Histrionic Personality Disorder Treatment: Does It Work?

Updated August 27, 2020
Medically Reviewed By: Aaron Dutil

Histrionic Personality Disorder is a mental disorder that is characterized by pervasive and uncontrolled emotionality and attention-seeking personality. It often begins when a person is in his late adolescence or early years of adulthood and is more common in women than in men.

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Signs and Symptoms of Histrionic Personality Disorder

An individual may have Histrionic personality disorder if he or she has 5 or more of the symptoms below:

  1. Discomfort in circumstances where the person is not the center of attention.
  2. Unbecoming, sexually seductive, or provoking behavior in his interaction with others.
  3. Displays of briskly moving and superficial expression of emotions.
  4. Consistent use of physical features to attract attention to self.
  5. Speech style is extremely impressionistic and insufficient in detail.
  6. Self-dramatization, theatrics, and over-expression of emotions
  7. Easy suggestibility (i.e., easily persuaded by others or situations).
  8. Consideration of relationships to be more personal than they are.

Treatments of Histrionic Personality Disorder

Compared to the treatment of other personality disorders like Borderline Personality Disorder, there have been relatively fewer studies on the treatment of Histrionic Personality Disorder. There is, however, substantial evidence that some techniques of psychotherapy help to reduce the symptoms of Histrionic Personality Disorder.

Histrionic Personality Disorder and its comorbidities can be treated in two main ways:

  • Psychotherapy
  • Pharmacotherapy

Psychotherapy

The main treatment type recommended for personality disorders, including Histrionic Personality Disorder, is Psychotherapy. It involves an individual (or a group of persons) with the diagnosis) with this clinical label seeing and carrying out activities structured by a consulting therapist (or a group of mental health professionals).

Certain types of psychotherapy are effective in the management of Histrionic Personality Disorder symptoms.

They are:

  • Supportive Therapy
  • Cognitive Behavior Therapy
  • Psychodynamic or Analytic psychotherapy

Supportive Therapy

This type of psychotherapy is used to help people to cope with long term or chronic illnesses. When applied to people with Histrionic Personality Disorder, they show improvement in self-esteem, they can better manage emotional stress, and they develop better coping strategies.

Supportive therapy achieves its results by using the following features:

Trusting Therapeutic Relationship: supportive psychotherapy can create a trusting relationship between the therapist(s) and the individual(s) with the disorder. Since the management of the disorder usually takes a long time, this relationship can help form a bedrock for a person with the disorder once there is a crisis.

Listening: a person with Histrionic Personality Disorder is listened to and heard. Concerns are taken very seriously, and they have the therapist’s full attention whenever they needed. This helps to remove the basic anxiety of people with Histrionic Personality Disorder.

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Information and advice: very accurate information and advice are given to individuals with Histrionic Personality Disorder. The information is well-timed and fitted for whatever situation the individual finds himself or herself. The information is given in a way that is not overwhelming but at the pace preferred by the individual.

Emotional release: people with Histrionic Personality Disorder are encouraged to express themselves and whatever they feel. Their emotional outbursts are not discouraged, and it is even accepted.

Reassurance: people with Histrionic Personality Disorder are reassured consistently and given hope that things will get better. The reassurance given is very specific, and it is offered in a way that the individual with the disorder can understand.

Skill Development: people with Histrionic Personality Disorder are encouraged to learn skills that will help with long term management of the disorder. They are also persuaded to take necessary and important actions that can help limit or reduce symptoms.

Self- help: as the therapy goes on, people with the disorder are encouraged to use the skills they have learned in therapy to “self-help.” This enables people with the disorder to transfer the progress made during therapy to the real world and eventual full-time self-management.

Cognitive Behavior Therapy

Histrionic Personality Disorder (HPD), like all other mental disorders, has a cognitive and behavioral part or component. Cognitive Behavior Therapy (CBT) aims to help people with Histrionic Personality Disorder by changing the maladaptive behavior and cognitive processes that maintain Histrionic Personality Disorder.

To understand the cognitive and behavioral aspects of the disorder, an individual with the disorder may be encouraged to keep a journal in which he or she describes each symptom that constitutes a problem.

