What Is Histrionic Personality Disorder? (HPD) Not such a commonly discussed or named or even recognized personality disorder in the lives of those who demonstrate its traits and suffer emotionally or for their loved ones. Outlining what HPD is can help people recognize and become aware of what they might be struggling with socially or occupationally and relationally.
Histrionic Personality Disorder (HPD) is found within the Cluster B of Personality Disorders in the DSM-IV and is now with regard to the DSM-5 often diagnosed as one of the remaining main personality disorder categories after the far-reaching and curious changes from the DSM-IV that are now a part of the very controversial DSM-5. Regardless of the DSM-5 re-categorizing and efforts to change terms and to have a wider-variety of ways to diagnose things by lumping them together in, among other explanations, an agenda to prescribe as many psychotropic medications as is possible as Allen Frances, M.D., in his book Saving Normal: An Insider’s Revolt against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life, writes, “And now the DSM-5 seemed poised to make some really big errors. In aggregate, the new disorders promoted so blithely by my friends would create tens of millions of new ‘patients’ I pictured all these normal enough people being captured in the DSM-5s excessively wide diagnostic net, and I worried that may would be exposed to unnecessary medicine with possibly dangerous side effects. The drug companies would be licking their chops figuring out how best to exploit the inviting new targets for their well-practiced disease-mongering.”
Histrionic Personality Disorder has at its core traits of an enduring pattern of attention-seeking and excessively dramatic behavior usually beginning in early adulthood and that is present in an individual in a broad range of situations. People with Histrionic Personality Disorder excessively and very dramatically express their emotions. They have a dramatic and enduring focus on their own very changeable emotions to the point of being very repetitive in their need to be heard about how they feel. Traits or symptoms of individuals with HPD include:
- Dramatic Emotionally
- Highly Emotional
- Strong Need – Center of Attention
- Strongly focused on appearance (Men and Women)
- Exaggerate Emotions – Feel Emotions in exaggerated ways
- Throw temper tantrums
- Cry if not Center of Attention
- Low Frustration Threshold
- Strong Dependency Needs
- Attempts to Impress or Please others with vague patterns of speech
The cognitive style in those with HPD is defined or measured by how an individual either does or does not function in terms of certain cognitive tasks that include the following:
- Use of Memory
An individual with HPD will present as superficial and lacking in details. Their employment of dramatizing has at its core the goal of impressing others. People with HPD often have an enduring pattern of stormy and insincere inter-personal relationships. This enduring schema results in a social or occupational impairment.
It is difficult to relate to people with HPD because of the way they speak, excessively express dramatic emotion and demand that others focus on their repetitive to almost obsessive focus on every single feeling they have and find very difficult to resolve in any way that would end the constant unrelenting attention-seeking for others to listen to them. People with Histrionic Personality Disorder are very self-focused and focused on their own emotions and needs that they often talk at and manipulate and demand so much from others that loved ones, friends, or co-workers are overwhelmed and it can be difficult to find ways to hear things over and over again and also to tolerate the lack of resolution no matter what one might suggest.
People with HPD drive intense drama and in the excessive emotional expression and self-focus trying to impress, please, and also be rescued (though they do not really ever find anything helpful because they are subconsciously invested in the attention of the emotions that they endlessly describe in dramatic ways that they are essentially protecting themselves against healthy attachment or boundaries and so forth that they absolutely emotionally lack. There is a significant learned helplessness in those with HPD that leads them to demand from others what they are unable to do for themselves emotionally.
Characteristics of this disorder include obsession with physical appearance, extreme extroversion, and inappropriate sexually seductive behavior.
People with HPD are extremely influenced by their emotional environment and need for constant approval from others. If the approval is not forthcoming, they can react in an unpredictable, often way. Their speech, often devoid of details can be impressionistic and dramatic to a compelling and confusing extent. Relating may quickly deteriorate when a person with HPD enters a relationship. They may constantly pester their partner for affirmation about how they look or how smart they are. They also often have unstable moods and may be so self-absorbed that they are not connected to or aware of others but are emotionally cut-off from others. Those with HPD may be in a great mood one moment and a very depressed mood the next.
