In this episode of The Personality Couch, we (licensed clinical psychologists Doc Bok and Doc Fish) unpack the differences and similarities between schizoid personality disorder and autism spectrum disorder, and whether you can be diagnosed with both. We start by discussing the limitations of current research before investigating the underlying causes of social withdrawal seen in both conditions. We conclude by emphasizing that while they may share observable traits, their origins and implications are fundamentally different.

🆘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 to Schizoid & Autism 00:58 Problems with ASD & SzPD research 04:42 Autistic Thinking Defined 05:26 Autistic Fantasy Defined 05:54 Autism Name Origins 06:25 Autistic Contiguous Position Defined 08:22 Similarities b/w Autism & Schizoid 10:54 Genetics & Etiological Differences 11:40 Schizophrenia’s Genetics 12:37 Autism Genetics 14:50 Can Schizoid and Autism Co-Occur? 17:58 Development of ASD vs SzPD 18:46 Imagination in Schizoid vs ASD 19:08 Late Diagnosing of ASD + Cultural Trends 21:24 Viewer Question: Phantasy of the Schizoid 25:18 Mirror Neurons in ASD vs SzPD 28:05 Our Thoughts About Dual ASD & SzPD Diagnoses 36:05 Summary & Conclusion

In this episode of The Personality Couch, we (licensed clinical psychologists Doc Bok and Doc Fish) use a fresh psychodynamic perspective to look at the misunderstood, quiet, awkward, and socially backwards schizoid. We explore the misunderstandings and stigmas surrounding schizoids, their emotional depth, and the historical perspectives that have shaped our understanding of this personality type. Our conversation highlights the internal struggles of schizoids, their coping mechanisms, and the rich inner lives they lead, often hidden from the outside world. We also take a look at the superpower of the schizoid and how they spot others’ disingenuousness. We emphasize the unique internal experiences of schizoids and the need for a compassionate approach in relationships and in clinical practice.

🆘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 to Schizoid Personality 01:42 What do Schizoids Look Like? 03:30 Stigmatization of Schizoids 05:05 Historical Names & Schizoids’ Discovery 06:18 Kahlbaum’s Heboid Personality 06:47 Hoch’s Shut In Personality 07:05 Kraeplin’s Mildly Defective Personality 07:26 Bleuler’s Schizoidie Personality 08:07 Jung’s Introverted Personality 09:12 Menninger & Schizoid’s False Shell / Exterior 09:52 Winnicott & Schizoid's False Self 10:35 Guntrip on Depression & Anhedonia in Schizoids 12:26 Schizoids as Therapists 13:40 Akhtar’s Overt & Covert Personality Features 15:08 Nancy McWilliams’ Psychodynamic Schizoid 15:43 Attachment’s Influence on Schizoid 16:25 Schizoid’s Core Fears 18:32 Schizoid and Histrionic Connection 19:40 Schizoid’s Defense Mechanisms 23:03 Sense of Self & Castle Metaphor 24:08 Schizoid vs Obsessive Compulsive Personalities 24:38 The Colorful Inner World of Schizoids 27:40 Schizoids’ Superpower 30:30 Summary and Conclusion

In this episode of The Personality Couch, we (licensed clinical psychologists Doc Bok and Doc Fish) dive into one of the most misunderstood personalities: the quiet, awkward, and socially backwards schizoid. We take a critical look at the DSM’s definition of this personality; the developmental pathways leading to schizoid traits; and the unique and complex inner world of schizoids. Using a turtle metaphor, we explore how schizoids resort to fantasy and withdraw inside their shell, escaping from the overwhelming social world. We also explore how schizoid types are often mislabeled as having autism and briefly discuss their differences. We conclude by discussing reasons for the schizoid’s withdrawal, highlighting that our global misunderstanding of this type drives them further away from relationships and from psychological help.

