What is histrionic personality

Histrionic Personality Disorder - StatPearls

Continuing Education Activity

A histrionic personality disorder, or commonly known as a dramatic personality disorder, is a psychiatric disorder distinguished by a pattern of exaggerated emotionality and attention-seeking behaviors. A histrionic personality disorder is categorized within the "Cluster B" of personality disorders. Cluster B personality disorders include conditions such as narcissistic personality disorder, borderline personality disorder, and antisocial personality disorder. These personality disorders are commonly described as dramatic, excitable, erratic, or volatile. Specifically, people with histrionic personality disorder are typically characterized as flirtatious, seductive, charming, manipulative, impulsive, and lively. This activity reviews the evaluation, treatment, and management of histrionic personality disorder and highlights the role of the interprofessional team in managing patients with this condition.

Objectives:

Explain the etiology of histrionic personality disorder.
Review the anticipated presentation of a patient with a histrionic personality disorder.
Describe the treatment considerations for histrionic personality disorder.
Outline the importance of improving care coordination as well as collaboration and communication amongst the interprofessional team to improve outcomes for the patient affected by histrionic personality disorder.

Access free multiple choice questions on this topic.

Introduction

Personality is the set of established patterns of behavior by which one relates to and understands the world around them. A personality disorder arises when one develops an inflexible and intransigent pattern of maladaptive thinking and behaving, which significantly impairs social or occupational functioning and can cause interpersonal distress.[1] Patterns of thinking and behaving must significantly deviate from cultural norms to meet the diagnostic criteria for personality disorder. Divergence from cultural expectations would manifest as disturbances with affectivity, cognition (perceives self, others, or events inappropriately), impulse control, or interpersonal functioning.[2] These disturbances are not due to another mental disorder, substance abuse, or other medical condition.[3]

Histrionic personality disorder, or dramatic personality disorder, is a psychiatric disorder distinguished by a pattern of exaggerated emotionality and attention-seeking behaviors. Histrionic personality disorder falls within the “Cluster B” of personality disorders.[4] Cluster B personality disorders include conditions such as narcissistic personality disorder, borderline personality disorder, and antisocial personality disorder.[2] These personality disorders are commonly described as dramatic, excitable, erratic, or volatile.[1] Specifically, people with histrionic personality disorder typically present as flirtatious, seductive, charming, manipulative, impulsive, and lively. [5]

People with histrionic personality disorder may feel underappreciated or disregarded when they are not the center of attention. These people are typically the life of the party and have a “larger than life” presence.[3] They may be vibrant, enchanting, overly seductive, or inappropriately sexual with most of the people they meet, even when they are not sexually attracted to them.[6] People presenting with histrionic personality disorder may demonstrate rapidly shifting and shallow emotions that others may perceive as insincere. Physical appearance may be used to draw attention to oneself by wearing bright-colored clothing or revealing garments.[6] Those with histrionic personality disorder may speak in a vague style that lacks in detail.[4] Furthermore, they may be dramatic and extremely emotionally expressive, even embarrassing friends and family with public displays of emotions.[3] They may be impressionable, gullible, suggestible, and easily influenced--especially by the people they admire. Additionally, they tend to consider relationships closer than they usually are.

Etiology

While it is unknown what explicitly causes histrionic personality disorder, it is likely a disorder that is multifactorial in its origin. Histrionic personality disorder probably develops as a conglomeration of both learned and inherited factors.[6] One hypothesis is that histrionic personality disorder may develop as a result of trauma experienced during childhood. Children may endure their trauma by coping with their environment in ways that may ultimately lead to a personality disorder.[2] Personality disorders in childhood may originate as an adaptation to cope with a traumatic situation or traumatic environment.[7]

Parenting styles may also influence the likelihood of developing a histrionic personality disorder. Parenting which lacks boundaries is over-indulgent or inconsistent may predispose children to develop histrionic personality disorder.[8] Moreover, parents who role model dramatic, erratic, volatile, or inappropriate sexual behavior put their children at high risk for developing this personality disorder. [9] Because histrionic personality disorder tends to run in families, there is some consideration that there is a genetic susceptibility for this disorder.[8] As with many psychiatric disorders, having a family history of personality disorders, psychiatric illness, or substance use disorders is a risk factor for histrionic personality disorder.[6]

