http://www.nvo.com/psych_help/histrionicpersonalitydisorder/
Funmi Tofowomo Okelola
-The Art of Living and Impermanence
Monday, October 21, 2013
USA Africa Dialogue Series - Histrionic Personality Disorder
Histrionic Personality Disorder
Paul J. Hannig, Ph.D., MFCC
The Performance...
Excessive emotionality and attention seeking of a pervasive nature characterizes the Histrionic Personality (HP). In some classification schemes, this disorder was termed Hysterical Personality (DSM IV, 1994). Lively and dramatic, this individual puts on a show for other people in order to gain attention for his/herself. But the attention is a facade. Another way to characterize the histrionic performer is to see him or her as playing a big dramatic game in order to deny intimacy and split off from the real self. In fact, the histrionic person may identify the false self as the real self and seek confirmation for his/her false performing self. But, in fact, while in the midst of a great performance, the Histrionic Personality (HP) actually vacates the real self and disappears. He or she is not there, or present in the moment. Only the actor, the actress, the clown, or the troublemaker is there. Even though some people may appear to be amused, they may experience the HP as being a bit crazy.
So the sought after accolades, praise and reassurances of worth are really mirrored manipulations of the HP. In terms of a principal caretaker or spouse, the HP fears rejection. The root causes of this type of personality disorder surround an unbonded mother relationship and a abusive paternal relationship. The HP will also manipulate others by guilt inducements. It is as if the person is saying, "How dare you deprive me of my joy, my peak experience". I believe that the latter dynamic is generated by the mother's attention being diverted away from caring for her child, by her husband and other siblings. So the attention seeking is really aimed at getting symbolic love nutrients and supplies. The person is trying to get what was never given. So the HP is in a habitual state of love and attention deprivation.
When a child is not the center or a parent's attention, neglect, lack of bonding and deprivation leaves one starving for attention, approval, praise and reassurance. The histrionic person is a very hurt individual and catharsis alone will not alleviate the debilitating behavior of this kind of person. The histrionic behavior has to be vigorously identified by loved ones and the therapist. Only by confronting the HP on the effects of his/her behavior can the HP turn syntonic histrionics in ego dystonic awareness. Once the individual learns that his or her behavior is actually destructive to the achievement of cherished goals, then immediate "all over the place dramatics" satisfaction may give way to long term gratification.
Interpersonal Relations...
Intimate partners complain that the HP is very crazy and unreal in many social situations. At work, the supermarket, the athletic event, the HP is into the "act" of drawing attention and acting ridiculous. He/she gets laughs at the partner's expense, while emotionally abandoning the partner to the point that the partner feels alone and rejected. The partner may be manipulated into feeling guilty, ashamed, or embarrassed at trying to call the HP's attention to the inappropriate behavior. Defensively, the HP is identified with the false lively, hyper-dramatic self and not with the abused, injured, decimated inner infant. To call the HP on his/her behavior is to activate horrendous inner trauma. But it also opens the floodgates to greater reality and intimacy in relationships.
The HP is highly reactive. If there is another major disorder present, such as delusional disorder, then emotional intensity will create anger, rage, abuse and distance in relationships. The partner, as well as the HP, will be caught in the vice of emotional instability, upheaval, divorce and dissatisfaction. So marital therapy or relationship counseling will have to be part of the treatment plan. Communication will also be a big issue in the symptom picture because the false self and its needs for safety, security and validation will dominate the personality and make real contact a very difficult thing to achieve.
The HP is an interpersonal cripple. He or she has never learned to relate to the insides of another human being. So the HP has to be constantly reminded of the feelings of other people, especially close loved ones. Preoccupation with self caused by fear of being hurt, unloved, abandoned or not being good enough, plus fears of evaluation and disapproval leave the HP in a constant state of hyper-alertness to injury. It is as if the HP is a shell shocked survivor of family warfare and all energy is invested in self-protection and the detection and surveillance of potential injury.
Married Hp's may unconsciously , in a low key, engage in ongoing verbal stabs at spouses and children. It is as if they are annoyed with the needs of others. One HP constantly threw small verbal jabs at his oedipal stage son, without being aware that these little stabs could eventually turn the child off to the father's later attempts to be loving and affectionate. The wife would witness these little jabs but they we not severe enough to arouse her to tell her husband about these little hurts. But she would become slowly aware of his abusive behavior and couldn't be intimate with him because of his jabbing behavior towards their child. Granted, the child may have been mildly annoying to the father, but not enough to warrant hostile reactivity in a normal parent-child relationship.
The key here is that very innocuous stimuli is reacted to by the HP with heightened, inappropriate reactivity and excitability. There is an expressed exaggeration of emotions. The HP appears to react to ordinary events with more anger, sadness, rejections and pleasure than seems indicated or warranted. Tolerance for events and stimuli is very low and the HP reacts to non-events as if they were real triggering events. It is important for the therapist and family members to monitor and record all situations that trigger the HP so that the deep underlying overload of pain can be accessed and released for therapeutic change. Ultimately, the hope for a Histrionic Personality Disordered individual lies in the awareness that by re-experiencing, fully feeling and integrating emotional pain can one become real enough to live a clear, centered and productive life.
Histrionic Personality Disorder is a debilitating and destructive disorder. However, if a person is willing, changes can be made through therapy. If you or someone you know displays more than half of these behavioral characteristics, please seek qualified professional help.
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