Peer-professional first person account: before psychosis--schizoid personality from the inside.

The occurrence of schizophrenia as a worsening of schizoid traits previously present has been a topic of interest for some time.1–4 However, it is generally the case that information on a day-to-day basis about the premorbid personalities of psychotic patients when they come into care is fragmented and limited. In this article, I describe my own experience of schizoidism, into which I had insight, before I became psychotic. I also give some comments on how this worsened into psychosis. This from-the-inside account shows the complexities of the predisposition to psychosis at the individual level. This avoids a merely retrospective study as I was aware of my schizoidism real time in 1968, 11 years before my main psychotic crisis. However, in 1975, just 4 years before the crisis in 1979, I had graduated with a First Class Honours degree in psychology from the University of Bristol, so I was quite well-read in human science and also had enough insight to realize that there were “unusualities” in my own personality that aligned me most closely to Bleuler’s “schizoid personality” as a category. Although I was not a cold person, I had lost count of the number of people who had said that I often was “far away,” “not aware,” “miles away,” or “remote” and these do tend to be the everyday descriptions of schizoidism in people known to me who have fitted this category, rather than “coldness.” For me, the inner life was far more prepossessing than the outer, in the terms of Guilford5 I was a cognitive and emotional introvert not extrovert. This made psychology, psychiatry, and psychoanalysis suit me far better than my previous subject at university, which had been geology. Reading previous critical writers on schizoidism such as Fairbairn,6 Guntrip,7 Storr,8 and, later, Sass9 had been a disturbing set of experiences, but it was of some relief to find that the way I felt about myself was a constellation of signs that did have meaning in terms of the recognized knowledge of the day. My subsequent journey on in psychology to PhD and DSc levels has at least give me the material to see more clearly the nature of the suffering I went through even before psychosis. Having said this, I hasten to add that there were many people in those days who regarded me as “perfectly normal,” so it is clear that these signs I will elucidate here were not necessarily at all noticeable to everybody else. It seems that the schizoid personality can suffer quietly and out of view.