Epidemiology

While approximately 9% of the general population has at least one personality disorder, the prevalence of histrionic personality disorder in the general populace runs about 2 to 3 %.[1] It is possible for people to have more than one personality disorder. Women are four times more likely to be diagnosed with histrionic personality disorder than men.[1] However, research suggests that women may be overly diagnosed with this disorder compared with men due to sexual-forwardness being less socially acceptable for women.[1] Furthermore, men may be less likely to report their symptoms and thereby be under-diagnosed.[1] Histrionic personality disorder tends to be ego-syntonic, meaning people with this disorder typically consider their behavior to be normal and struggle to identify a problem. [2] This lack of insight may contribute to the underdiagnosis of this personality disorder until later in life once patterns of behavior have significantly interfered with relationships, work, or interpersonal wellness.[3]

History and Physical

Mental health care professionals will make a diagnosis of histrionic personality disorder after evaluating for abiding patterns of behavior and symptomology.[4] Personality continues to evolve throughout development; therefore, histrionic personality disorders are typically not diagnosed until after age 18.[1]

Evaluation

Per DSM-5 criteria, a diagnosis of a histrionic personality disorder requires a pervasive and ubiquitous pattern of consistent attention-seeking behaviors and emotional dysregulation as outlined by specific manifestations. Diagnosis requires meeting five (or more) of the following criteria:

Uncomfortable when not the center of attention
Seductive or provocative behavior
Shifting and shallow emotions
Uses appearance to draw attention
Impressionistic and vague speech
Dramatic or exaggerated emotions
Suggestible (easily influenced by others)
Considers relationships more intimate than they are

These patients take repression and dissociation as a significant form of defense mechanism.

Treatment / Management

The treatment of choice for histrionic personality disorder is psychotherapy. Supportive psychotherapy is a recommended modality of treatment for patients with histrionic personality disorder, as this approach is found to be encouraging, reassuring, and non-threatening.[5] Supportive psychotherapy aims to reduce emotional distress, improve self-esteem, and to enhance the patient’s coping skills, all through attentive and sympathetic listening.[5]

Psychodynamic psychotherapy (also called insight-oriented therapy) has also proven to be a successful approach in treating patients with histrionic personality disorder.[8] The goal of this therapy is to alter an aspect of a patient’s dysfunctional personality by integrating crucial developmental milestones a patient may have missed during previous stages of emotional maturation.[4] Psychodynamic psychotherapy aims to resolve underlying, unconscious conflicts in an effort for patients to understand themselves and their behaviors better. [8] The patients are encouraged to substitute excessively dramatic speech for a more adaptive action or behavior, to promote better communication with others.[1] Through psychodynamic psychotherapy, patients learn to recognize that hyper-sexual, attention-seeking behaviors are maladaptive, and discover new, healthier ways to develop self-esteem.[4]

Group therapy and family therapy are not typically recommended as the first-line modality in treating histrionic personality disorder. People with histrionic personality disorder tend to desire to be the center of attention, which may be distracting from therapeutic goals in a group setting.[5] Additionally, people with this disorder may exhibit shallow emotions appearing insincere to those groups or family members participating in therapy concurrently.[5] Histrionic patients may be inappropriately sexual with their therapists; therefore, it is critical to set firm boundaries with patients.[1] The roleplay model and assertive approaches may help in minimizing conflicts.

While the gold standard for treating personality disorders is psychotherapy, patients with histrionic personality disorder may be profoundly symptomatic.[9] Patients may experience affective dysregulation, where they frequently endure mood swings, anger, tearfulness, anxiety, and depression. While there are no FDA-approved medications for the treatment of histrionic personality disorder, affective dysregulation may be treated with antidepressants, mood stabilizers, and antipsychotics.[9] Antidepressants have proven to be effective include desipramine, fluoxetine, amitriptyline, and fluvoxamine.[8] The mood stabilizers with proven therapeutic benefits include lamotrigine, carbamazepine, topiramate, valproate, and lithium.[9] Research has demonstrated that antipsychotics such as risperidone, aripiprazole, olanzapine, and haloperidol have been useful in treating affective dysregulation.[1] Patients with histrionic personality disorder may struggle with impulse control and regulation of their behaviors. Clinical trials have demonstrated that mood stabilizers specifically can target these symptoms.[9]

The biofeedback mechanism may help these patients control their inner feelings.

