‘Drama Queens’ May Suffer From Histrionic Personality Disorder

In the beginning, Mia seemed to have a therapeutic effect on Cory in a way other women hadn’t. She was vivacious, charismatic, endlessly charming, and always dressed to kill. Cory would have loved her makeup-less and in sweatpants, but he enjoyed her no matter how much mascara or how high the heels. She was affectionate and fun, and Cory was happy just to be around her.

Problems arose less than a month into the relationship, however, when Cory began to report feeling real insecurity - something he hadn’t experienced since adolescence. He believed the problem had arisen because of the way Mia, whom he adored, continually flirted with other men in his presence. At first he thought she wanted to make him a little jealous, to prove to herself how much he cared, but after several instances and more than a few conversations about it, Mia proclaimed that she didn’t know what the big deal was. She said she couldn’t help it if she “love[d] people” and if “they loved [her] back.”

Cory took Mia as his date to the wedding of a cousin where she met his family for the first time. His parents were initially quite charmed by her, but as the evening grew on, Mia’s behavior seemed to spiral downward. She danced “a little too closely” with several of Cory’s male relatives, and flirted repeatedly with the groom, whom she’d asked to dance more than once. Cory felt Mia was being insincere - a pattern he had begun to notice - and this bothered him most. Even the bride had become annoyed. When Cory pulled Mia aside to ask her to please pay more attention to him and less to the other guests (he was concerned about what his parents might be thinking), she began to sob loudly. She accused him of being controlling and jealous and then, without any warning, slapped him across the face. The other guests were noticeably appalled.

After the events of the wedding, Cory and Mia’s relationship grew especially stormy. At the slightest provocation, Mia flew into tearful tirades. She accused Cory of believing she was “not good enough” for him. But just as quickly as these storms had started, Mia was laughing again - cuddling up and assuring Cory he was the “love of [her] life.” Cory was confused by the behavior as much as by the heartfelt words; their relationship was so new, after all.

Cory eventually began to despair of Mia’s catastrophizing behavior and the way everything needed to be in perpetual chaos in order for her to thrive. Even though Mia tended to believe every situation - from the assignments she was given in her college classes to the way someone looked at her at the salon - was the “worst thing ever,” she still seemed to find a thrill in the attention she got from crying about, what were to Cory, seemingly minor events. Eventually Cory decided to end the relationship - less as a result of Mia’s extreme behaviors than because all of their conversations had become shallow and Mia-centered. Whenever he tried to introduce a new topic, she feigned excited interest for a second, but invariably brought the subject back to her.

The Symptoms of a Histrionic Personality

The World Health Organization’s (WHO) International Classification of Diseases, describes histrionic personality disorder (HPD) as being characterized by:

(a) self-dramatization, theatricality, exaggerated expression of emotions;

(b) suggestibility, easily influenced by others or by circumstances;

(c) shallow and labile affectivity;

(d) continual seeking for excitement and activities in which the patient is the center of attention;

(e) inappropriate seductiveness in appearance or behavior;

(f) over-concern with physical attractiveness.

People with HPD may appear to be highly self-involved and self-indulgent; usually long for attention and appreciation from others; may be manipulative; and can be characterized as having feelings that are easily hurt or offended. People with HPD tend to exhibit inappropriate intimacy, as well. In other words, they believe their relationships are far more familiar and intimate than they are, given the time and two-way concern it takes to develop such relationships. People often experience those with HPD as highly dramatic and chaos-seeking. They tend to experience minor events as worst-case-scenario, and as a result, may exhibit emotional reactions inconsistent with events.

Treatment for HPD

Psychotherapy can be effective for people with HPD, but it should be stated that individuals with this disorder have difficulty addressing any unconscious motivations behind their behaviors, so this type of analysis will largely be unhelpful to them. What helps instead, is having a therapist who is willing to honestly address any descriptive or emotional exaggerations on the part of the patient, as well as behaviors which may be causing distress so as to help the patient find a more logical, less emotionally extreme path. Medications may also be unhelpful for people with HPD, except in the treatment of co-occurring issues. A therapeutic approach that involves relatively long-term psychotherapy and self-help modalities is often best.

When Cory attempted to end his relationship with Mia, she grew intensely distraught and emotionally needy. She repeatedly texted and once showed up unannounced at his workplace. Cory found her in the lobby of his engineering firm crying to the receptionist about the way Cory had supposedly treated her, though at the same time, declaring her love for him. He was able to convince her that seeing a therapist might be a good idea, and she consented at first in an attempt to win Cory back. While their relationship did not survive, Mia did develop a positive relationship with her therapist and began to take a serious look at her thoughts and emotional patterns.

Posted on July 17th, 2013
Posted in Mental Health

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