- Hi, I'm Dr. Tracey Marks, a psychiatrist.
And I make mental health education videos.
Today I'm talking about histrionic personality disorder,
what it is and what we do about it.
This is based on a viewer question.
Histrionic personality falls into the cluster B
grouping of personality disorders.
I explain the different groupings of personality disorders
and what even constitutes a personality disorder,
in this video.
Cluster B refers to the group of personality disorders
that share the characteristics of being dramatic,
emotional, or erratic.
And the personalities that fit into this group
are antisocial, borderline, histrionic, and narcissistic.
I mention this because typically people don't fit
neatly into one personality disorder, it's more common
for someone to have a mixture of traits from the different
disorders, particularly the ones that
are within the same cluster.
Keep in mind, personality disorders start in the late
teen years to early adulthood.
It's not something that shows up for the first time
at 30, also you can have some of these personality traits
without having the full disorder.
Personality disorders cause problems that manifest
mostly through relationships.
But it can also cause internal distress and unhappiness,
and I'll show you what I mean by that.
So let's look at what histrionic personality disorder
looks like, the criteria is based on the Diagnostic
and Statistical Manual of Mental Disorders Fifth Edition.
Histrionic disorder is a pattern of excessive emotionality
and attention seeking, beginning in early adulthood
and present in a variety of contexts, as indicated by five
or more of the following.
Number one, is uncomfortable in situations in which
he or she is not the center of attention.
This is more than just wanting or wishing that people
would pay attention to you for a change.
This is a deep seeded discomfort that makes you act
in certain ways to become the center of attention.
For example, you can do this in a superficial way
by dressing dramatically or making up stories that
are exaggerated to get people listening to you,
and captivated by you.
Showering people with compliments when you talk to them,
is another way you can pull in their attention.
These are not schemes that the person cooks up
and then implements just at the right time, it's done
on an unconscious level.
Yes, it's common sense that if you compliment people
or tell interesting stories you'll get them
to listen to you.
But it's not this deliberate plan to divert attention
from everyone else and put it on you, it's just
this natural pattern of behavior that you learn
over time, that doing these things gives you warm fuzzy's
because people are listening to you and want
to be around you.
Number two, your interactions are often sexually
seductive or provocative.
What does this look like?
This is not being seductive or provocative with someone
you wanna hook up with, even if you wanna hook up
with a lot of people.
This is being provocative in multiple settings,
including professional settings where that kind
of behavior is beyond what's socially acceptable.
Number three, displays rapidly shifting or shallow
expression of emotions.
Number four, consistently uses physical appearance
to draw attention to yourself.
You may make dramatic changes to your hair frequently
or wear flashy clothes, not because you happen to like
a certain designer who has a lot of flair, but because
you know that you want people to look at you when you walk
into a room.
You spend a lot of time trying to impress people
with your appearance.
Another way this can look, is you may milk people
for compliments by putting yourself down in the hopes
that they'll compliment you in return.
Number five, has a style of speech that is excessively
impressionistic and lacking in detail.
This could sound like speech that has a lot of fluff
to it, but not much behind it.
Here's an example.
Let's say I say, "Judy, is just amazing,
she does amazing work."
Now, you know that I barely know Judy, so you say,
"What is it about her work that's amazing?"
I say, "Well just look at her, she's a doll,
I just love her."
I've said nothing of substance with that answer.
If you press me on it I'll just get annoyed
and think, "Why are you all over me, back up?"
You think, "I don't like her because
she's fake and shallow."
And this is one of the ways that this personality
can cause friction and problems in relationships.
Number six, shows self-dramatization, theatricality,
and exaggerated expression of emotion.
So this is over the top emotional expression that can
embarrass people close to you.
Like I can run up to you and give you a kiss on the mouth
and tell you how much I've missed you, even though
I just saw you yesterday and you're my cubicle mate.
Or upsetting things make me need to fan myself
and faint.
Number seven, is suggestible or easily influenced
by others or circumstances.
