The Empty Core: An Object Relations Approach to Psychotherapy of the Schizoid Personality

by Jeffrey Seinfeld

This book is about the psychodynamics and treatment of schizoid disorders. These patients are pervasive in psychotherapeutic practice, but are often misdiagnosed as neurotic, borderline, or narcissistic. Far more attention is devoted in the literature to the narcissistic and borderline conditions than to this most common of the personality disorders.
Schizoid patients go through the motions of daily living, but superficially, like robots, without any zest or enthusiasm. They may be involved in ongoing relationships and social situations, but they do not experience the joy or pain of living because a crucial part of their feelings has been radically repressed and isolated from their central personality. They have split off the emotional hunger for love, care, and contact, and at the heart of the personality there is a core of emptiness. The hunger for love, first felt as a vital, fleeting need, becomes a constant state of mind as it remains unmet. This state of mind is split off from the remaining personality, and gradually its needs are extinguished. The active emptiness of hunger becomes a frozen, static, lifeless emptiness. Thus, schizoid patients experience a death-in-life and a pervasive, compulsive conflictual hunger for food, drugs, sex, money, admiration, or tyranny over others to fill the empty core. They go through life as the living dead, hungering for things, as the vampire thirsts for blood to keep itself going.
In treatment, these patients go through the motions of therapy without genuine involvement. Initially, therapists often mistake them for easy patients because they do not make inordinate demands. The therapist may forget to discuss the patient in supervision or never think of him between sessions. Dr. Seinfeld poignantly describes the apathy that gradually pervades the therapeutic relationship. A profound fear of rejection and merger underlies the patient's seeming indifference to the therapist, and the patient may drop out after a small mistake or a therapeutic lapse in empathy.
Dr. Seinfeld shows how the therapist can engage these patients while avoiding the common therapeutic pitfalls. The book delineates the phases of the treatment process and presents clear guidelines for intervention, which requires exquisite timing and precision. With extensive clinical vignettes, Dr. Seinfeld guides the reader in reaching the lost, empty heart of the schizoid personality.

Genres: Psychology, Psychoanalysis

272 pages, Hardcover

First published October 1, 1991

Reviews

[Yousef Mahmood · Rating 5 out of 5]

It's an essential thing to understand the schizoid position, it underlids many if not most of our psychopathology

I could see how existentialist philosophy influenced the object relation schools of psychology.. in terms of how we relate to one another and to the world

In summary the schizoid state is important for personality development as it lowers our dependence on the external world, giving us the freedom to be


But the pathologal schizoid is when the child is not nurtured with love, his self fails to intergrate .. it becomes empty, melancholic and nihilistic
The schizoid child tries relate to internal objects but not the external world because the internal representations are static, immobile, inert
They won't judge him or abandon him


He withdraws from the world and tries to find other ways to fill his hunger for nurturance
These ways could be substance abuse, antisocial behavior, sadism, anorexia ..etc.

Some schizoid patients become masochistic and self destruct in order to satisfy the introjected inner parent, others become fragmented and develop multiple self states with their own desires, cognitions, emotions..etc.
These self states are ways of ( being-in-the-world),
The topic is longer than this and I'll come back later to finish the review
But it's definitely a book that I would recommend to anyone who's interested in psychology

[Yonty · Rating 4 out of 5]

The most insightful book about the schizoid condition that I have read. While there were many valuable insights and a reduction of symptoms in many of Seinfeld's included case studies, even by the end of the book there was still a lot of unanswered questions about how the schizoid person can fill the "empty void" within. Even while some people were able to return to work and enjoy romantic and other interpersonal relationships they were still troubled by the deep sense of emptiness characteristic of the disorder that was left unresolved even as their quality of life improved.
The interpretation of his patient's actions, patterns, progress, and other symbols in therapy were intelligent and graceful as well as his acute sensitivity of knowing when and how to interpret and when not to is a true testament to his experience as therapist and maturity as an individual.

A bit wordy and academic at times, the jargon can make reading difficult. This book was not intended for lay people but for clinical use and in education.

I am immensely grateful for the thoughtful time and effort he went to treat this deeply painful and lonely condition that seems all to have been left forgotton, underdiagnosed, and undertreated in modern clinical practice.

[Megan · Rating 5 out of 5]

possibly one of the clearest, most succinct, and accessibly written books out there weaving together insights from various traditions within the british school of psychoanalysis. there aren't many works exclusively devoted to discussing the schizoid condition, so i appreciate its focus as well as the cross-comparisons/distinctions made with borderline etiology. would highly recommend to clinicians and laymen alike.

[Shi2chi · Rating 5 out of 5]

It gives much insight into the schizoid condition however not just schizoids but also narcissists and borderlines due to having a schizoid core are also studied.
In this book you will be introduced to many schizoid related concepts through "Object-relation theory" many quotes from Fairbairn and others are included.
There is also a good number of case-studies, analysis and therapeutic strategies explained.

[Alice · Rating 5 out of 5]

I found this really insightful. This book had a few answers for questions I have been thinking lately.

Highly recommended to everyone with Schizoid Personality Disorder.

[Håkon Mjelde · Rating 4 out of 5]

It did provide a great deal of insight into our need for isolation, and our issues with alienation and relationships. Written in a clear and succinct way.