Histrionics can be described as seductive, indecisive, overemotional, demonstrative, and attention seeking, yet at the root of their character lies a basic feeling of helplessness and a need to make others the center of their lives. Histrionics put much of their energy into cultivating many superficial relationships and lack fidelity and loyalty not only to sexual partners but across all interpersonal relationships. Histrionic characteristics are a valued part of our culture. Friendly, expressive, and sociable people are often the life of the party (recall the classmate scenario at the beginning of the chapter). Oldham and Morris (1995) describe the dramatic style as those living their lives through sensation and romance in almost a theatrical way. The outgoing style (as described by Millon) is charming, with a zest for life that is contagious. The disorder, however, has a deficient sense of self-esteem, is cognitively global and diffuse, and uses sexual provocativeness inappropriately.
Several variants of the histrionic personality exist. Theatrical histrionics are chameleons, transforming themselves to fit each new situation. The infantile histrionic is a blend with the borderline personality, with rapidly changing emotions. The vivacious histrionic is a blend of extremely high levels of energy with many narcissistic traits. The appeasing histrionic is a combination of dependent and compulsive features, becoming syrupy sweet and good. The tempestuous histrionic personifies many borderline personality features, being intensely moody and having the least developed self-identity of the histrionics. The disingenuous histrionic is a blend with antisocial features, being manipulative and revengeful.
The modern-day histrionic personality grew out of a long history of the hysterical personality that can be traced back to ancient Greece but was really the cornerstone of the psychoanalytic movement. In the 1890s, Breuer and Freud hypothesized about the unconscious mechanisms that were at work in their famous hysterical patient, Anna O. Eventually, Freud discovered the defense mechanism of repression and, even more important, he proposed that hysterical symptoms were the result of unconscious instincts threatening to seep into consciousness. This discovery of secret wishes and unconscious desires has led to most of the major developments in psychoanalysis. A host of analysts who have written about various histrionic character types, including Kernberg, Reich, and Fromm, included the defense mechanisms—repression, sexualization, and dissociation—as integral personality components maintaining the histrionic type. The development of the hysterical character is still feverishly debated. Freud believed oedipal fixations were key, but modern analytic thinkers believe low-functioning hysterics have oral concerns and higher functioning hysterics, as Freud suggested, have issues related to the oedipal stage of development.
Cognitions and defense mechanisms are closely intertwined for histrionics. Their cognitions are scattered, diffuse, global, and overly simplistic. They possess a filter to keep out any ideas that are too detailed, philosophical, or concrete. Instead, they view the world through their own imprecise and overemotional lens. Their attention is extremely limited; thus they possess few schemas for making sense of our complex world and tend to make broad overgeneralizations. The histrionic also fails to develop a well-formed sense of identity, never identifying goals and putting together a life plan. Many believe that histrionics fundamentally feel inadequate and are unable to handle life; hence, they actively seek help from others by making themselves attractive and desirable. At the core, however, remain intensely negative beliefs despite the admiration and adoration of others.
Although at first histrionics seem attractive and charming interpersonally, eventually most people tire of their neediness and shallowness. Hence, histrionics cycle through friendships and sexual relationships quickly. From a social learning perspective, it is fairly easy to make sense of the development of a histrionic. Parents who reinforce desirable behaviors on a variable schedule force children to become more and more extreme and exaggerated in their behaviors to secure needed attention and nurturance. These behaviors cross over into other social interactions when they enter adolescence and learn to exploit their developing sexuality to capture others' attention.
There is some evidence of the role of biology in the development of the histrionic personality. Most of the evidence comes from research in sociopathy and the theoretical assumption that histrionic personality is the female expression of the antisocial personality. Assortative mating theory proposes that traits attractive to the opposite sex tend to become amplified over many generations and that histrionics have amassed a superabundance of these traits.
From an evolutionary neurodevelopmental perspective, the histrionic is referred to as the active and other-oriented personality. Histrionics actively work to bind others to them but only with the goal of collecting back-up alternatives to ensure a steady supply of affection.
While histrionics are easy to identify because of their drama and theatrics, they do share characteristics with the dependent and borderline personalities as well as the narcissistic and antisocial personalities. Histrionics are prone to developing certain Axis I disorders such as somatoform disorders, dissociative disorders, anxiety disorders, mood disorders, and drug and alcohol abuse.
Histrionics rarely seek therapy. However, several techniques may be of use in treating histrionics. The therapist must be alert to the histrionic's attempts to manipulate the therapist into indulging the client's need for endless nurturance. In addition, the client may have difficulty setting goals as self-improvement may run counter to the purposes of therapy. Cognitively, histrionics must learn to focus their attention and set goals for therapy. Interpersonally, they need to work on developing their own identity. What may prove useful in therapy is assertiveness training and active listening skills geared toward changing their old patterns of interaction.
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