Differential Diagnosis

The differential diagnosis for histrionic personality disorder includes narcissistic personality disorder, borderline personality disorder, dependent personality disorder, somatic symptom disorder, and illness anxiety disorder.[1] Like histrionic personality disorder, patients with narcissistic personality disorder prefer to be the center of attention.[2] However, patients with narcissistic personality disorder want attention, which results from admiration or veneration, whereas people with histrionic personality disorder are not particular about what type of attention they garner. Patients with histrionic personality disorder are similar to those with borderline personality because both types of patients experience intense emotions; however, patients with borderline personality disorder usually dislike themselves. [5] Dependent personality disorder should be considered in the differential diagnosis for histrionic personality disorder as with both personality disorders, the patient will prefer to be around others.[6] However, patients with dependent personality disorder tend to be more submissive, and their behavior is more inhibited as they are preoccupied with fears of rejection.[5] Somatic symptom disorder and illness anxiety disorder are also included in the differential for histrionic personality disorder as patients with histrionic personality disorder may use physical symptoms and complaints to gain attention from others.[8]

Prognosis

While there is no cure for histrionic personality disorder, many people who have histrionic personality disorder can have useful and productive lives.[10] Patients who participate in therapy tend to have better outcomes as they gain insight into their condition and function more optimally socially and occupationally.[1] However, people with severe histrionic personality disorder may experience problems at work and in social or romantic relationships. [5]

Complications

People with histrionic personality disorder are at a higher risk of developing depression than the general population.[6] Additionally, people with histrionic personality disorder are at increased risk of developing substance use disorders such as cannabis use disorder and alcohol use disorder.[9] They are also prone to having somatization disorder, panic attacks, and conversion disorders. Attention seeking behavior may confer them in showing frequent suicidal threats and gestures.

Deterrence and Patient Education

As with other psychiatric disorders, patient education is a crucial component of successfully managing histrionic personality disorder. Patients diagnosed with histrionic personality disorder would benefit from understanding the maladaptive characteristics of their personality to gain insight and ultimately gain some control.[2] Patients should receive information that there is no cure to histrionic personality disorder; however, medications may be used to ameliorate symptoms. [1] Mood symptoms may correlate with life events, and moods are prone to highs and lows in association with life occurrences.[3] Nevertheless, medications should not be changed each time the patient experiences alterations in moods or emotional crises.[3] Patients with histrionic personality disorder may require longer trials on medications to determine if the medication is effective.[5] Premature termination of psychiatric medications does not allow for adequate medication trials.[10] Furthermore, it requires emphasis that psychotherapy is a vital element of treatment, specifically supportive psychotherapy or psychodynamic psychotherapy.[3]

Enhancing Healthcare Team Outcomes

To promote better outcomes for patients with histrionic personality disorder, it is vital for patients to receive an accurate diagnosis. All providers would benefit from having a greater understanding of this disorder so that patients may receive the care they need. Psychiatric disturbances can affect anyone; however, if the physician or nurse provider is not considering histrionic personality disorder as a differential diagnosis, the patient will not receive the treatment they need. [7] Once a qualified practitioner makes a diagnosis of histrionic personality disorder, a comprehensive care plan should be discussed with the patient, including access to psychiatry and psychotherapy.[1] It is paramount for patients to have a clear understanding that there is no FDA approved medications for histrionic personality disorder, and prescribing providers need to delineate treatment goals.[10] The treating psychiatrist, mental health nurse, and psychotherapist should collaborate to devise an optimal treatment plan.[10] Ideal treatment plans would include psychotherapy frequently (weekly to bi-weekly) and the use of psychiatric medications if mood symptoms are interfering with the patient’s functioning.[10] However, frequent medication changes should be avoided, drugs lethal in overdose should be avoided, and medications with addictive potential should be avoided.[7]

