If parents, educators, and physicians would look (direct their vision with feeling) at children's eyes, the tragedy of the schizoid child who is not understood could be partly avoided.
The schizoid's inability to focus stems from his anxiety about the feelings which would come through in his eyes. He is afraid to let his eyes actively express fear or anger because this would make him conscious of these feelings. To look with feeling is to be aware of the feeling. The suppression of the feeling requires that the eyes be kept vacant, or distant. The lack of expression in the eyes, like the lack of responsiveness in the body, is part of the schizoid defense against feeling. However, when the feelings break through the defense and inundate the ego, the eyes “go off,” as Reich pointed out, or the fear and rage may pour through them chaotically, without focus and direction, as in the case of the schizophrenic girl in my office. Thus, when eyes have either the “far-off’ look or a look of wild, undirected rage or terror they denote schizophrenia. Vacant and distant eyes indicate a schizoid state.
When one moves from the eyes to the total expression of the face, other signs of the schizoid disturbance are seen. The most important is an absence of facial expression, similar to the lack of feeling in the eyes. It has been said that the schizoid face has a mask-like quality. It lacks the normal play of feeling that makes the healthy face look alive. The mask takes several forms: it may show the bewilderment of the clown, the naive innocence of the child, the knowing look of the sophisticate, the haughtiness of the aristocrat. Its characteristic feature is a “fixed” smile, in which the eyes do not participate. This typical schizoid smile can be recognized by (1) its unvarying quality, (2) its lack of appropriateness, (3) its unrelatedness to a feeling of pleasure. It can be interpreted as an attempt to relieve the tension of the mask-like visage when feelings arise which the schizoid cannot express or communicate. The smile hides and denies the existence of any negative attitude. Harvey Cleckley refers to this schizoid expression as the “mask of sanity.”22
Behind the mask of the fixed smile and the knowing look one can discern an expression in the schizoid face which I would describe as cadaverous. It is the look of a skull or death's-head. In some cases it can be seen only if a steady pressure is exerted with the thumbs upon the cheekbones on both sides of the bridge of the nose. Under this pressure the fixed smile disappears, the facial bones stand out, the color drains from the face, and the eyes seem to be hollow sockets. It is a ghastly expression and strikes one as the look of death. The patient is not aware of this expression, since it is hidden by the mask, but its presence is another gauge to the depth of his fear. It would be correct to say that the schizoid individual is “scared to death,” literally and not just in a manner of speaking. This expression also appears in the figure drawings of some patients, as Figures 2 and 13 show.
The schizoid mask is not removable at will. The schizoid's facial expression is frozen by an underlying terror, and the mask is his armor against this terror. The mask also enables the schizoid person to appear before the world without causing the shock reaction his cadaverous expression would otherwise provoke. To remove the mask, the “rigor mortis” must be thawed out, the fear and terror must be made conscious, and their grip upon the personality released.
Kretschmer poses the question that must challenge the mind of anyone who has had contact with the schizoid personality. “What is there in the deep under all these masks?” he asks. “Perhaps there is nothing, dark, hollow-eyed nothing—affective anemia.23 He continues: “One cannot know what they feel: sometimes they don't know themselves, or only dimly.” If one asks the schizoid individual what he feels, the most common answer is, “Nothing. I don't feel anything.” Yet when, in the course of therapy, he allows his feelings to come to the surface, he will reveal that he has the same desires and wants as any other person and that they were always present. His mask and his denial of feeling is a defense against his terror and his rage, but it also serves to suppress all desires. He believes that he cannot allow himself to feel or to want, since this would leave him vulnerable to some catastrophe, rejection, or abandonment. If one wants nothing, one cannot be hurt.
At times, when the schizoid patient is out of control and overwhelmed by his inner feelings, his facial expression becomes so distorted that it looks inhuman. When he allows a feeling of anger to arise, or when he adopts the facial expression of anger, his visage frequently looks demonic. What one sees is not anger but the dark eyes and knit brows of a frightening black rage. In the regressed and withdrawn schizophrenic the face and head often resemble a gargoyle. At other times the face seems to melt and an infantile smile plays about the mouth, without, however, involving the eyes.
This dissociation between the smile about the mouth and the lack of expression in the eyes is typical of the schizoid personality. Eugen Bleuler has commented as follows on the split in the facial expression of the schizophrenic: “The mimic lacks unity—the wrinkled forehead, for example, expresses something like surprise; the eyes with their little crow's-feet give the impression of laughter; and the corners of the mouth may be drooping as in sorrow. Often the facial expression seems exaggerated and highly melodramatic.”24
Another characteristic feature of the schizoid face is its rigid jaw. This is invariably present. Together with the fixed smile, it creates a marked lack of coordination between the upper and lower parts of the face. The rigid jaw expresses an attitude of defiance that belies the vacant or frightened look in the eyes. The rigidity of the jaw helps to block off any feeling of fear or terror from becoming manifest in the eyes. In effect, the schizoid is saying, I will not be afraid.
I have found that it is almost impossible for the patient to mobilize any conscious expression in his eyes before the tension is substantially reduced. This usually happens when the patient gives in to his feelings of sadness, and cries.
If one observes the crying of an infant, one will notice that it begins with a quiver in the chin. The chin recedes, the mouth droops, and the jaw drops as the infant gives way to the convulsive release of feeling in the crying. The rigidity of the schizoid jaw inhibits this release. It functions, therefore, as a general defense against all feeling.
A dynamic interpretation of the tension in and about the schizoid head was suggested to me by a short unpublished monograph on the snarling reflex.25 Generally, the schizoid patient cannot snarl, that is, he cannot curl his upper lip and bare his teeth. Normal individuals find it easier to make this gesture. The schizoid difficulty is due to the immobilization of the upper half of the face, extending over the scalp to the nuchal region at the junction of the head with the back of the neck. These nuchal muscles are tightly contracted in the schizoid condition. One can appreciate the tension involved if one assumes an exaggerated expression of fright: opening the eyes wide, raising the brows, and pulling the head back. One then feels the muscles at the base of the skull contract. Snarling and biting require a direction of motion exactly opposite to that which occurs in fright. In biting, the head is brought forward, so that the upper teeth inflict the bite while the lower ones hold the object. Since the schizoid is frozen in the state of terror, he cannot execute this movement or make the gesture of snarling.
The schizoid inhibition of snarling and biting relates to a deep-seated oral disturbance which is also manifest in the schizoid reluctance to reach out with his mouth and to suck. This total oral disturbance stems from an infantile conflict with a mother who could not fulfill the child's oral erotic needs. The infant's frustration leads to biting impulses, to which the mother reacts with such hostility that the child has no alternative but to suppress its oral desires and repress its oral aggression.
BODILY RIGIDITY, FRAGMENTATION, AND COLLAPSE
Another common finding in the schizoid body is the lack of alignment between the head and the rest of the body. The head is often carried at an angle to the trunk, inclining either left or right. This carriage is another indication of the dissociation between the head and the body, but I never fully understood the reason for this position of the