People with HPD though always seeking the center of attention are also plagued with a sense of inadequacy and inferiority. People with HPD often are dramatically expressive with their emotions. These emotions displayed are often not situationally appropriate. “Histrionic” refers to the dramatic outbursts people with HPD have. A person with HPD can literally fly off the handle, throw a temper tantrum, and create a scene at any given moment and it is rare that others will see it coming unless and until they know a person with HPD really well. People who are Histrionic can also try to manipulate others into accommodating their wishes through emotional blackmail. The World Health Organization’s ICD-10 lists Histrionic Personality Disorder as:
A personality disorder characterized by:
- shallow and labile affectivity,
- exaggerated expression of emotions,
- lack of consideration for others,
- easily hurt feelings, and
- continuous seeking for appreciation, excitement and attention.
Millon’s subtypes (Source: Wikipedia)
Theodore Millon identified six subtypes of histrionic personality disorder. Any individual histrionic may exhibit none or one of the following:
|Appeasing||Including dependent and compulsive features||Seeks to placate, mend, patch up, smooth over troubles; knack for settling differences, moderating tempers by yielding, compromising, conceding; sacrifices self for commendation; fruitlessly placates the unplacatable.|
|Vivacious||The seductiveness of the histrionic mixed with the energy typical of hypomania. Some narcissistic features can also be present||Vigorous, charming, bubbly, brisk, spirited, flippant, impulsive; seeks momentary cheerfulness and playful adventures; animated, energetic, ebullient.|
|Tempestuous||Including negativistic features||Impulsive, out of control; moody complaints, sulking; precipitous emotion, stormy, impassioned, easily wrought-up, periodically inflamed, turbulent.|
|Disingenuous||Including antisocial features||Underhanded, double-dealing, scheming, contriving, plotting, crafty, false-hearted; egocentric, insincere, deceitful, calculating, guileful.|
|Theatrical||Variant of “pure” pattern||Affected, mannered, put-on; postures are striking, eyecatching, graphic; markets self-appearance; is synthesized, stagy; simulates desirable/dramatic poses.|
|Infantile||Including borderline features||Labile, high-strung, volatile emotions; childlike hysteria and nascent pouting; demanding, overwrought; fastens and clutches to another; is overly attached, hangs on, stays fused to and clinging.|
Comorbid conditions include: antisocial, dependent, borderline, and narcissistic personality disorders, as well as depression, anxiety disorders, panic disorder, somatoform disorders, anorexia nervosa, substance use disorder, and attachment disorders, including reactive attachment disorder. (Co-morbid conditions source: Wikipedia)
Despite changes to the categorization and the naming of DSM-IV diagnostic labels as is the case in the DSM-5 Histrionic Personality Disorder as named was dropped. However, it is now diagnosed based on many of its original traits and symptoms though often under the diagnostic label of Borderline Personality Disorder or Narcissistic Personality Disorder according to the DSM-5 diagnosing criteria which assimilate all of the features of HPD that were previously classified as co-morbid personality disorders in an effort to diagnose based not only on traits but also on levels of functioning or not functioning based on the DSM-5 criteria as to how to apply the changes within to actual diagnoses.
Despite the “bible” of Psychiatry finding ways to serve itself and Big Pharma – not necessarily the patient/client more effectively, Histrionic Personality, the meat of what it is, still does indeed exist, is experienced by people who struggle to relate in lasting age and situationally appropriate ways that affect them greatly in their lives and also effect their loved ones. It is therefore still very important that Histrionic Personality Disorder, what is actually is as described above is describe for people and is a source of information, a point from which increased self-awareness by those unsure as to why aspects of their lives are not working well can gain insight and hopefully seek treatment that can help them. Treatment that need not include Biopsychiatry’s Big Pharma a-drug-for-every-mental-health-challenge one-size-fits-all cop-out solution.
Psychiatry’s re-categorizing, dropping the HPD name does not negate its existence. Anyone relating to this information personally or realizing a loved one may have this mental health challenge will be best served by seeking help outside of the realm of psychiatry.