A Guide to Histrionic Personality Disorder
Histrionic Personality Disorder (HPD) is a mental health condition characterized by a pervasive pattern of excessive emotional outbursts and attention-seeking behavior. This disorder goes beyond enjoying the spotlight; individuals with this disorder will behave dramatically and even inappropriately at any opportunity to get the attention and validation that they crave.
Because individuals with HPD often act out in dramatic fashion, they find it difficult to maintain relationships and friendships. They often suffer from low self-esteem and a distorted sense of self. This fuels their insatiable need for external approval and reassurance. In extreme cases, someone with histrionic personality disorder may even threaten or attempt suicide for the attention they so deeply crave.
In this article, we hope to illuminate this complex and misunderstood disorder, strategies for coping, and help foster greater empathy for those who are living with HPD.
Defining Characteristics of Histrionic Personality Disorder:
Individuals with HPD typically display a consistent pattern of attention-seeking behaviors and emotional excessiveness, often from early adulthood. We look for the following patterns of behavior when diagnosing someone with HPD:
Excessive Attention-Seeking:
Individuals with HPD often feel uncomfortable or jealous when they are not the center of attention. They may engage in dramatic, flirtatious, or provocative behavior to gain the attention of others.
Emotional Excessiveness:
People with HPD may appear to be theatrical or overly enthusiastic about trivial matters. They express their emotions in a shallow and exaggerated manner. Histrionic personalities may use grandiose, superlative language but without much substance. They may always seem to be “performing” even in the most casual settings.
Seductive Behavior:
There is often inappropriate sexually seductive or provocative behavior in interactions with others, regardless of the nature of the relationship. They may not even be sexually attracted to the person but will behave in this way for validation and attention.
Shifting and Shallow Emotions:
Emotions can shift rapidly and may seem insincere or superficial. For example, at a social gathering, a person with HPD may be telling a funny story and laughing one moment, then suddenly become visibly upset or start crying to regain the spotlight. This rapid shift is often a way to maintain attention or sympathy from others. They also may profess deep love and admiration for a new friend or romantic interest very quickly; however, these intense emotions can evaporate just as quickly if the person feels they are not receiving enough attention or if someone else seems more interesting.
Physical Appearance:
Individuals with HPD often use their physical appearance to draw attention to themselves, which may include flamboyant or provocative dressing such as brightly-colored or obviously expensive clothing, or something revealing.
Suggestibility:
Individuals with HPD are often highly suggestible where they are easily influenced by others’ opinions, ideas, and behaviors. People with HPD may frequently change their opinions, interests, or behavior to match those of the people around them in order to gain approval or attention. They are also particularly susceptible to the influence of authority figures or people they perceive as having power or status. This can lead them to adopt views or take actions that they might not otherwise consider. They may also express different values or beliefs depending on who they are interacting with.
Perceived Relationships:
Relationships are often perceived as more intimate than they actually are. Individuals with HPD may overestimate the closeness of their relationships.
Causes and Risk Factors of Histrionic Personality Disorder:
The exact cause of HPD is not fully understood, but several factors are believed to contribute to its development:
Genetic Factors:
There may be a genetic predisposition to Histrionic Personality Disorder. A family history of personality disorders or other mental health conditions such as anxiety or depression can increase the risk.
Environmental Factors:
Childhood experiences where a parent is neglectful on positive reinforcement, or overemphasizes appearance and social approval, can play a role. Parenting styles that are overindulgent where the parent does little to nothing to properly correct bad behavior can be a factor. Perhaps the parent may have even been a little too excessive with their positive reinforcement. Children who are also exposed to dramatic and erratic behavior may end up learning bad patterns in habit.
Psychological Factors:
Certain personality traits can predispose individuals to develop HPD. If an individual already has a high sensitivity to negative feedback, or a high need for approval and attention, they can be more susceptible to developing HPD.
How to treat HPD:
Treating Histrionic Personality Disorder can be challenging as many individuals with the disorder may not recognize or acknowledge that they may have it. In some cultures or social contexts (such as in the entertainment business), flamboyant and dramatic behaviors exhibited by individuals with HPD may be tolerated or even encouraged.
With that being said, those who do seek treatment can feel confident that psychotherapy will help and ameliorate symptoms of this disorder. Cognitive Behavioral Therapy (CBT) can guide histrionic personalities to explore this deep-seated need for attention and approval and start rebuilding healthy thought patterns.