Histrionic personality disorder management requires the efforts of an interprofessional team that includes physicians, specialists, specialty-trained nursing staff, and pharmacists, all collaborating across disciplinary lines to drive outcomes positively. [Level V]

Review Questions

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References

1.: Nestadt G, Romanoski AJ, Chahal R, Merchant A, Folstein MF, Gruenberg EM, McHugh PR. An epidemiological study of histrionic personality disorder. Psychol Med. 1990 May;20(2):413-22. [PubMed: 2356266]
2.: Cale EM, Lilienfeld SO. Histrionic personality disorder and antisocial personality disorder: sex-differentiated manifestations of psychopathy? J Pers Disord. 2002 Feb;16(1):52-72. [PubMed: 11881161]
3.: Rienzi BM, Scrams DJ. Gender stereotypes for paranoid, antisocial, compulsive, dependent, and histrionic personality disorders. Psychol Rep. 1991 Dec;69(3 Pt 1):976-8. [PubMed: 1784694]
4.: Kellett S. A time series evaluation of the treatment of histrionic personality disorder with cognitive analytic therapy. Psychol Psychother. 2007 Sep;80(Pt 3):389-405. [PubMed: 17877864]
5.: Novais F, Araújo A, Godinho P. Historical roots of histrionic personality disorder. Front Psychol. 2015;6:1463. [PMC free article: PMC4585318] [PubMed: 26441812]
6.: Lilienfeld SO, Van Valkenburg C, Larntz K, Akiskal HS. The relationship of histrionic personality disorder to antisocial personality and somatization disorders. Am J Psychiatry. 1986 Jun;143(6):718-22. [PubMed: 3717392]
7.: Apt C, Hurlbert DF. The sexual attitudes, behavior, and relationships of women with histrionic personality disorder. J Sex Marital Ther. 1994 Summer;20(2):125-33. [PubMed: 8035469]
8.: Morrison J. Histrionic personality disorder in women with somatization disorder. Psychosomatics. 1989 Fall;30(4):433-7. [PubMed: 2798737]
9.: Sulz S. [Hysteria I. Histrionic personality disorder. A psychotherapeutic challenge]. Nervenarzt. 2010 Jul;81(7):879-87; quiz 888. [PubMed: 20585747]
10.: Hori A. Pharmacotherapy for personality disorders. Psychiatry Clin Neurosci. 1998 Feb;52(1):13-9. [PubMed: 9682928]

Histrionic Personality Disorder - StatPearls

Continuing Education Activity

Objectives:

Explain the etiology of histrionic personality disorder.
Review the anticipated presentation of a patient with a histrionic personality disorder.
Describe the treatment considerations for histrionic personality disorder.
Outline the importance of improving care coordination as well as collaboration and communication amongst the interprofessional team to improve outcomes for the patient affected by histrionic personality disorder.

Access free multiple choice questions on this topic.

Introduction

Etiology

Epidemiology

History and Physical

Evaluation

Uncomfortable when not the center of attention
Seductive or provocative behavior
Shifting and shallow emotions
Uses appearance to draw attention
Impressionistic and vague speech
Dramatic or exaggerated emotions
Suggestible (easily influenced by others)
Considers relationships more intimate than they are

These patients take repression and dissociation as a significant form of defense mechanism.

Treatment / Management

The biofeedback mechanism may help these patients control their inner feelings.

Differential Diagnosis

Prognosis

Complications

Deterrence and Patient Education

Enhancing Healthcare Team Outcomes

Review Questions

Access free multiple choice questions on this topic.
Comment on this article.

