Addressing Histrionic Personality Disorder

Strengths Based Biopsychosocial

Approach to Recovery from Histrionic

PersonalityDr. Dawn-Elise Snipes PhD, LPC-MHSP, LMHC, NCC

Executive Director, AllCEUs

Recovery & Resilience International in partnership with AllCEUs.com Unlimited CE for $59 | Webinars $5 | Specialty Certificates $89

Objectives Review the characteristics of Histrionic Personality Explore the functions of these symptoms Identify what may cause these symptoms to

develop Explore what is maintaining these symptoms

(benefits to the client) Explore the effects of these symptoms on

significant others Identify interventions to help the person more

effectively manage emotions and relationships


First Step Address Emotional Dyscontrol

Identify and prevent vulnerabilities Identify what works to help self-soothe Identify helpful distraction techniques

Develop a safety plan


Next Step Identify the most salient symptoms

Their function (and alternate ways to meet that need) What it looks like How that behavior is being maintained (what are the benefits

and other ways to get the same benefit) Mnemonic

Provocative (or seductive) behaviorRelationships are considered more intimate than they actually

areAttention-seeking Influenced easily by others or circumstancesSpeech (style) wants to impress; lacks detailEmotional lability; shallowness


Provocative (or seductive) behavior Function

Makes the person center of attention Provides as sense of control and power

What Does it Look Like Make-up; physical appearance is used to draw attention to

self Theatrical or exaggerated emotions Uncomfortable when he or she is not the center of attention

Origins Conditional love Oversexualization


Effects/Benefits Relationships are often based upon shallow,

dramatic behavior Relationships are unstable when the person is not

the center of attention May have a more difficult time with the aging

process Interventions

Develop a positive self-concept based on more than appearance

Explore the origins of messages that the person had to be attractive/sexual to be lovable


Relationships are considered more intimate than they actually are Function: Allows the person to feel loved

and important What does it look like

Oversharing Lack of boundaries Believing oneself to be indispensable to another

Origins Often from an overly enmeshed (modeling) or

disengaged (reacting) family


Overly Intimate Effects

The person with HPD generally over shares and expects too much out of other people from the beginning.

The perception of relationships being overly intimate can also support the person’s need for attention (name-dropping)

Benefits For a short time the person may be able to exist

in a glamorous fantasy world (escape)


Attention-seeking/Theatrical Function: Allows the person to believe themselves

to be the center of attention What does it look like

Hugely dramatic displays to maintain your status as the center of attention, whether it's negative or positive: Starting screaming matches in public, making up stories about alien abduction, always the life of the party

Origins This behavior may have been developed as a way of

distracting from interpersonal chaos within the family It may have also been developed as a way to get

attention in a neglectful situation


Theatricality Effects

Presents an image of a drama-queen/king Certainly gets people’s attention, but not always

for the best Benefits

Attention = Importance Drama/Chaos = Focusing on something “out

there”


Influenced easily by others or circumstances Function: Chameleon like in order to remain

the center of attention…will jump on the popular bandwagon

What does it look like Opinions regularly change Often deferring to opinions of others

Origins This can be reinforced in situations in which it is not

“safe” to have personal opinions (abandonment, punishment, disapproval)


Easily Influenced Effects

Person can easily be taken advantage of Person may be viewed as untrustworthy

Benefits Can be “liked” and “popular” in the moment


Speech (style) grandiose; lacks detail Function: Vague references make it easier

to change positions, manipulate information to be the center of attention or maintain approval

What does it look like Politicians Choosing extreme language … “I always…” “I am just so busy. I’m not sure when I will find

the time”


Grandiose Effects

Helps create a grandiose image of the person Like relationships that are overly intimate, this

turns simple events and feelings into huge productions

Benefits Being vague and grandiose often keeps people

from asking too many questions The person may be able to avoid unpleasant

things by being “too busy” “exhausted” “totally crazy”


Emotional lability; shallowness Function: Allows the person to use the most

effective emotion and change when necessary What does it look like

I feel therefore I amPeople with HPD tend to regard everything through

the lens of emotion, which in turn drives their dramatic actions.

Origins People start viewing feelings as facts

I feel angry, therefore I am justified in being angry (now who can I blame)


Emotional Effects

Unpredictable emotions makes it very exhausting to be in a relationship with this person

The inability to separate facts from feelings often leads to overgeneralization and keeps the person stuck in misery and negativity.

Benefit Since their actions and thoughts are based on

how they feel, people who have to be around them spend a good deal of time trying to keep them happy

Interventions Develop a stable, positive sense of self Use distress tolerance, mindfulness and coping

skills to deal with overwhelming emotions (usually anger or fear)

Examine and address beliefs that are contributing to distress

Learn about healthy relationships Mindfulness and self-awareness Unconditional positive regard Empathy Effective communication


Summary HPD belongs to the group of disorders

characterized by A lack of a sense of self Difficulty forming authentic relationships High levels of anxiety and emotionality

People with HPD are often thought of as “drama queens”

One of the first goals of treatment is to identify the client’s dysfunctional behaviors and their function


Summary cont… HPD symptoms are very common in today’s society

which may make it more difficult for the person to identify them as problems or issues

Therapists can assist the client in identifying target behaviors by examining the effect of these behaviors using motivational enhancement techniques

When you….. How does it impact

Your mood/health/energy & why Your relationships & why

What types of things cause conflict or problems in your relationships? Why? Is this something you want to address?


Summary cont… Most personality disordered behavior is

egosyntonic. Help the patient identify the behaviors they

exhibit which may be problematic Discuss in session what triggers those

behaviors, what function the behavior served and other ways to meet that need.

While it is true the behaviors characteristic of personality disorders cannot be completely erased, they can be boxed up and stored in the archives

Addressing Histrionic Personality Disorder

Education

Transcript of Addressing Histrionic Personality Disorder