David Mowers writes:
What would you consider to be a condition of someone who was introverted to the point of Anhedonia but on occasion has schizoid breaks with reality assaulting other people but in such a way as to be fully in control and capable of avoiding legal punishment for their actions?
In fact, was so fully confident in their ability to do anything that they did such without consideration of social conditions, rules or laws to the point that they appeared extroverted to others?
First of all, those would not be schizoid breaks. The only schizoid symptom here in the withdrawal to the point of anhedonia.
Second, I would say that this aggressive behavior is highly choreographed, stylized, shrewd, devious and manipulative. This is not typical aggressive behavior. Instead, this person is acting out a carefully plotted and planned out aggressive act as if they were acting a role in a play. In other words, for some reason, with this aggressive behavior, they are “putting on a show” for some reason.
There is also a lot of cocky overconfidence in the way this person describes how they can expertly choreograph this aggression in such a way as to avoid punishment. I’d say there is some narcissism going on there. This person is way too overconfident and it’s probably going to get them in trouble some day if it hasn’t already.
But this is not any known psychological disorder in terms of an actual documented syndrome. Is the person happy or unhappy with this behavior? How do they feel about the anhedonia?
It is important to note that many things that cause psychological distress are not really diagnosable DSM disorders. All sorts of things cause distress in life, and individuals experience distress in all sorts of ways that do not necessarily line up with diagnosable conditions.
I have had clients who clearly had something obviously wrong with them, but they did not meet criteria for any known DSM disorder. Sure, they had symptoms of one or more disorders, but not enough to meet criteria for any one of them in particular.
Human beings are variable, and it is all too common for someone to present with a symptom or two of a more than one disorder. If you add them all up and throw the ingredients all together, you can bake up something called a disorder, but it typically is not in the DSM nor does it look like anything described but not in the DSM. In other words, it is not a known “syndrome.”
Often it is hard to even say if the disorder is an anxiety disorder, a mood disorder, a substance use disorder, etc. You can have mood, anxiety, disassociate, personality, substance use and even psychotic symptoms all presenting at once in a single individual. In these cases, you don’t even have the option of diagnosing Anxiety Disorder NOS, Mood Disorder NOS, Psychotic Disorder NOS, etc. The person has simply piled a group of symptoms together in a one from column A, three from column B, two from column 3, etc. fashion.
Unfortunately, this sort of thing is quite common. A lot of times you end up treating individual symptoms and defenses instead of whole packages called disorders, which probably makes more sense in a lot of cases anyway.