This characteristic can really be a problem because you
can be overly trusting of people and susceptible to brain
washing, or you can make big decisions based on hunches
but those hunches change with the latest trend.
The last one is, you consider relationships to be
more intimate than they actually are.
You relate to people as if you're the closest of friends.
Here's an example.
You go to see your new doctor, Dr. Samuel Jones,
and within 15 minutes of the visit you're calling him Sammy.
Now, it's one thing to drop someone's professional title
and call them by their first name, but using a presumed
childhood nickname takes it to another level.
Social conventions are that you don't call people
by a nickname unless you've been given permission
or you knew them back in the day when
they went by that name.
Someone may think, "The nerve of this person."
But you're not deliberately trying to be respectful,
you feel close enough to this person that you're comfortable
being that casual.
Another example is using terms of endearment, like honey
and sweetie all the time, some people are very offended
by that, but you feel connected enough to that person
that it seems like a natural thing to say.
You may recognize some of these things in yourself,
and as I've said, we all have traits of some of
the personality's, but for the disorder you need at least
five of these.
And these are things that you do a lot, in multiple
settings, and they cause problems for you.
What can you do about histrionic personality disorder?
Well, like most of the personality disorders,
because it's a part of your makeup you don't usually
seek help for the personality issues.
In fact, often the person with histrionic personality
disorder doesn't see that they have a problem.
They may think that they just have problems finding
a partner or they have a problem with their partner.
In those cases they may seek help for the relationship
but not the personality.
Also there's a threshold issue to this.
There are people who are just more dramatic with
their emotional expression and will even say,
"I'm not for everyone."
And they'll usually connect with a more low-key person
who likes their energy and doesn't mind letting
them be the center of attention.
What's the difference between this and a extrovert?
Extroversion is a personality trait where a persons
orientation to life is more focused
on the external object.
And in this case an object means a person.
That's how it was originally proposed by
the psychiatrist Carl Young.
A more modern explanation of extroversion is that
it's a personality style where the person is more outgoing
and derives energy from interacting with people.
Whereas the introverted person still interacts
with people, they need some amount of mental solitude
and time in your own head to be recharged.
Too much interaction depletes the introvert,
too much mental solitude depletes the extrovert.
With histrionic personality there's more to the personality
than being energized by people, it has more to do
with this insatiable need for attention
and the things that you do, and the lengths to which
you will go to get that attention.
Think of histrionic personality disorder as having
an internal deficit that's driving the behavior.
As I went through the criteria it sounds as though
this is the personality of someone who's just dramatic
and fun, but it's not fun.
People with histrionic personality disorder can have
serious emotional intimacy problems, because of
the superficial connectedness that they have.
They tend to attach very quickly and easily,
but it's not reciprocated because it's too much too soon.
Their provocative mannerisms can cause conflict with same
sex friends who might feel threatened
by this kind of behavior.
They tend to get bored very easily and have affairs,
or multiple job changes, or just general instability
because they can't stay happy with something.
The treatment for histrionic personality disorder
depends on the problems that it causes.
This disorder is associated with higher rates of depression,
as well as sematic symptom disorder.
And this is a disorder where you can over focus on having
a physical problem, an old term for this is hypochondriasis
or hypochondriac.
I talk about that disorder in this video.
If you develop depression and anxiety because of this
you could see a psychiatrist
for possible medication treatment.
To really get at the heart of changing your personality
you would have to recognize that the root of your problems
with other people is your personality.
And that's a hard step for most people to get to.
They're more likely to see their problems as caused
by their circumstances.
But if you choose to focus on changing yourself
you would need psychotherapy.
And this could be psychoanalytically focused,
cognitive behavior therapy, or interpersonal therapy.
Dialectical behavior therapy is a variation of cognitive
behavior therapy used for borderline personality disorder.
And it may be a good choice, because there is overlap
between histrionic and borderline personality disorder,
especially with the way it effects relationships.
That's histrionic personality disorder.
Thanks for watching.
See ya next time.