Treatment and HISTRIONIC PERSONALITY DISORDER
HISTRIONIC PERSONALITY DISORDER
People who have long histories of drawing attention to themselves and of
engaging in excited emotional displays that are caused by insignificant
events are captured in the diagnosis of histrionic personality disorder. Such
people are apt to be superficially charming, warm, and gregarious, but they
are often viewed by others as insincere and shallow. They seem to be seeking
admiration by playing continually to unknown audiences. Once they form
relationships, they become demanding and inconsiderate, egocentric, and
self-absorbed. They can be enormously flirtatious or coquettish, yet their
sexual adjustment is as often naive or frigid, suggesting that their flirtatious
behavior serves the ends of attention-getting much more than those of sexuality.
This disorder occurs more commonly among women (Kass, Spitzer,
and Williams, 1983) but, as the following case indicates, it is also seen
among men.
At forty-two, Michael entered therapy after his second marriage failed. He
strikes you as every bit the college professor: pipe-smoking, tweedy, facile with
words, and somewhat theatrical. His difficulties are gripping, and they extend
beyond his marriage. He has been the victim of muggings and robberies, of badly
diagnosed ailments, and wrongly prescribed drugs. His scholarly papers are often
rejected by journal editors, and his colleagues seem not to appreciate his genius.
For all of this, he seems clearly a charming man, though one who is more interested
in the therapist's reactions than in understanding his own plight.
Michael reports that he has an interesting social life, though he complains in
passing that people often do not invite him to dinner a second time. Nor do they
lend him money or allow him to borrow their car. Some probing reveals that Michael
has frequently failed to repay loans, and that he has often been involved in
accidents with other people's cars ("well, they're insured ... "). He is prone to
cancel social engagements at the last minute if something more interesting comes
up. Indeed, he calls often to change his scheduled therapy sessions and is upset
when those changes cannot be arranged.
For the out-patient treatment I recommend this therapy.
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