Many readers will find aspects of the histrionic in their own personality. American standards, in particular, reward those who are friendly, expressive, and sociable. Several normal-range variants of the histrionic personality have been proposed, each capitalizing on a slightly different constellation of characteristics. The dramatic style (Oldham & Morris, 1990) emphasizes feeling, color, and attention. Such persons process their world effectively, value the impact of emotion, and display their emotions easily and openly. They experience life through sensation and romance, deliberately make themselves physically attractive, consciously dress with the opposite sex in mind, and become engaging, charming, or even seductive when "on stage." Many are highly intuitive and quickly sense what to talk about and how others wish to be regarded. Most trust others easily and readily involve themselves in relationships.
The outgoing style (Millon et al., 1994) focuses more on sociability than on theatrics. Possessing great confidence in their influence and charm, such persons go out of their way to be popular and just naturally know how to make others like them. Usually, they are described as warm, lively, dramatic, energizing, or provocative. Most see themselves as cheerful and optimistic. Their joy in life is infectious, stimulating others to equal exuberance. Many act and think like young adolescents, even into their middle and older years. Most are open to new possibilities and find tremendous joy in new experiences.
By working backwards from the disordered traits that underlie the criteria of the DSM-IV, a sketch of the normal-range histrionic can be developed (see Sperry, 1995). Histrionic personality-disordered individuals usually become angry, depressed, or envious when not the center of attention, whereas those with a more outgoing style enjoy compliments and praise without depending on them. Moreover, the outgoing, too, enjoy entertaining others, yet can relinquish the floor and become part of the audience.
Interpersonally, histrionics rely on a blanket sexual allure. This contrasts with the outgoing, who are more fittingly charming, engaging, and subtle. Emotionally, histrionics are fickle with their rapidly shifting moods. The outgoing, on the other hand, have a more appropriate control of their emotions. Also, physical attraction by way of style, fashion, and designer apparel is of utmost importance to histrionics. The outgoing, too, possess such interests though they fall short of a disordered obsession.
For each of the preceding contrasts, Yvonne seems to fall more toward the pathological end. Compliments and praise are not enough; she must be the center of attention at all times, as she herself admits. Moreover, Yvonne is more sexually provocative than subtle, as seen by her use of posture and double entendre. As she speaks with the interviewer, her emotions change quickly, often in response to her own free associations. Finally, she is inappropriately dressed for the clinical interview. Looking more as if she were destined for a nightclub than a psychological assessment, she is obviously invested in creating an attractive physical presence.
The remainder of the diagnostic criteria can also be put on a continuum with normality (see Sperry, 1995). The disordered are cognitively global, diffuse, and impressionistic, whereas the styled are more constructive in qualifying and detailing appraisals, given their authenticity of emotion (Kernberg, 1992). As opposed to the disordered, who are constantly engaged in dramatic and theatrical expression, the styled are less amplified without the interest of taking center stage. While the disordered are easily swayed by the influences of others, the styled are capable of making their own decisions, even at the expense of attention and approval. Finally, the disordered consider relationships to be more friendly or intimate than they really are, whereas the styled are anchored to a more solid sense of self, allowing for a greater sense of continuity over time and more insight into the nature of personal relationships.
Yvonne falls more toward pathology than normality. At the beginning of the interview, she seems unable to hold a point and explore it in depth, but instead digresses from one superficiality to the next, perhaps somewhat deliberately as a means of avoiding conflict or unpleasant emotions; for example, she is on a first-name basis with her physician, she has been a dancer since she was little, and so on. She overdramatizes her physical pain with theatrics obviously intended to impress the listener and uses facial expressions to exaggerate and underscore her emotions far beyond what ordinary communication would require. Finally, far from being able to appreciate others on their own terms, Yvonne instead remarks on how easily she gets to know others and how quickly she becomes bored with them.
Before moving on, you should be aware that this chapter makes an important simplifying assumption. Like all such assumptions, it makes the material easier to understand but distorts reality somewhat in the process. Just as the antisocial chapter implicitly assumes the vast majority of antisocials are men, this chapter assumes that the vast majority of histrionics are female (see "Focus on Feminist Psychology" box). According to the DSM-IV-TR (2000), females more than males have been clinically diagnosed as histrionic personality, yet this difference is consistent within gender ratios of each clinical setting. Many males have manifested histrionic traits, such as a chronic need to call attention and approval to themselves through exaggerated sex role stereotypic behaviors. Kernberg (1992) describes two kinds of male histrionics: the first, a caricature of the masculine stereotype; the second, more infantile and subtly effeminate. As society condones the braggadocios male for his athletic prowess or corporate proficiency, it is conceivable that such histrionic traits go unnoticed. Rather, it is typically considered of poor taste when a woman boasts her splendor and irresistible charm. Because of this societal masking of male histrionic characteristics, it has been difficult to ascertain the true cognitive, interpersonal, and psychodynamic similarities between males and females. Although both are constant attention-seekers, the developmental pathways, associated symptoms, and preferred treatment modalities could well be different. Accordingly, this chapter focuses on the histrionic personality as it occurs in women.
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