🆘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 to Schizoid Personality 03:45 Attachment Trauma in Schizoids 05:50 Schizoids are Like Turtles 07:18 Problems with the DSM-5 Schizoid 08:41 Psychodynamic Schizoid: A Conflict-Based Approach 10:33 Schizoid vs Autism Spectrum Disorder (ASD) 15:57 DSM Criteria for Schizoid Personality Disorder 19:41 The Challenges of Goal Setting 20:48 Decreased Sexual Desire 22:04 Sherlock Holmes: The Quintessential Schizoid 23:20 Anhedonia vs Depression in Schizoids 25:02 Difficulty Forming / Indifference to Relationships 30:33 Emotional Coldness and Detachment 33:53 Anger & Joy in Schizoids 37:36 Not Psychosis or Autism 38:36 Summary & Closing

In this episode of the Personality Couch Podcast, I (licensed clinical psychologist, Doc Bok) take a different approach and lean into the clinical practice part of this podcast. I spill the tea on significant changes in the healthcare landscape, particularly focusing on the rise of telehealth and the influence of venture capital-backed mega telehealth companies. I highlight the conflicts of interest with wealthy investors, ethical and privacy concerns, and market consolidation that threaten the integrity of mental health care and private practice as we know it. This episode emphasizes the importance of patient and clinician awareness, and I provide actionable steps to navigate the evolving healthcare environment.

📝Let me know your feedback on this "tea spilling episode!" https://www.personalitycouch.com/#contact

👩‍💼Are you a clinician stuck on the business side of private practice? To schedule a consultation, please visit the practice website! https://www.questpsych.org/

Chapters 00:00 Healthcare Changes Post Pandemic 03:24 What is a Venture Capital Company? 04:13 How Venture Capital Telehealth is Different From Private Practice 05:29 Meet the Telehealth Companies’ Investors 08:02 Conflicts of Interest for Investors 09:52 Privacy Concerns 12:19 Ethical Concerns 14:28 Market Consolidation 19:02 Vertical Integration 20:09 Therapists’ Stories & Lawsuits 23:12 What Can Patients Do? 24:08 What Can Clinicians Do?

In this episode of The Personality Couch, we (licensed clinical psychologists Doc Bok and Doc Fish) dive deep into the dark end of the paranoid personality spectrum, focusing on three notorious cases of mass murder: Jeffrey Weise (school shooter), Richard Farley (jilted lover), and Timothy McVeigh (Oklahoma City bomber). We explore the psychological underpinnings of each of these severe paranoid personalities, the impact of childhood trauma, and how their psyches came unglued. We firstly look at the case of Weise, a 16-year-old school shooter who experienced significant childhood trauma and rejection at the hands of his family. We then turn to look at Farley, an incredibly dangerous example of how erotomania, or extreme unrequited love, can turn into your worst nightmare. Lastly, we take a close look at the infamous Timothy McVeigh, a domestic terrorist obsessed with fantasy, fiction, and comics about revenge. Separating from the Army, but desperate to be a hero, he found an enemy in the very US Government that he used to defend. Our discussion emphasizes that while not all paranoid personalities are violent (most aren’t), paranoid personalities in forensic settings can quickly unravel, making them among the most likely to commit mass murder.

Are you a clinician stuck on a case? To schedule a consultation, please visit the practice website to contact us! https://www.questpsych.org/

Chapters 00:00 Introduction to Paranoid Personalities and Violence 02:07 Childhood Trauma’s Impact 05:00 Case Study: Jeffrey Weise - The Traumatized Killer 05:37 Weise’s background 07:52 The Day of the Shooting 10:18 Motivations 11:11 Analysis & Discussion 14:00 Case Study: Richard Farley - The Rejected Lover 14:50 Farley’s obsession with Laura Black 17:45 The Day of the Shooting 21:50 Farley’s Motivations 23:30 Analysis & Discussion 24:46 Masochistic Infatuation Defined 25:18 Erotomania Explained 27:22 Case Study: Timothy McVeigh: The Oklahoma City Bomber 27:44 Background 33:07 Leading up to the Bombing 36:48 Motivations 38:30 Analysis & Discussion 40:19 Summary & Conclusions

In this episode of The Personality Couch Podcast, we (licensed clinical psychologists Doc Bok and Doc Fish) unpack how paranoia, paranoid personalities, and psychotic disorders overlap. We explore the line between personality disorders and psychosis; misuse of the term schizophrenia; and introduce the concept of paraphrenia as it relates to psychosis in the paranoid personality. We also explore the historical context of paranoia, the nuances between paranoia and delusions, and how the terms became so intertwined in history. We end with our own unfiltered thoughts about limitations to DSM diagnostic categories and how paranoia became so confusing!

