can run in families. Therefore, individuals are more likely to be diagnosed if they have relatives with schizophrenia, STPD or other personality disorders.
- Environmental factors. Adverse childhood experiences such as abuse, neglect or trauma may mean someone is more likely to have schizotypal personality disorder.
Treatment for schizotypal personality disorder
Personality disorder diagnosis can be considered controversial because some believe that it is unhelpful to call someone’s personality a ‘disorder,’ particularly if the person believes that their behaviours are reasonable and are out of their control. Additionally, for people with schizotypal personality disorder who experience paranoia surrounding social interactions, it may be especially hard for them to receive treatment.
For some people, however, receiving a diagnosis can help them better understand their experiences and seek treatment and support. The National Institute for Health and Care Excellence (NICE) recommends psychological therapies for personality disorders.
Commonly, talking therapies are used alongside other treatments, such as medication. Reality is typically more distorted with schizotypal personality disorder than with schizoid personality disorder. Medication may be used for more acute phases of the disorder, which commonly occur during stressful situations that the individual cannot cope with adequately.
More research is needed to be done into the use of talking therapies to support people with personality disorders, however, some of the most used include dialectical behavioural therapy, cognitive behavioural therapy and group therapy.
Group therapy
Given that many people who are diagnosed with schizotypal personality disorder have difficulty trusting others, a group therapy setting can be beneficial as it can help individuals feel more supported by others with similar conditions. Not only can group therapy help improve social skills, but it can also address social discomfort that is typically experienced by people with STPD.
Dialectical behavioural therapy (DBT)
DBT helps people manage difficult emotions and was originally created to support people with borderline personality disorder. It helps people to accept their emotions and make positive changes to their behaviour. Dialectical behavioural therapy focuses on the person’s strengths and can help people with STPD manage their emotions and communication skills.
Mentalisation-based therapy
Mentalisation-based therapy is a therapeutic approach that helps people better understand their ability to relate to themselves and others. It can be helpful for people with schizotypal personality disorder as it guides emotional containment. This type of therapy also avoids silences which might otherwise promote paranoia.
Cognitive behavioural therapy (CBT)
CBT is the most popular form of psychotherapy for schizotypal personality disorder. Similarly to DBT, CBT helps individuals understand their distorted thoughts and change their thinking. It can be an especially useful approach to help individuals better communicate and understand healthy relationship behaviours. CBT can also support people with STPD in managing their social anxiety.
What should I be looking for in a counsellor or therapist?
Currently, there are no official rules or regulations in place to stipulate what level of training and experience a counsellor needs to treat schizotypal personality disorder, however, we do recommend that you check that your therapist is experienced in the area for which you are seeking help.
You can find a list of professionals on Counselling Directory and browse a few profiles to find one who best resonates with you.
Talking to a healthcare professional, such as a doctor – particularly if you recognise other symptoms of mental health conditions like anxiety or depression – is a brave first step towards recovery. Your doctor may then refer you to a psychologist or psychiatrist who will be able to establish a diagnosis if you feel this would benefit you. For people with schizotypal personality disorder, discomfort in social situations can perpetuate social isolation. Seeking support early on is an effective way to prevent this and assist long-term change.