References

1.: Nestadt G, Romanoski AJ, Chahal R, Merchant A, Folstein MF, Gruenberg EM, McHugh PR. An epidemiological study of histrionic personality disorder. Psychol Med. 1990 May;20(2):413-22. [PubMed: 2356266]
2.: Cale EM, Lilienfeld SO. Histrionic personality disorder and antisocial personality disorder: sex-differentiated manifestations of psychopathy? J Pers Disord. 2002 Feb;16(1):52-72. [PubMed: 11881161]
3.: Rienzi BM, Scrams DJ. Gender stereotypes for paranoid, antisocial, compulsive, dependent, and histrionic personality disorders. Psychol Rep. 1991 Dec;69(3 Pt 1):976-8. [PubMed: 1784694]
4.: Kellett S. A time series evaluation of the treatment of histrionic personality disorder with cognitive analytic therapy. Psychol Psychother. 2007 Sep;80(Pt 3):389-405. [PubMed: 17877864]
5.: Novais F, Araújo A, Godinho P. Historical roots of histrionic personality disorder. Front Psychol. 2015;6:1463. [PMC free article: PMC4585318] [PubMed: 26441812]
6.: Lilienfeld SO, Van Valkenburg C, Larntz K, Akiskal HS. The relationship of histrionic personality disorder to antisocial personality and somatization disorders. Am J Psychiatry. 1986 Jun;143(6):718-22. [PubMed: 3717392]
7.: Apt C, Hurlbert DF. The sexual attitudes, behavior, and relationships of women with histrionic personality disorder. J Sex Marital Ther. 1994 Summer;20(2):125-33. [PubMed: 8035469]
8.: Morrison J. Histrionic personality disorder in women with somatization disorder. Psychosomatics. 1989 Fall;30(4):433-7. [PubMed: 2798737]
9.: Sulz S. [Hysteria I. Histrionic personality disorder. A psychotherapeutic challenge]. Nervenarzt. 2010 Jul;81(7):879-87; quiz 888. [PubMed: 20585747]
10.: Hori A. Pharmacotherapy for personality disorders. Psychiatry Clin Neurosci. 1998 Feb;52(1):13-9. [PubMed: 9682928]

Hysterical personality disorder - treatment of hysteroid disorders in the Allianz Central Medical Health Center

Hysterical (hysterical) personality disorder is one of the variants of personality disorder (the obsolete name is “psychopathy”), characterized, along with the common features for this group, by the following distinctive features:

strong desire to be the center of attention. Situations where they are deprived of this attention cause severe discomfort, up to the appearance of various physical ailments; nine0006
theatricality of behavior: dramatization of events, pretentiousness of speech and gestures, hypertrophied manifestation of emotions;
increased suggestibility: easily influenced by other people or situations;
superficiality and lability of emotional experiences, frequent mood swings;
extreme preoccupation with their appearance. Physical attractiveness is another way for them to get attention;
inadequate assessment of the degree of closeness of relationships with other people (they consider relationships closer than they really are), as well as frequent provocative behavior aimed at seduction. nine0006

Symptoms

Extreme emotional variability and sensitivity, combined with an all-encompassing thirst for attention, form the core of this pathology.

People with hysterical personality disorder are very much like actors who live for praise and applause. Alternative names: theatrical, histrionic (from the Latin histrio - “actor”) disorder, reflect its essence. It was previously thought that women were more susceptible to this pathology, however, recent studies have shown that it occurs with the same frequency in men and women. nine0003

People with histrionic personality disorder often resort to various types of manipulative behavior to quench their thirst for attention. These can be both the aforementioned dramatic and theatrical speech and gestures, extravagant appearance and clothing, as well as more serious, even potentially dangerous options, such as demonstrative suicide attempts or simulation of somatic diseases.

Despite the brightness of the symptoms of hysteroid disorder, an important component of the differential diagnosis is the exclusion or detection of a real concomitant somatic or mental pathology. nine0003

Important

To conduct a competent differential diagnosis, you need to contact a specialist, otherwise there is a high risk of missing a concomitant disease and undergoing unnecessary medical examinations and procedures.

