Young schizoid and schizotypal patients are often caught in tense family situations similar to those arising in the families of certain schizophrenic patients. The parents may maintain unrealistically high expectations - in some instances because of a child’s precocious intelligence, and in others because of a child’s seeming normality in early life - without taking sufficiently into consideration the disability imposed by the chronic emotional disorder as it becomes manifest in adolescence. Therapy with the family as a whole, or with just the parents alone, may help educate the parents about their child’s lower ceiling of potential. This in turn may reduce the family’s impatience and intolerance.
In one such family, for example, a 27-year-old schizotypal patient had been, until college, a straight-A student who, his father assumed, could one day take over the reins of the family business. As the man became increasingly eccentric and asocial in his 20s, he felt threatened in ordinary work settings and retreated into a world of computer baseball, which he shared with a few friends of similar bent. His father upbraided him as being “lazy” and “infantile,” criticisms that led to depression and suicidal feelings in the patient. It was only after the therapist, meeting with the parents alone, was able to explain the nature and limitations of their son’s condition that they were able to adopt a more tolerant and compassionate attitude. With this the patient’s depression subsided, and he was permitted to pursue his interests and to live his life at his own pace.
Revision date: June 11, 2011
Last revised: by Andrew G. Epstein, M.D.