addressing histrionic personality disorder
TRANSCRIPT
Strengths Based Biopsychosocial
Approach to Recovery from Histrionic
PersonalityDr. Dawn-Elise Snipes PhD, LPC-MHSP, LMHC, NCC
Executive Director, AllCEUs
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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
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First Step Address Emotional Dyscontrol
Identify and prevent vulnerabilities Identify what works to help self-soothe Identify helpful distraction techniques
Develop a safety plan
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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
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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
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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
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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
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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)
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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
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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”
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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)
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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
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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”
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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”
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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)
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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
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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
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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?
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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