A pattern of attention-seeking behavior and excessive emotionality characterizes Histrionic Personality Disorder (HPD). Individuals with HPD often exhibit a variety of distinctive traits and behaviors, including attention-seeking, emotional expressiveness, seductive behavior, need for approval, suggestibility, rapidly shifting emotions, exaggerated speech, overestimation of relationships, and self-dramatization. They may quickly experience shifting emotions, exaggerated expressions, and a strong need for approval and reassurance from others. These traits can significantly impact their personal and professional relationships, challenging them to maintain stable and meaningful connections. Understanding HPD involves recognizing the deep-seated need for validation and the dramatic manner in which individuals with this disorder express themselves. Underneath Histrionic Personality Disorder, a wide range of intense emotions cause the person significant distress and emotional pain. Some histrionic behaviors come from this problematic emotionality for the person to manage.
Treatment:
For individuals with HPD, treatment can be complex. These individuals dislike routine, exaggerated feelings, and overdramatization can make therapy sessions challenging. Many times, individuals seek out treatment for depression, anxiety, and or substance abuse. HPD is typically treated with medication and psychotherapy; the medication isn’t for HPD itself but for the secondary symptoms. Psychotherapy, which is talk therapy, is the most common form of treatment for these individuals. Cognitive Behavioral Therapy (CBT), a highly effective psychotherapy modality, can help recognize and identify attention-seeking behaviors and thought patterns. A therapist’s goal in using CBT on an HPD client is to help them modify these behaviors and develop coping skills to improve themselves and their relationships.
Other than CBT therapy, some therapists may use Supportive Therapy. This approach can be encouraging, reassuring, and non-treating to HPD clients. Supportive therapy reduces emotional distress, improves self-esteem, and helps develop and enhance coping skills. The therapist engages in attentive and sympathetic listening to achieve an effective outcome. Supportive therapy can also include group therapy, a great way to form a sense of community. Psychodynamic Therapy approaches can also be effective in Histrionic Personality Disorder clients. This approach aims to uncover underlying issues in one’s unconscious. It gives insight to the individual and can help them understand themselves and their behaviors more. There is an emphasis on communication and recognizing how inappropriate behaviors are not helpful.
Relationships:
These behaviors can often lead to difficulties in personal and professional relationships. However, with understanding and patience, it is possible to maintain stable relationships with individuals with HPD. They may struggle with their constant need for attention and approval, and their dramatic and sometimes inappropriate behavior can be off-putting to others. These individuals can be manipulative, impulsive, and dramatic, which impacts how they handle relationships. They tend to lack empathy because they have a hard time recognizing their emotions and the emotions of others. Their emotions can be highly volatile, shifting rapidly from one extreme to another, making it difficult for partners and friends to navigate interactions. Additionally, their tendency to perceive relationships as more intimate than they are can lead to misunderstandings and unrealistic expectations. However, healthy and fulfilling relationships can be fostered by setting clear boundaries and encouraging therapy.
The histrionic relationship cycle can be different in every relationship. It could involve self-sabotaging behaviors, like flirting or arguing, followed by efforts to regain your approval and attention. Flirting can be a significant and intrusive challenge for those in a relationship with an HPD individual. Even though flirting doesn’t necessarily mean a partner is unfaithful, their behavior may make their partner feel they are crossing a boundary. Flirting is a sexually provocative behavior, and an HPD individual’s goal is to gain attention. Histrionic individual’s emotions and moods often shift from different emotional states. These can result in the significant other dealing with emotional outbursts and arguments and can occur in public places. It may lead to ignoring the HPD individual, but this can make the situation worse. Dr. Holly Schiff, a licensed clinical psychologist, says partners with HPD will often use emotional manipulation in relationships. It is due to their lack of understanding of empathy and dramatic tendencies.
Here are specific strategies you can adapt to help support and strengthen the relationship with an individual with HPD:
- Remaining calm: It may be your first reaction to engage in inappropriate behaviors or feed into their dramatic behaviors. By not engaging in these behaviors, you may help them realize these behaviors are not attention-seeking.
- Proper and clear communication: When appropriately communicated, your partner with a histrionic personality may be more mindful of your feelings while also setting clear boundaries and expectations.
- Including your partner: Attention is a major element of HPD, so in a social setting, taking a proactive approach may help them not feel neglected. Taking the initiative in a social setting, like introducing them to a new social environment or new conversations, can prevent them from lashing out. It doesn’t cater to their need for attention but protects them from situations that may hurt them.
- Take time for yourself: Alone time and self-care will help you recenter yourself and avoid arguments and conflict. Being with a partner with HPD can be emotionally draining and frustrating. Spending time with friends, exercising, and having hobbies can bring you joy and fulfillment.
Someone with HPD can be overwhelming, confusing, and challenging to navigate. Here are some tips and skills to use in a personal or professional relationship with someone with Histrionic Personality Disorder.
- Set Boundaries: Setting clear and consistent boundaries prevents manipulative or attention-seeking behaviors from becoming overwhelming.
- Stay Calm: Maintain a calm demeanor, regardless of whether the person is dramatic or emotional. This can help de-escalate situations and provide a stabilizing influence.
- Encourage Therapy: Gently encourage the person to seek professional help. Therapy, particularly cognitive-behavioral or psychodynamic therapy, can be very beneficial for managing HPD symptoms.
- Validate Feelings: Acknowledge their emotions without reinforcing the need for excessive attention. Show empathy while guiding them towards more balanced emotional responses.
- Avoid Reinforcing Attention-Seeking Behavior: Avoid rewarding dramatic or exaggerated behavior with excessive attention. Instead, provide positive reinforcement when they display more appropriate behaviors.
- Be Patient: Understand that change takes time. Be patient and supportive as the individual works through their issues with the help of a therapist.
- Promote Independence: Encourage them to develop their interests and hobbies that do not solely rely on receiving attention from others. It can help build self-esteem and reduce the reliance on external validation.
- Communicate Clearly: Use direct and clear communication to avoid misunderstandings and help them understand their behavior’s impact on others.
These tips can help an individual navigate a complicated and overwhelming relationship. You can foster a healthier relationship with someone who has HPD and support them in their journey towards more balanced and fulfilling interactions.
Histrionic Personality Disorder is a complex mental health disorder that may be difficult to navigate and can be a learning curve for people in relationships with HPD. However, when treated and using the proper skills, HPD can be manageable, stable, and can have fulfilling relationships. Understanding the disorder and its components can make worlds of a difference when dealing with an HPD individual, either personally or professionally.
References
https://my.clevelandclinic.org/health/diseases/9743-histrionic-personality-disorder
https://psychcentral.com/relationships/ignoring-someone-with-histrionic-personality-disorder
https://www.verywellhealth.com/how-histrionic-personality-disorder-is-treated-5194017
https://www.sjrp.com/blog/addiction/how-to-deal-with-someone-with-histrionic-personality-disorder/
