Understanding Histrionic Personality Disorder
Page Four
For them, even relating to God—the most true and faithful source of love and acceptance—presents a great challenge because they are too terrified to look within and face themselves. They are afraid to see how unlovable they feel inside the recesses of their minds. But until they face those feelings they have trouble letting God into those needy recesses. Yet that is the place that we must all begin our spiritual journey.
People with histrionic personalities can also have problems in their relationships with God because they want to be the center of attention. Obviously, this doesn't work with God! He calls us to be humble servants, not admired stars. And as Elijah learned, despite His power and majesty, God often speaks in a whisper (I Kings 19:12). This is a difficult combination for these individuals. They will give their all to gain the attention and acceptance they long for, but they expect to be the center of attention in return.
Treatment
Unfortunately, most people with histrionic personalities are poorly motivated to change. They have such a lifelong pattern of avoiding emotional pain through massive repression and temporary attention getting maneuvers that they rarely seek help unless they are experiencing a deteriorating relationship, depression, or some other troubling social or emotional problem. And once they receive a little relief from their presenting problem, they tend to go on their way rather than facing their deeper emotional, spiritual, and relational struggles. If they will stay in therapy, however, they can get a great deal of help.
The ultimate need of histrionic individuals in therapy is to change their deeply ingrained tendency to try to fulfill all their needs by looking to others for attention rather than develop a solid sense of their own self-worth or self-esteem. To do this, histrionic individuals need to feel accepted and relatively safe and comfortable with their therapist. Gradually, they can begin to observe their pattern of avoiding their inner emotional anxiety by frantically looking for attention. In this process they need to learn to sit with their emotional discomfort instead of running from it.
As people with histrionic personalities learn to bear and face their fears of abandonment and inner emptiness they can increasingly focus on their internal world rather than on ways of trying to elicit attention from others. Since histrionic individuals avoid introspection by focusing on the outside world, this can be frightening and difficult. It is essential, however, to learn to see the futility of their relational and coping style in order to think more clearly and be less impulsive and more centered. In the process, they will gain insights into their unrealistic assumptions about themselves and life. They will come to see how they concluded they had to be the center of attention to feel good about themselves and they will realize that belief is an emotionally destructive idea.
Living With the Histrionic
Life with the histrionic can be challenging, confusing, frustrating, and oftentimes painful. Since histrionics struggle with depth in relationships, their partners are often left questioning their failed attempts to increase intimacy or closeness. While the histrionic will attempt to draw a partner into a rescuing, admiring role in order to ward off the anxiety of potential rejection, they may just as quickly display scorn or contempt for the same partner once they tire of their present life's routine.
 For the partner, the most helpful
approach to living well with a histrionic
person is to offer maximal emotional
support while maintaining
strong personal boundaries.
Partners of histrionics often live a life on eggshells, not knowing when they will be smothered with superficial affection or loathed for being too predictable or dependable. This is turn can begin to undercut the partner's self-esteem. By definition, the anonymous people in the "audience" of the histrionic person are less interesting or exciting than the "beautiful" person holding center stage! This impact can be both subtle and cumulative, eventually leaving the partner of the histrionic filled with uncertainty and self-doubt. It can also leave partners resentful because they feel that they can never provide enough attention or admiration to fill the histrionic's emptiness.
In the face of the histrionic's compulsive optimism, denial, disassociation, and evasion, the partner who raises the issues of life's negative consequences and inevitable pain, can expect to be the brunt of the histrionic's wrath.
For the partner, the most helpful approach to living well with a histrionic person is to offer maximal emotional support while maintaining strong personal boundaries. By adopting a loving, but objective stance, while holding the histrionic accountable for his/her behaviors, the partner gives the histrionic person the best chance of learning to trust in a relationship—not out of successful performance, but because of mutual participation and acceptance.
It is also important to sensitively encourage behaviors that are mature, responsible, and based in reality if the histrionic is to emerge from his or her position of childlike powerlessness. Remaining loving and flexible, while tactfully confronting destructive behaviors in the relationship, can help the histrionic gain a realistic understanding of his or her impact on the relationship.
Frequently Asked Questions About
Histrionic Personality Disorder
1. Are there medications for HPD? There are no medications that specifically treat the common symptoms of HPD. When histrionic individuals are also suffering from depression or anxiety, medication may help reduce those symptoms.
2. Isn't Histrionic Personality Disorder just a form of pride that should be confessed? While the histrionic individual often displays very prideful behavior, his or her motivations and actions are actually masked cries for love and help, and they often grow out of very low self-esteem. While pride is an issue we all struggle with, the most urgent need for the histrionic personality is to learn an appropriate sense of self-assurance—the self-assurance that can best be nurtured through experiences of unconditional Christlike love. In fact, Christ is an excellent model for relating to individuals with histrionic personalities. He displayed a firm love that was at the same time unconditional and uncompromising.
3. Where can I learn more? Additional assistance can be obtained through Internet sites and support groups specializing in personality disorders, including histrionic, borderline, or narcissistic.
1. Adapted from Sperry, L., 1995. Handbook of Diagnosis and Treatment of the DSM-IV Personality Disorders. New York: Brunner/Mazel
Gary D. Hanson, M.A., a Christian counselor with masters degrees in Marriage and Family Therapy and Business Administration. Mr. Hanson offers individual and family counseling and consults with the business community. Gary and his wife, Joy, are the parents of two children and live in Plymouth, Minnesota.
Written and © Copyright by Gary D. Hanson
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