Schizoid

SCHIZOID. As early as Krepelin, when identifying the nosological form 'early dementia' (dementia praecox), noted that individuals who developed early dementia often exhibited peculiar character traits even before their illness. According to Krepelin, these traits in boys are: quiet, timid, extremely obedient, diligent- 'a model of modesty and obedience'- disinclined to social interaction with peers; in rarer cases- a restless, unwilling to work, prone to vagrancy and mischief-making adolescent. In girls: excitability, sensitivity, nervousness, willfulness, and a tendency toward fantasy and hypocrisy. Initially, there were debates as to whether these character traits represented an already begun, but slowly progressing process, but Krepelin himself pointed out that similar characters were often observed in families of patients with early dementia in individuals who never subsequently developed psychosis, and Bleuler, studying heredity in families of schizophrenics, first clearly presented that 'schizophrenia is only a separate case of widespread constitutional peculiarities common in the family.' As early as 1916, Yudin expressed the idea that schizophrenia develops on the basis of a homozygous dihybrid hereditary formula, while schizoidia develops in heterozygotes. Hannushkin in 1914 and independently of him Popper pointed out that outside the schizophrenic process, under the influence of both somatogenic and psychogenic harmful factors, 'schizophrenic reactions' can arise that do not lead to a resulting defective state and end in recovery (see Mental reaction). Kretschmer, linking schizoid character traits with somatic peculiarities (see Constitution, mental constitutions), and Hoffmann and Kahn, having conducted mass genealogical studies in families of schizophrenics, firmly established the theory of schizoid constitution. Kretschmer's vivid pictorial description of the schizoid character contributed to the widespread dissemination of the theory. Carriers of the schizoid constitution, according to Kretschmer, are primarily people between whom and the rest of the world stands 'a curtain of glass'; these are people regarding whom 'we cannot say what is hidden behind this facade'; these are people regarding whom 'after ten years of living together with them we cannot say that we know them'; the main, characteristic trait of these people is autism- life within oneself, unsociability or superficial sociability with others, without deep contact with them. Of the schizoid qualities of character 'observed on the surface,' Kretschmer distinguishes: 1) unsociable, reserved, serious (lacking humor); 2) shy, fearful, finely sensitive, sentimental, nervous, excitable; a lover of books and nature; 3) obedient, indifferent, dull. At the same time, one can single out a contrasting pair of such properties: on the one hand, a group of psychically insensitive, dull individuals, and on the other- reaching 'to mimosa-like fineness of feeling, to angry excitability.' These anesthetic and hyperesthetic elements usually interweave in S. with each other, forming what Kretschmer calls the 'psychoesthetic proportion' of the schizoid character. The predominant mood of S. at this time fluctuates between these traits: not in waves (legato), as in cycloids, between excitement and depression, but in jumps (staccato) and 'flows with remarkable colors of radiance between shyness, irony, gloom, and cruelty.' In S., sharp age-related breaks in character are also observed, especially at the age of sexual development. In the surrounding social environment (Kretschmer naturally takes into account only the bourgeois environment), S., according to Kretschmer, reveal themselves as sentimental, affectless people, or as finely feeling but cold 'aesthetic-aristocrats,' or as cold despots, authoritative natures, fanatics, or as indifferent, worthless idlers. The theory of schizoidia has caused in psychiatry debates that have not yet subsided and continue to this day. The first controversial question is the relationship of schizoidia to the disease process-schizophrenia. If one can agree that S., under the influence of psychogenic or even somatogenic harmful factors, give as a reaction temporary schizophrenic-like psychopathic outbreaks, it is much more difficult to understand how from a quantitative intensification of dynamic characterological moments an organic process can develop, as most psychiatrists conceive of dementia praecox and schizophrenia. Meanwhile, Kretschmer considers that schizothymia (normal schizoid-colored character)-schizoidia (psychopathic character)-schizophrenia is a continuous, quantitatively increasing series, and schizophrenia is only the 'psychotic peak points of Schizoidie,' 'having in schizoids its abortive form, and in schizothymics its rudiment or its broad biological basis.' The French psychiatrist Claude therefore distinguishes, on the one hand, 'schizomanias' that run according to the 'type of character development,' and on the other- 'schizophrenias'-organic diseases that proceed according to pathophysiological laws. Schizophrenia, according to Claude, is encephalitis, the course and symptoms of which are determined by anatomy. Borch, Grule, Mayer-Gross, studying in schizophrenia 'primary' symptoms peculiar to it alone [peculiarities of emotion, impulses, disturbance of activity, disturbance of intentional (see Intentions) activity], consider that schizoid moments only pathoplastically overlay them. Kahn considers that for the development of schizophrenia to schizoid genes must be added the 'gene of the process.' Bleuler Jr., studying the genealogy of families of schizophrenics, comes to the conclusion that cases of dementia praecox with the most severe and rapid course do not have schizoids in their families. From a genetic point of view, between schizophrenia-homozygosity (XXYY) and schizophrenia-heterozygosity (XXXY, xxYY, XxYY), one can see 'not only a quantitative but also a qualitative difference, and the development of the process only in schizophrenia can be explained by the low resistance to exogenous harmful factors only of homozygotes (Yudin). Mollweide, Kleist consider that the schizoid constitution is determined by the innate weakness of certain anatomical systems and thus to a certain extent try to reconcile the contradiction between the organicity of schizophrenia and the characterological basis of schizoidia. The second question connected with the theory of schizoidia is the question of whether the schizoid character is a strictly isolated biological peculiarity of a certain group of people. The division by Kretschmer, Bleuler of all people into schizoids and cycloids, the broad description of the schizoid character by Kretschmer led to the fact that pure schizoid people are few, that most possess both schizoid and cycloid elements to one degree or another. 'One must ask regarding each person not whether he is schizoid or cycloid, but to what extent he is schizoid or cycloid.' Bumke directly points out that 'the name S. is simply substituted for the concept of man and everything comes down to the fact that even a schizophrenic has some general human traits.' 'S. is an artificial construction which gives nothing for understanding schizophrenia.' Berze points out that Kretschmer's description of S. is interesting only from the phenomenological-psychological side, but from the biological side-it gives nothing. In response to this criticism Kretschmer wrote (Veranlagung zu seelischen Storungen, 1924): 'There is a big difference to say that what in psychopathology is called S. has its parallels in normal psychic life, or to assert that in psychopathology itself the understanding of S. must be expanded. Often in other psychopathies there are traits similar to schizoid ones, but from this it does not follow that all these neurasthenic, hysterical psychopaths, fantasists, etc. must be included in the group S. We call schizoid psychopaths only those who have exact definite mental, somatic and genetic traits; only these few psychopaths we call schizoids, otherwise this term loses all meaning.' Thus Kretschmer places under the concept of S. certain biological-genetic foundations. Jung's introverted type and the extraverted type opposed to it¹, taken by him only descriptively from a psychological point of view, are not identical to S. and cycloid of Kretschmer. In any person, withdrawal (introversion) can develop under the influence, for example, of offense, wounded self-esteem, under the influence of concentration on important questions, but the autism of S. is a special form of innate inclinations, also of course dependent in their development on the environment, but in their basis determined biologically, and therefore narrower than introversion. Such are the foundations of the discussion that arose in connection with the understanding of severe S. Undoubtedly in Kretschmer's teaching there are great errors: he himself does not sufficiently clearly distinguish temperament from character, incorrectly considers character only as a passive unfolding of the biological type, whereas character is formed and mediated by all the conditions of the individual's work activity in the collective, does not see the difference between development and process. With all this, it is undoubtedly true that the theory of schizoidia has given and gives psychiatry much that is valuable.