Treatment and prognosis

The prognosis for hysterical personality disorder is usually favorable - it is possible to achieve stable and long-term compensation.
nine0023
Correction is easier in individuals whose hysterical manifestations are concentrated mainly in the sphere of physical sensations and ailments (a hysterical lump in the throat, trembling in the whole body or in separate parts, numbness and other disturbances of sensitivity, etc. ). With adequate treatment, such people become well adapted socially and professionally by adulthood, although there are still noticeable elements of theatricality in their appearance, speech and gestures. nine0003
It must be emphasized that in this disorder, it is often not a true simulation of symptoms, in which the simulator lies about his malaise, but the result of the peculiarities of perception and thinking of a hysteroid personality. With this disorder, part of what is happening (external events or internal sensations) is perceived especially sharply, and part is only superficial or even escapes attention. In combination with the rich imagination inherent in people of this type, this leads to the fact that in places they blur the line between reality and fantasy. As a result, certain physical symptoms appear, which are not the fruit of true simulation, i.e. deliberate deception. A person really believes that the symptoms he produces are a manifestation of a real disease beyond his control. nine0003
The prognosis becomes less certain if the symptomatology is dominated by pathological fantasizing (pseudology), which manifests itself in telling a lot of invented facts about oneself, designed to impress listeners with the extraordinary significance and uniqueness of the narrator. Such people lie about themselves relentlessly and almost constantly, sometimes senselessly, even though it is obvious that they will be exposed. Often, pathological liars, possessing outstanding acting talent, resort to criminal activity - all kinds of fraud options. nine0003
Due to the peculiarities of the psyche, self-seeking for medical help is quite common for people with hysterical personality disorder. Treatment of this pathology, first of all, occurs by methods of psychotherapy. The most commonly used areas are: psychoanalysis, cognitive, psychodynamic and group psychotherapy. Drug treatment is used only in individual cases and is auxiliary.

The Alliance mental health center employs qualified psychotherapists who have effective methods for diagnosing and treating hysterical personality disorder. Our specialists have many years of successful experience in this field, individually and carefully approach the management of each case, which allows us to get a positive effect from the treatment in the shortest possible time and improve the patient's quality of life. nine0003
People with histrionic personality disorder are bright, emotionally charged and attention-hungry individuals. Resorting to various manipulations, they themselves are often used by others because of their suggestibility and desire to please. Tireless actors, they often lose the line between reality and fantasy. In a state of mental compensation, they manage to achieve a high level of social and professional adaptation and lead an active lifestyle.

Hysterical personality and love - Psychologos

Hysterical people love love. They love everything that can increase their self-esteem - ecstasy, ecstasy, passion; love is perceived by them as the pinnacle of their experiences.

If obsessive personalities view love yearning as violence, then hysterical personalities belong to the Dionysian side of the Apollonian line of attitude towards love. They are attracted to boundless love experiences, but not in the form of self-giving, as is the case with depressive individuals, but in terms of spreading and expanding their "I", to the apotheosis of their "I". If depressive individuals seek to cross the boundaries of their own "I" for a symbiotic merger with another, with a partner, and thereby try to transcend themselves outside, then hysterical individuals try to increase the intensity of their experiences, that is, they direct love feelings inward, to satisfy their "I ". In this regard, the love relationships of hysterical personalities are characterized by intensity, passion and exactingness. They seek in love, first of all, confirmation of their "I", they like the ecstasy and intoxication that a partner gives them, they expect the climax of their life in connection with a love relationship. For them, the erotic atmosphere is a matter of course, they resort to various methods of charm and seduction, often being true masters of erotica. This implies mastery of various erotic tools - from flirting and coquetry to mastering the art of seduction in all its nuances. Tantrums tend to believe that a partner should keep them feeling their own love attraction. They have a great power of suggestion that is hard to avoid. In the consciousness of their merits and their attractiveness, they force the partner to believe in it. nine0003
When establishing a love relationship, the most important thing for them is the strength of desire. These people take the fortress by storm, without delaying the siege, according to the principle "veni-vidi-vici" - "I came, I saw, I conquered." They easily come into contact with the opposite sex; communication for them is not boring and painful. They love love more than a partner, they like to get acquainted with different ways and patterns of love, as they are filled with curiosity and love hunger. They like splendor and luxury, holidays and celebrations, they are ready to celebrate on any occasion, while being in the spotlight with their charm, temperament, spontaneity and extravagant clothes. They consider it a deadly sin if the partner did not find love qualities in them or did not appreciate them - they endure this with difficulty and can hardly forgive. For them, the situation “it would be better if the horse was stolen” is preferable than a calm, without sentimentality life. Boredom is mortally unbearable for them, they are always bored, being left alone with themselves. They are bright, lively, quirky partners, spontaneous and unpredictable in their sensual manifestations, capable of intense short-term love. They strive for pleasure, are prone to fantasizing and ... often lose. To fidelity, at least their own, they are dismissive. Secret, forbidden love is especially attractive to them, as it gives scope for romantic fantasies. nine0003
There are difficult circumstances in their sexuality: erotic play, tender love foreplay is more important for them than the satisfaction of sexual desires. They like to say unexpectedly:

"Stay with me some more and everything will be fine" - and it gives great pleasure to slow down or postpone the completion of sexual intimacy. They want to perpetuate their honeymoon, and after the wedding heights, they hardly endure immersion in everyday life. They love variety. If healthy attitudes regarding one's own gender and the opposite sex are not realized, hysterical personalities easily experience a violation of their love abilities up to frigidity and violations of sexual potency. Both genders view sex as more of a self-esteem-enhancing goal and a test of how their desires affect their partner. In this they differ from obsessive individuals who use sex to bind a partner to themselves. For hysterical personalities, it is important to delight in the power of their influence on a partner, on how deeply the features of their character and their very essence influence him. nine0003
The more pronounced the specific features of the hysterical personality structure, the more demanding the manners become, the more clearly the exactingness in confirming one's own value is manifested. In such cases, a love affair has a dominant attitude towards constant confirmation of its own significance, in connection with which a constant renewal of love is necessary, and the inherent inconstancy of hysterical personalities is enhanced. The need to increase self-esteem at the same time leads to new attempts to surprise others, to create an unusual, festive atmosphere. nine0003
Naturally, aging causes a decrease in attractiveness, which is mainly of an external, superficial nature, which, accordingly, leads to the emergence of age-related crises.

Tantrums need a partner, but not in the same way as depressed individuals who cannot live without committing themselves to him; they need a mirror that reflects their ability to arouse love in order to increase their own unstable self-esteem. Their self-admiration needs constant confirmation. They easily succumb to flattery, which they willingly believe. They need a partner, first of all, in order to enlist his confirmation of their charm, beauty, value and attractiveness. In this regard, they are prone to narcissistic partner choice, however, not due to the fear of "all other" persons of the opposite sex, as is the case with schizoids, but especially because they hope to find their own likeness in the partner, in which they regain and love themselves. nine0003
Quite often, hysterical individuals of both sexes find nondescript and unobtrusive partners for themselves in order to exalt themselves against their background and be the object of their unconditional adoration. This is reminiscent of the fable about the peacock who wanted to marry a simple hen: in the registry book, the raven noted with surprise that the beautiful peacock wanted to register a marriage with a nondescript hen due to the fact that, as he pointedly noted, "I and my wife are crazy love me." Such a strong thirst for constant confirmation of one's own value and significance, of course, cannot be quenched, no partner can fully satisfy it. In this case, they are looking for a new partner who could play the role assigned to him by a hysterical personality. Desperate adventurers and cunning manipulators of men's hearts are, as it were, scalp collectors, whose self-esteem depends on the number of their victims and for whom love is a game for which one has to pay a high price. nine0003
As great as their demands for love are, so too great are the disappointments associated with these demands and hopes: dissatisfaction, whims, bad moods and nagging accusations after each new love adventure often end in financial costs and overt persecution of a partner whom they consider as their property and which, in their opinion, is not entitled to play an independent role. Since hysterical personalities' self-esteem is associated solely with evidence of love for them, they are insatiable in the means and methods by which they achieve this: they constantly compare a partner with others "who know how to love truly", while implying what others are able to do for them whatever they wish; they make scenes and passionately reproach the partner for “not loving them enough”, they react violently, catastrophically, if the partner moves away from them. At the same time, such a mixture of feelings and calculation is observed that the partner cannot understand what is the matter. nine0003
If love or marriage is based on illusory expectations, then the requirements for a partner exceed what the hysterical person puts in. This causes disappointment, this kind of relationship is recognized as unsuccessful and a new search for "great love" begins. Partner relationships of hysterical personalities are characterized by frequent breaks and reconciliations; in the end they demand compensation for their disappointment, in new relationships they are overly demanding, which becomes a source of new failures and failures. nine0003