The individual is also encouraged to record the behaviors, thoughts, and emotions associated with the symptom. Whatever happens before and after the symptom is recorded together with what is thought to increase or reduce the expression of the symptom.

The core features of CBT used for people with HPD are:

The sufferer is an active partner:

In CBT, the individual with HPD is encouraged to take an active role in therapy with the therapist acting as a guide to help him or her to come to conclusions.

Socratic questioning:

Beliefs, behaviors, and thoughts that are thought to be maladaptive are usually not challenged directly. First, questions are asked in ways that help the individual come to the conclusion that they are might be maladaptive.

Attention to provoking and maintaining factors.

The information from journals kept by the individual with HPD is used by the therapist to pick out provoking factors and to maintain the symptoms of the disorder.

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Coping skills and strategies

In therapy sessions, coping skills and strategies are taught to people with HPD to help them to manage the cognitive and behavioral aspects of the disorder properly.

Self Help

People with Histrionic Personality Disorder are encouraged to try out techniques thought by the therapist by themselves in social situations. This usually leads to improvement in the social space of people with HPD.

Psychodynamic Therapy

This kind of psychotherapy tries to treat people with Histrionic Personality Disorder (HPD) in attempting to uncover and correct the origins of the disorder. It is based on the assumption that the disorder is caused by early life experiences, which lead to unconscious factors that account for maladaptive thinking, emotions, and behavior later in adulthood.

When psychodynamic therapy is used, it might follow a process like this:

The therapist explains the aim of the therapy of linking past and present behavior patterns to the patient.

The individual with HPD is then encouraged to explore ideas and fantasies that were previously hidden in her subconscious. Expression of ideas, feelings, and emotions that are considered shameful is encouraged. People with HPD are also asked to review their part in difficulties they usually ascribe to other people.

When they realize their roles in creating these difficulties, people with HPD are encouraged to try out new responses to these situations where the difficulties might arise.

Other kinds of psychotherapy include:

  • Group therapy

This type of psychotherapy is not very for people with Histrionic Personality Disorder because of the fact they like to be the center of attraction. When people with HPD begin to respond to individual therapy, they can sometimes benefit from group therapy.

Group therapy shares the therapeutic factors common to all kinds of psychological treatment, including restoring hope, releasing emotion, giving information, providing a rationale, and suggestion.

Group therapy has the important features of other psychotherapies and also has added benefits like making people with Histrionic Personality Disorder see that others share their experience. They are also sometimes able to get advice from other people with disorders on what worked and what did not.

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They can sometimes get the support of others in the group and are able to build new relationships that serve as compensation for the ones they might have lost.

  • Couple therapy

This type of therapy can be helpful, especially for the partner of a person with Histrionic Personality Disorder. It has the same problem as group therapy; the individual with HPD might always try to be the sole holder of attention. Once this problem is overcome, however, couple therapy can also begin to deliver some dividends.

Medications

Medication has not been proven to be very effective in treating HPD. Medications can, however, be used to treat co-morbidities. Comorbidities are like depression, and antidepressants and anxiolytics can treat anxiety. Mood stabilizers can be used to treat some impulsive behaviors seen in Histrionic Personality Disorder. Please always consult a medical professional before making any changes to your medications.

Self Care

Although this is not a mode of treatment, it can add to the general wellbeing of anyone with HPD. Self-care habits should be practiced. Examples of such self-care habits include good sleeping habits, regular exercise, nutritious diet intake, proper stress management, and so on.

Conclusion

Histrionic Personality Disorder can be treated. If you are concerned that you or someone you care about might have a borderline personality disorder, you should reach out to a competent mental health professional and get more detailed information about treatment for the disorder. You could get further details from highly qualified mental health professionals at BetterHelp.

References

American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM- 5) American Psychiatric Association, Washington, DC.

Paul Harrison, Philip Cowen, Tom Burns, Mina Fazel (2018). Shorter Oxford Textbook of PsychiatrySeventh Edition Oxford University Press, Oxford, United Kingdom.

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