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The Blinding Spot Light:

Histrionic Personality Disorder Defined.

A term Paper
Presented to
Mr. Lourd Greggory Crisol
Department Of English
CASS, MSU-IIT

In partial Fulfillment of the Requirements for

ENGLISH 2 (Writing in the Discipline)

Second Semester, SY 2013 2014

By:

Justine Mae D. Espliguez

March 12, 2014

Introduction
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HPD has a unique position among the personality disorders in that it is the
only personality disorder explicitly connected to a patient's physical appearance.
Researchers have found that HPD appears primarily in men and women with
above-average physical appearances. Some research has suggested that the
connection between HPD and physical appearance holds for women rather than
for men. Both women and men with HPD express a strong need to be the center
of attention. Individuals with HPD exaggerate, throw temper tantrums, and cry if
they are not the center of attention. Patients with HPD are naive, gullible, have a
low frustration threshold, and strong dependency needs.

Cognitive style can be defined as a way in which an individual works with

and solves cognitive tasks such as reasoning, learning, thinking, understanding,
making decisions, and using memory. The cognitive style of individuals with HPD
is superficial and lacks detail. In their inter-personal relationships, individuals with
HPD use dramatization with a goal of impressing others. The enduring pattern of
their insincere and stormy relationships leads to impairment in social and
occupational areas.

People with histrionic personality disorder are inclined to express their

emotions in an exaggerated fashion for example hugging someone you just met
or crying uncontrollably during a sad movie (Skodol & Gunderson 2008). They
also tend to be vain, self-centered and incomparable when they are not in the
limelight. They are seductive in appearance and behavior and they are typically
concerned with their looks. In addition they seek reassurance and approval
constantly and becomes upset or angry when others do not attend to them or
praise them.
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Histrionic Personality disorder shares features with borderline personality

disorder, including rapidly shifting emotions and intense unstable relationships.
However, whereas people with borderline personality disorder often are effacing
in an attempt to win the favor of others, people with histrionic personality disorder
wants to be the center of attention. They pursue other attention by being highly
dramatic and overly seductive by emphasizing the positive qualities of their
appearance.

The Case of Pat

When we first met, Pat seemed a certain enjoyment in life. She was a
single in her mid-30 and had recently gone back for school for her masters
degree. She often dressed in a flamboyant manner that made her stand out from
the rest of her co-workers. During the day she worked as a teacher for children
with disabilities, and when she wasnt in class, she was often out late for a date.
When I first spoke with her. She enthusiastically told me how impressed she was
with my work in the field of children with disabilities and she had been extremely
successful in using some techniques with her students. She was clearly
overdoing the praise, but who wouldnt appreciate such flattering comments?

Because some of our research was being done with children in her
classroom, I had frequent meeting with Pat. Over a period of weeks, however our
interactions grew strained. She frequently complain with different illnesses and
injuries (for instance, falling the parking lot and twisting her neck looking out a
window.) that interfered with her duties in her classroom. She was much
disorganized leaving to the last minute tasks that requires considerable planning.
Pat made promises to other people that are impossible to keep but that seemed
to be aimed at winning their approval. When she couldnt keep the promise she
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had made, she would usually make up story that was designed to elicit sympathy
and compassion.

Pat often interrupted about research to talk about her latest boyfriend. The
boyfriends changed almost weekly, but her enthusiasm (like no other man I have
ever met!) and optimism about the future (hes the guy I want to spend the rest
of my life with.) remained high for each of them. Wedding plans were seriously
discussed with almost everyone despite of the brief time they had together,
especially to other male teachers, who would often bail her out of trouble she
would get into because of disorganization.

When it became clear that she would not able to keep her teaching job
due to her poor performance , she manage to manipulate several of the male
teachers and the principal into recommending her into a new job In a nearby
school district transfer her into another school district. A year later she was still
employed at a new school, but had been moved twice in different classrooms.
According to the other teachers she worked with, Pat continue to lack close
interpersonal relationships with significant others, although she herself described
the person she was with currently as deeply involved. After a rather long
depression, pat sought help from a psychologist, who along with her depression,
diagnosed her as having a histrionic personality disorder.

Like other with this personality disorder, pat engaged in excessive displays
of emotion that primary served her to be in the center of attention. Through their
dress, mannerisms, speech, people with this disorder often act in very dramatic
ways. Pat promised a massive and unique party for one of her students. She
was very self-centered, yet on the surface seemed to be very interested with
others.
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Causes of Histrionic Personality Disorder.

Despite the long history of histrionic PD, little research has been done on
the causes and treatment of histrionic PD. One possible hypothesis involves a
possible relationship with antisocial personality disorder. Evidence suggests that
histrionic personality and antisocial personality co-occur more often than the
chance would account for.

Neurochemical/Physiological Causes

Studies show that patients with HPD have highly responsive

noradrenergic systems, the mechanisms surrounding the release of a
neurotransmitter called norepinephrine. Neurotransmitters are chemicals that
communicate impulses from one nerve cell to another in the brain, and these
impulses dictate behavior. The tendency towards an excessively emotional
reaction to rejection, common among patients with HPD, may be attributed to a
malfunction in a group of neurotransmitters called catecholamine.
(Norepinephrine belongs to this group of neurotransmitters.)

Developmental Causes

Psychoanalytic theory, developed by Freud, outlines a series of

psychosexual stages of development through which each individual passes.
These stages determine an individual's later psychological development as an
adult. Early psychoanalysts proposed that the genital phase, Freud's fifth or last
stage of psychosexual development, is a determinant of HPD. Later
psychoanalysts considered the oral phase, Freud's first stage of psychosexual
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development, to be a more important determinant of HPD. Most psychoanalysts

agree that a traumatic childhood contributes towards the development of HPD.
Some theorists suggest that the more severe forms of HPD derive from
disapproval in the early mother-child relationship.