Are you a clinician stuck on a case? To schedule a consultation, please visit the practice website, which will guide you to the email address to use. https://www.questpsych.org/

Chapters 00:00 Introduction to Paranoia and Psychosis 02:14 Defining Paranoia 03:15 Sociocultural Paranoia: The Salem Witch Trials 04:22 How Paranoia Leads to Psychosis: A Train Metaphor 06:51 Defining Delusions 08:21 Persecutory Delusions 08:55 Delusions of Grandeur 09:32 Jealous Delusions 10:01 Erotomanic Delusions 12:01 When Paranoia Becomes a Diagnosis 13:14 Paranoia in Personality Disorders 14:34 Wait- Paranoid Schizophrenia is NOT a Diagnosis?! 16:03 Defining Paraphrenia 16:43 Defining Schizophrenia 17:54 How is Paranoid Personality Disorder Different from Schizophrenia? 22:50 The Difference Between Schizophrenia and Paraphrenia 23:11 Confusion in Definitions and DSM Limitations 27:24 Closing

In this episode of The Personality Couch Podcast, we (licensed clinical psychologists Doc Bok and Doc Fish) continue our discussion about paranoid personality disorder, exploring its three severity levels: Mild, Borderline, and Paraphrenic. We unpack the six subtypes of paranoid personalities as outlined by Dr. Theodore Millon: The Self-Righteous Mistrustful, The Obdurate Mistrustful, the Querulous Paranoid, the Insular Paranoid, the severe Fanatic Paraphrenic, and Malignant Paraphrenic. We highlight the fragility of Paranoids at all levels of severity, noting they can easily deteriorate with stressors and setbacks. We emphasize the importance of understanding these very common personality dynamics in all settings, especially with increasing paranoia in the post-pandemic world.

Are you a clinician stuck on a case? To schedule a consultation, please visit the practice website, which will guide you to the email address to use. www.questpsych.org

Chapters 00:00 Introduction to Paranoid Personality Disorder 03:44 Paranoid Personality Disorder Symptoms 06:03 Historical Examples 06:09 Timothy McVeigh - Oklahoma City Bombings 06:36 Richard Farley - Erotomania 07:52 Explaining the 3 Severity Levels 09:30 Mild Paranoid Personalities: Mistrustful Types 10:16 Self-Righteous Subtype 14:28 Obdurate Subtype 17:14 Moderate Paranoid Personalities: Disorder Level 17:44 Querulous Subtype 21:32 Insular Subtype 23:52 Severe Paranoid Personalities: Paraphrenic Level 25:44 Fanatic Subtype 30:57 Malignant Subtype 36:12 Summary & Conclusion

In this episode of The Personality Couch Podcast, we (licensed clinical psychologists Doc Bok and Doc Fish) help differentiate between paranoid and borderline personality disorders. We explore the similarities and differences between these two disorders, discussing their core characteristics, emotional responses, symptoms, and how our own intuition helps us more than we realize. We specifically look at the instability unique to these two personality disorders and how both express anger, shame, and fear. As both disorders can have fleeting episodes of psychosis, we also discuss how delusions can show up in each, but how their triggers are vastly different. We further discuss our own personal experiences treating both disorders and ways we use our intuition to guide diagnosis. We end by highlighting the need for empathy in treatment and welcome other providers to reference this information or to contact us directly if in need of a consultation.

To schedule a consultation, please visit the practice website for more information! www.questpsych.org

Chapters 00:00 Intro to Paranoid vs Borderline Personality Disorders 01:59 What is an Unstable Personality Structure? 03:34 Borderline Personality Symptoms Explained 06:50 Paranoid Personality Symptoms Explained 08:30 Comparing and Contrasting BPD and Paranoid PD 08:32 Anger 11:40 Shame 13:03 Fear 14:15 Paranoia & Psychotic Episodes 15:54 Fluidity vs. Rigidity 17:21 Using Intuition with Paranoid and Borderline Personalities 17:35 Dramatic Narratives 19:44 Dependent and Avoidant Attachment Dynamics 23:35 Countertransference 25:20 How they Present to Treatment 26:31 Suicidality & Trauma 28:47 Summary, Learning, and Conclusion