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cognitive-behavioral approach
This approach explains personality as the consistent emotional and behavioral reaction to an individual's interpretation of events. This approach also emphasizes the ideas of social learning, and childhood experiences are seen as important factors in determining core beliefs, which will eventually influence the individual's perceptions and interpretations of the world.

This can explain how Phoebe may have developed schizotypal personality disorder. Her turbulent childhood was full of hardships that may have led her to acquire some unconventional beliefs about the world in order to justify certain events happening. For example, when her mother killed herself, she may have started to believe in spirits of reincarnation in order to avoid grief associated with the event. Instances such as these could have led her to form several strange core beliefs that have since guided her in her interpretations of events. This would result in Phoebe's magical thinking, belief in various superstitions, and other symptoms of schizotypy.

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Phoebe's general personality can best be described as:

empathetic

optimistic

quirky

eccentric

erratic

whimsical

unconventional

childish

sometimes dimwitted

frank

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incorrect interpretation of events, such as feeling that a truly harmless or insignificant event has personal meaning

i.e. when Phoebe believed a stray cat was actually the reincarnation of her mother because it jumped into her guitar case.

dressing in peculiar ways, such as wearing oddly-matched clothes

i.e. when Phoebe bought Santa Claus pants as maternity pants and did not realize their unusual nature.

belief in special powers, such as telepathy or superstition

i.e. when Phoebe became convinced somebody would die every time she went to the dentist.

unusual perceptions, such as sensing an absent person's presence

i.e. when one of Phoebe's clients died on her massage table and she felt as if she were possessed by the woman for several days thereafter

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nature

According to the Mayo Clinic, having an immediate family member with schizotypal symptoms can increase your predisposition to schizotypy by as much as 50%.

This is important to note, as Phoebe's birth mother, Phoebe Abbott, is portrayed on the show as having similar eccentric behaviors as her daughter and could also be possibly diagnosed with schizotypal personality disorder or other related personality disorders.

nurture

Social risk factors for schizotypal personality disorder include a lower socioeconomic status than average families, homelessness or poor financial standing, and the premature placement of a child into an adult role before the age of 14.

Phoebe meets nearly all of the risk factors for environmental causes, as her family was not well-off even before she was homeless.

She never attended a high school or college.

The life she experienced while homeless was also rough, as she was supposedly forced to mug other people to make a living, was chased by an escaped mental patient who wanted to kill her, and was stabbed by a cop.

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Phoebe could be diagnosed with schizotypal personality disorder due to the persistent presence of eccentric behaviors, unusual perceptions, and instances of magical thinking.

The major discrepancy in such a diagnoses is that fact that she is not uncomfortable in close relationships, and she is not socially isolated.

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Therapy is considered to be the biggest aid to schizotypal personality disorder. This includes:

Psychodynamic psychotherapy (aka psychoanalytic talk therapy), which aims to help an individual understand and better manage their defense against negative emotions.

Cognitive behavioral therapy (CBT), which emphasizes improvement of social relationships and skills, as well as helps an individual understand the connections between their thoughts and behaviors.

Medications can also be used to calm symptoms of schizotypal personality disorder, such as associated paranoia, odd behaviors, or magical thinking.

Neuroleptics, such as Haldol and Prolixin can be used to treat positive symptoms. This might include paranoia and magical thinking.

Atypical antipsychotics, such as Clozaril, can be used similar to treat positive symptoms, however they are shown to exhibit fewer side-effects.

Serotonergic medications are also recommended for those with schizotypal personality disorder, because they are at a higher risk of developing depression.

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Schizotypal personality disorder can easily be confused with other personality disorders from Cluster A (that is, paranoid personality disorder and schizoid personality disorder).

The main difference between schizotypal personality disorder and paranoid personality disorder is the accusatory nature of the latter. Individuals with paranoid personality disorder tend to believe that everyone they know has malevolent intent, and that they wish to harm them in some way.

Likewise, those with schizoid personality disorder are considered aloof, and they tend to be socially isolated like somebody with schizotypal would be, however they are content with this and do not make any effort to make friends.

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Phoebe had an unusual and rather traumatic childhood that could have led to the development of a personality disorder.

Her father abandoned her mother when Phoebe was still an infant, and when her mother remarried, her step-father ended up in prison.

Her mother committed suicide via carbon monoxide poisoning, which forced Phoebe to live on the streets of New York City at the age of 14.

Phoebe also has a twin sister, Ursula, who is shown repeatedly to be rude, manipulative, and abusive.