Histrionic Personality Disorder

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When it comes to thinking or sharing thoughts, being a paramedic has its advantage. When I am not working alone on a responder car I am scheduled to work on, what we call, a truck which is your regular large ambulance.

It is whilst working on a truck last week that I discussed a certain characteristic I had recently come across. Initially the idea of ‘virtue signalling’ (VS) was mentioned .  However, following further investigation and research I came across a disorder called ‘Histrionic Personality Disorder’ (HPD).

So what was the topic of the conversation?

Keith's Story - Male Victim of Domestic Abuse & Depression Histrionic Personality Disorder

I am sure we all know the type of person or at least have met one or two during our lifetime that crave to be the centre of everyone’s attentions. Social media platforms such as facebook, twitter and redditt have brought these people forward. In fact, flick through your home page on facebook (for example) and you will unconsciously read posts by such people.

Craving attention

These people will crave attention by claiming that something has gone wrong (again) and therefore require and revel in the sympathy of those of whom respond. In effect, they like to be the centre of their own little world evoking attention and focus from other people.

This condition does indeed have a sliding scale. At its best it may be low profile with the odd little comment fishing for personal compliments, to its worst it may require the destruction of any potential competition to gain a series of affections and attention. This does indeed have a close relationship with narcissism but demonstrates signs such as people who are; lively, dramatic, vivacious, enthusiastic, and flirtatious lives.

Centre point

Keith's Story - Male Victim of Domestic Abuse & Depression Histrionic Personality Disorder

Narcissism, however takes a step back as narcissists don’t always wish to be at the centre of everything if in fact everything is going their way. On the other hand, people with HPD insist and structure a system to ensure that all eyes are on them.

It’s all about me

To make this more tangible the example I will give is commonplace within HPD. I have met (mainly women) who have flirted outrageously to gain the attention of men. Within a moment they will then complain that these said men are being exploitative and making sexual comments or references. As a result, they will revel in the sympathy produced from her accusations.  This of course has negative consequences upon the men she is accusing. For this matter, the accuser will not care. The outcome they have craved has been achieved and the consequences are negligible in comparison to the achieved awards.

Mental condition

According to Seligman, Martin E.P. (1984). “Chapter 11”. Abnormal Psychology. W.W. Norton & Company. It is estimated that HPD is diagnosed four times as frequently in women as men. It affects 2–3% of the general population and 10–15% in inpatient and outpatient mental health institutions.

With HPD being diagnosed as a disorder it therefore owns certain characteristics. Personality disorders are often rigid, inflexible and maladaptive, causing impairment in functioning or internal distress. A personality disorder is an enduring pattern of inner experience and behaviour that deviates markedly from the expectations of the individual’s culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time and leads to distress or impairment.

Me, me, me

Keith's Story - Male Victim of Domestic Abuse & Depression Histrionic Personality Disorder

Histrionic personality disorder, put simply, is characterized by constant attention-seeking, emotional overreaction, and suggestibility. A person with this condition tends to over-dramatize situations, which may impair relationships and lead to depression.

Experience

For any person who has experienced abuse from a partner can draw a comparison with HPD and false accusers.

I have found that individuals with histrionic personality disorder exhibit excessive emotionality and as a result have a tendency to regard things in an emotional manner. This makes them, in effect, attention seekers. People with this disorder are uncomfortable when they are not the centre of attention.

When I consider the behaviour of my abusive ex she met a great many of the characteristics evident within this condition. Amongst my friends and family (especially around my father) she was constantly seeking approval or attention. Furthermore, her use of her sexuality in inappropriate situations became a matter of concern. Within social situations she was considered as lively and was able to charm those of whom she made contact with.

Such a nice person…not

Keith's Story - Male Victim of Domestic Abuse & Depression Histrionic Personality Disorder

For many people this may have seemed delightful or even charming. Yet she was equally able to  embarrass me with excessive public displays of emotion, such as having temper tantrums to finally, accusing me of a crime that didn’t happen to seek attention from the police and her family. Unfortunately for her, it became apparent that she had a history of doing this to other men who had attempted to have a relationship with her.