Another component of Freud's theory is the defense mechanism. Defense

mechanisms are sets of systematic, unconscious methods that people develop to
cope with conflict and to reduce anxiety. According to Freud's theory, all people
use defense mechanisms, but different people use different types of defense
mechanisms. Individuals with HPD differ in the severity of the maladaptive
defense mechanisms they use. Patients with more severe cases of HPD may
utilize the defense mechanisms of repression, denial, and dissociation.

Biosocial Learning Causes

A biosocial model in psychology asserts that social and biological factors

contribute to the development of personality. Biosocial learning models of HPD
suggest that individuals may acquire HPD from inconsistent interpersonal
reinforcement offered by parents. Proponents of biosocial learning models
indicate that individuals with HPD have learned to get what they want from others
by drawing attention to themselves.

Sociocultural Causes

Studies of specific cultures with high rates of HPD suggest social and
cultural causes of HPD. For example, some researchers would expect to find this
disorder more often among cultures that tend to value uninhibited displays of
emotion.
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Personal Variables

Researchers have found some connections between the age of individuals

with HPD and the behavior displayed by these individuals. The symptoms of
HPD are long-lasting; however, histrionic character traits that are exhibited may
change with age. For example, research suggests that seductiveness may be
employed more often by a young adult than by an older one. To impress others,
older adults with HPD may shift their strategy from sexual seductiveness to a
paternal or maternal seductiveness. Some histrionic symptoms such as attention-
seeking, however, may become more apparent as an individual with HPD ages.

Treatments for Histrionic Personality Disorder

Psychodynamic therapy

HPD, like other personality disorders, may require several years of

therapy and may affect individuals throughout their lives. Some professionals
believe that psychoanalytic therapy is a treatment of choice for HPD because it
assists patients to become aware of their own feelings. Long-term
psychodynamic therapy needs to target the underlying conflicts of individuals
with HPD and to assist patients in decreasing their emotional reactivity.
Therapists work with thematic dream material related to intimacy and recall.
Individuals with HPD may have difficulty recalling because of their tendency to
repress material.
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Cognitive-behavioral therapy

Cognitive therapy is a treatment directed at reducing the dysfunctional

thoughts of individuals with HPD. Such thoughts include themes about not being
able to take care of oneself. Cognitive therapy for HPD focuses on a shift from
global, suggestible thinking to a more methodical, systematic, and structured
focus on problems. Cognitive-behavioral training in relaxation for an individual
with HPD emphasizes challenging automatic thoughts about inferiority and not
being able to handle one's life. Cognitive-behavioral therapy teaches individuals
with HPD to identify automatic thoughts, to work on impulsive behavior, and to
develop better problem-solving skills. Behavioral therapists employ assertiveness
training to assist individuals with HPD to learn to cope using their own resources.
Behavioral therapists use response cost to decrease the excessively dramatic
behaviors of these individuals. Response cost is a behavioral technique that
involves removing a stimulus from an individual's environment so that the
response that directly precedes the removal is weakened. Behavioral therapy for
HPD includes techniques such as modeling and behavioral rehearsal to teach
patients about the effect of their theatrical behavior on others in a work setting.

Group therapy

Group therapy is suggested to assist individuals with HPD to work on

interpersonal relationships. Psychodrama techniques or group role play can
assist individuals with HPD to practice problems at work and to learn to decrease
the display of excessively dramatic behaviors. Using role-playing, individuals with
HPD can explore interpersonal relationships and outcomes to understand better
the process associated with different scenarios. Group therapists need to monitor
the group because individuals with HPD tend to take over and dominate others.

Family therapy
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To teach assertion rather than avoidance of conflict, family therapists need

to direct individuals with HPD to speak directly to other family members. Family
therapy can support family members to meet their own needs without supporting
the histrionic behavior of the individual with HPD who uses dramatic crises to
keep the family closely connected. Family therapists employ behavioral contracts
to support assertive behaviors rather than temper tantrums.

Medications

Pharmacotherapy is not a treatment of choice for individuals with HPD

unless HPD occurs with another disorder. For example, if HPD occurs with
depression, antidepressants may be prescribed. Medication needs to be
monitored for abuse.

Alternative therapies

Meditation has been used to assist extroverted patients with HPD to relax
and to focus on their own inner feelings. Some therapists employ hypnosis to
assist individuals with HPD to relax when they experience a fast heart rate or
palpitations during an expression of excessively dramatic, emotional, and
excitable behavior.

Summary and Conclusion

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Histrionic personality Disorder is a pervasive pattern of excessive

emotionally and attention seeking beginning in early adulthood. There are
several causes of Histrionic PD but theres no one specific reason why an
individual develops such kind of personality disorder.

There are also several treatments provided by psychologists and

psychiatrists to help patients with histrionic PD namely: Cognitive-behavioral
therapy, Psychodynamic therapy, Group therapy and family therapy.
Pharmacotherapy is only used when Histrionic PD is accompanied with another
disorder. Alternative therapy is also available like meditation.

References:
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Psych Central Staff and John M. Grohol, Psy.D. Histrionic Personality Disorder
Treatment http://psychcentral.com/disorders/sx17t.html PsychCentral.com. 9
Oct 2013

Judy Koenigsberg, Ph.D. Histrionic Personality

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Bornstein, Robert F. "Dependent and Histrionic Personality Disorders." In Oxford

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