Attention: Group therapy or family therapy is generally not recommended for individuals with Histrionic Personality Disorder. This is because histrionic personalities may see an opportunity to exhibit excessive attention-seeking behaviors in a group setting. They may dominate the conversation or divert attention to themselves; they could engage in dramatic or exaggerated behaviors to be the center of focus. This can hinder the therapeutic progress of other members and create an unbalanced dynamic.
Lastly, it is important to note that there are no specific medications to treat HPD. Medications may only be prescribed to address symptoms of other co-occuring disorders such as depression or anxiety.
How to best support someone with HPD while also taking care of yourself:
Supporting someone with HPD while not giving into their emotional, dramatic outbursts requires a careful balance of empathy and boundary-setting. Here are some strategies on how to best support someone with HPD while also taking care of yourself:
Communicate your boundaries:
Clearly set your boundaries and then communicate them. Do you have a significant other who constantly requires attention and gets upset if you try to have some alone time? You can say to them: “I need a little bit of alone time every morning to focus on my personal work but we can talk after lunch.” Do they start raising their voice at you quickly if you are not paying attention to them? Ask them to speak to you in a calm way or remove yourself from the situation.
Encourage behaviors that are constructive and positive (and not attention-seeking!)
You can praise and acknowledge them when they display appropriate behavior or express their emotions in a healthy way. For example, you can say: “I appreciate how you talked about your feelings today. It made our conversation so meaningful.” You can also highlight their positive traits and achievements that do NOT involve dramatic or attention-seeking behaviors.
Recommend professional help:
It may be difficult to convince someone with HPD to go to therapy due to their lack of insight into their condition. As a friend, family member, significant other, or mentor to someone with HPD you could encourage them to go to therapy by framing it in a positive light – after all, therapy is a safe space where they actually are entitled to undivided attention and care from a professional.
Stay calm:
Stay Calm: Maintain a calm and composed demeanor, even when the individual is being overly dramatic. This can help de-escalate situations and prevent reinforcement of their behavior. Stick to “I” statements: “I can see that you are upset. Let’s take a deep breath and then talk about what’s upsetting you.” Do not react strongly to tantrums or dramatic outbursts to avoid reinforcing negative histrionic behaviors.
Histrionic Personality Disorder: God can meet our needs!
Individuals with HPD, as well as those with depression, anxiety, and many other mental afflictions, suffer from a profound sense of emptiness and hopelessness. Life on earth has somehow made them feel so empty and unloved – causing people to seek any means possible to fill that void.
Those with HPD, as we know, exhibit dramatic and attention-seeking behaviors, to fill a deep void with attention and external validation. However, the superficial relationships they form fail to provide the deep connection and validation they need, perpetuating their cycle of emptiness and low self-esteem. This profound sense of emptiness can make it difficult for them to find lasting happiness and fulfillment in life.
However, the Bible explains that this God-sized void came from being separated from Him because of the original sin. But Jesus Christ died and rose again to be the bridge for us to meet God and restore the image of God and receive His Spirit in our hearts. When we believe and receive this free gift, God fills the void in our lives, providing comfort, purpose, and a sense of completeness.
Psalm 107:9: “For he satisfies the longing soul, and the hungry soul he fills with good things.”
The Bible assures us that God meets the deep needs and desires of our hearts, filling us with good things and satisfying our inner longing even while on earth. John 4:13-14: “Jesus said to her, ‘Everyone who drinks of this water will be thirsty again, but whoever drinks of the water that I will give him will never be thirsty again. The water that I will give him will become in him a spring of water welling up to eternal life.’”
The above passage is referring to Jesus speaking to the Samaritan woman at the well, offering her living water that quenches the deepest thirst of the soul, symbolizing eternal satisfaction and fulfillment found in Him.
Christ is the ultimate source of fulfillment and satisfaction. By turning to Him, individuals can find the love, purpose, and completeness that fill the deepest voids in their lives.
Enjoyed our blogpost? Subscribe to our newsletter for more resources on mental health and integrating the Gospel message in your healing journey.
If you found our resources useful, please consider donating to Oak Health Foundation, which is a 501(3)c nonprofit dedicated to providing resources regarding holistic mental healthcare and subsidized treatment for those in need.