Hey, give me a minute

When I think about it I can recall times when she would send me a text message apologising for something she may have said or done earlier in the day. If I was unable to reply instantly (probably because I was at work) she would send me another text saying how awful I was and that I deserved what she did. Instantly re-texting to apologise – and so it continued throughout the night. This whole process was illogical of which, it transpires, is also a common feature of HPD.

Extreme

I think it is both fair and honest to state that we would all like to be seen as desired or attractive, yet people with HPD seem to take this to the extreme. My ex would dress inappropriately or seem invasive within people’s conversations. Her discussions were often exaggerated or flavoured with stories of woe and drama with the sole purpose of getting people to talk about her and how ‘amazing’ she has been.

However, the reality was not often met by her stories. As a classroom assistant she would claim to be a teacher. As a divorcee she would claim to be a victim and to live the life she wanted she tried to get me into debt – of which she was already in.

Rewards

Keith's Story - Male Victim of Domestic Abuse & Depression Histrionic Personality Disorder

Of course, reflection is a good thing. And I can now see that these character traits explained why she tended to see things from a highly emotional perspective. In short, she craved attention and the emotional “reward” that she gained from it. Furthermore, she obviously felt uncomfortable when she wasn’t the centre of attention. Although she was often seen as lively and energetic she equally became greatly distressed when she was not capturing the attention of others (especially work colleagues or other males). I suppose by calling her a “drama queen” would best fit her characteristic.

PRAISE ME

Whilst reading around the subject I came across a mnemonic that has sometimes been used to describe the criteria for histrionic personality disorder. Ironically it is labelled as “PRAISE ME”:

P – provocative (or seductive) behaviour

R – relationships, considered more intimate than they are

A – attention, must be at centre of

I – influenced easily

S – speech (style) – wants to impress, lacks detail

E – emotional liability, shallowness

 

M – make-up – physical appearance used to draw attention to self

E – exaggerated emotions – theatrical

Negative and positive

Keith's Story - Male Victim of Domestic Abuse & Depression Histrionic Personality Disorder

Regardless of how it is seen I discovered that people who suffer from HPD are often just as interested in attracting negative attention, including shock, anger, outrage, shame, guilt and remorse. And all of this fits in the persona of someone who makes false allegations to win favour from those of whom she shares the story with.

Roots

Although the roots of modern histrionic personality can be traced back to Freud’s description of “hysterical neuroses” (Sperry, 2003 Handbook of Diagnosis and Treatment of DSM-IV-TR Personality Disorders. New York: Bruner-Routledge;), personality was already a matter of attention before.

In the mid-19th century, Ernst von Feuchtersleben, (1765–1834) who wrote the Textbook of Medical Psychology (1845) made the first psychosocial description of what would become the histrionic personality. He described hysterical women as being sexually heightened, selfish and “overprivileged with satiety and boredom” (Millon, 2011 Disorders of Personality: Introducing a DSM/ICD Spectrum from Normal to Abnormal, 3rd Edn. New Jersey: John Wiley & Sons).

Several theorists studied the particular traits of HPD including histrionic’s impressionist cognitive style and inattention to detail. In his book, “Hysterical Personality Style and the Histrionic Personality Disorder,” Horowitz (1991), focused on the connection between perception and behaviour in HPD. Horowitz argued that it was based on a disturbed mental representation of the self. On the other hand, according to the biosocial-learning model, proposed by Theodore Millon and other authors, this personality type may arise from unconscious patterns of reinforcement provided by parents and others. According to these authors, their core beliefs include “I am inadequate and unable to handle the life on my own” and “It is necessary to be loved by everyone, all the time.”

So what do I know?

Keith's Story - Male Victim of Domestic Abuse & Depression Histrionic Personality Disorder

Although beyond A level psychology I cannot consider myself to be a psychologist. However, I have found many of the above characteristics in many people. By them seeing themselves as the centre of attention they believe that so many other people believe in them and support their accusations. Yet I have given consideration to the point that HPD is in fact a medical condition greatly hidden. Although I am not stating that these people are dangerous in a physical sense they are extremely dangerous to fall out with. They have an expertise in manipulation and playing the victim when the evidence does not exist beyond their own claims.

People with HPD are both dangerous and manipulative and yet also fail to accept their own problems. Like any other mental health condition, they do indeed require medical assistance if only to save them from themselves and other being pulled into their viciousness and manipulation.

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