What is histrionic personality disorder?

What is the definition of histrionic personality disorder?

“Historically, histrionic personality disorder was primarily a disease found in women. That’s why we called it, formerly hysterical personality disorder, of which -hyster- means uterus. But, this disease, which seems to imitate all diseases, is like a chameleon, according to the English doctor Sydenham and it has always failed medicine. Its symptoms, whose expression changes over time and cultural mutations, are elusive and often take the body hostage. Hysteria in its pain of existing makes the body speak in its materiality, apart from any cerebral dysfunction” defines in the preamble Rosa Caron, psychologist, psychoanalyst and lecturer in clinical psychopathology at the University of Lille. Hysteria can be considered as a way of being in the world with an ambiguous relationship to the symptom: at the same time, the hysteric complains about his symptom and enjoys it.. “Today, we use the term histrionic personality disorder, because -histrion- means comedian. The patient affected by this mental condition is theatrical: his emotional reactions are exacerbated. He needs the attention of others to be focused on him. With his rather seductive behavior, the person suffering from histrionic personality disorder uses all the means in his possession to “manipulate” the other“, explains Stéphane Rusinek, professor of clinical psychology at the University of Lille.

Is this disorder part of the DSM?

This disorder is part of the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

What are the symptoms of histrionic behavior? Examples.

Symptoms of histrionic personality disorder are always unconscious.

• The patient is constantly seeking attention and when he does not have it, he is often depressed.
• These people are seductive and they take care of their appearance because they want to project a good image of themselves. They like to seduce, and this in several aspects of their life (sentimental, professional, etc.).
• The expression of their emotions is very strong and spectacular.
• Patients with histrionic personality disorder get tired quicklywhich is why they can quickly change jobs or friends.

What causes histrionic personality disorder?

According to the clinical psychologist, “there are genetic factors, learning and schemas with which the person grows, especially during adolescence. These are essentially learnings, forms of reactions that have worked, and which the person continues to use in adulthood.“.”The place given to the child, family historythe words that bathed his childhood and which drew the outline of the family system or the family novel, participate in the construction of a singular psychic reality and inscribe each one unconsciously in subjective positions conditioned by the vision that he/she she integrated people, explains Rosa Caron. The development of histrionic personality disorder can thus be “made” : it is a real formation of the unconscious, a return in the form of a symptom of what has been repressed, but in a disguised, transformed form“.

Is there a test to make the diagnosis?

“There are personality tests, but they are not diagnostic tests.“, specifies Stéphane Rusinek. The limit of the test is that it only takes the symptoms and conceals the context in which they occur. For a professional, such as a psychologist, the conditions and circumstances of the appearance of the symptoms are very important.

What is the treatment for histrionic personality disorder?

► A therapy. “The primary goal of therapy is to make the person recognize that he is suffering because of these exacerbated modes of reaction. Once the disorder is recognized, it will then be a question of accepting its reactions“, says the professor of psychology. But the path is not easy. Our personality is how we react to others. However, we react to abandonment or to stress, for example, by a way of thinking that is always the same. The basis of our personality is therefore to always react in the same way, because the latter suits us. Moreover, having the existence of this disorder recognized is a challenge, since for people with histrionic personality disorder, the problem always comes from others. “The second part of the therapy consists of teaching the patient to have a repertoire of behaviors to better understand the other: we ask them to test different behaviors and other ways of thinking and seeing what results. And the person becomes aware that by reacting in a different way, he wins more and more often. She adapts, her suffering and that which she can unconsciously inflict on others ends up disappearing. For this type of therapy to work, the process must come from the patient and the patient must be motivated to change. From there everyone gets better“, indicates Stéphane Rusinek.

► Psychoanalysis. This is a completely different approach. “It’s a long term therapy, which proposes to visit what founds the singular coordinates of the patient’s psychic reality. It is a question of unraveling by the method of free associations, what the words of childhood, perceived by the child were able to tie, explains psychologist Rosa Caron. This “talking cure”, which allows the patient to understand the stakes of his relational dynamics and the handling of transference which replays the way of being in the world and of being connected, gradually bring about a transformation of the relationship to the world, away from the illusions of identification. This is why it is often said, metaphorically, that the symptom is a language that must be deciphered..”

Thanks to Rosa Caron, psychologist, psychoanalyst and lecturer in clinical psychopathology at the University of Lille (PSITEC lab) and to Stéphane Rusinek, professor of clinical psychology at the University of Lille (PSITEC lab) and Director of Education from the AFTCC (French Association of Behavioral and Cognitive Therapy), for their contribution to this article.

Source: American Psychiatric Association