We all get our first experience with the opposite sex from our parents, brothers and sisters. The relationship of parents to each other - whether their marriage is based on love or otherwise, - the love experience of our brothers and sisters - all this shapes our expectations of partnership, love and sex. Whether our parents have the happiness of mutual love or do without idealizing each other, pity, despise or even hate each other, whether we know about their capabilities, concerns and problems, their relationships, their joys and their mutual trust - our views depend on this. to choose a partner, our expectations and our ideas about their implementation in mutual existence. Parents, who are the ideal of superiority and infallibility for children, are forced to show them the perfect marriage, no matter what happens behind the scenes of this game. This ideal is what grown-up children hope to find in a partner. Parents who do not meet their children's needs to create ideas of the opposite sex cause them frustration and fear, which leaves a negative imprint on the expectations associated with partnerships. nine0003
The love life of hysterical personalities is further complicated by the fact that, being fixed on their first connection with a person of the opposite sex, they cannot completely renounce identification with her. In this respect, tantrums remain at that stage of the child's development, corresponding to 4-5 years, when, as we now know, he identifies with the impressions received earlier and develops the initial preforms of his ideas about his own and the opposite sex. Fundamentally, there are the following possibilities here: the childish reverence or idealization of a parent of the opposite sex or a brother (sister) in relation to a partner is repeated, from whom they expect the embodiment of the “dream of a man” (“dream of a woman”), or previously experienced disappointment, fear and hatred, caused by unprocessed childhood impressions of the person who cared for the child, how negative experiences are transferred to the partner. In this case, the partner is treated with prejudice and from the very beginning of the relationship, it is expected that it will be painful. There is a projection of the original image of the mother or father onto the partner and installation on this initial image, regardless of what role the partner actually plays, i.e., it becomes stuck in the long-standing role of "son" or "daughter". nine0003
A son disappointed by his mother may develop misogyny, he takes revenge on his partners for the disappointment he suffered, becoming like Don Juan, who seduced and then left women, causing them the same pain that his mother caused him. Daughters disappointed by their father take revenge on men in the same way: they develop man-hatred or a false idea of \u200b\u200bfemale emancipation - they not only strive to realize equal rights with men and increase their own significance, but "turn the spear in the opposite direction", demanding equality for reasons of revenge and while taking a purely feminine position. Or they throw men away from them, considering contact with them as a meeting with an unloving, rejecting father ("if you do not love me, then I do not want to pay attention to you, and get out" - the psychodynamic basis of some virgins). Some of them, like Circe from Homer's Odyssey, attract men only with their sexuality, choosing various forms of seduction, and in doing so use and humiliate men, "turning them into pigs." Close to this type are those women who make excessive physical, psychological and material demands on men, using, exhausting and depriving them of strength and power, as if "castrating" them and humiliating their manhood. Such "demonic" women prone to ruin and destruction are often found in Strindberg's novels and plays. In the end, disappointment with the opposite sex or fear of it leads to homosexuality. It may also be that in this case a sister or brother replaces the mother or father. nine0003
The association with first impressions of a person of the opposite sex caring for a child is a universal human phenomenon that the French have expressed as follows: "We always return to our first love."

Examples of dependence on the person who cared for the child in early childhood on their "family romance" are so well known that hysterical personalities often find themselves in a situation of "triangular" dependence, in which their position between two parents is subconsciously repeated and which is often found in as the basis for structuring the personality in a family with an only child. It seems to them that, being in such a "triangle", they are thrown to the will of fate and often, referring to "fate", they say that they are constantly "pushed" into such relationships that all the men or women they met, already connected to others. In fact, in search of a partner who is connected with another, knowing that he is not free, hysterical personalities, as it were, renew their long-standing rivalry with their mother or father. They are fixed on taking the chosen one away from the other, entering into a rival relationship with the abandoned one, and in every possible way strive to prick him, at the same time demanding seriousness, responsibility and manifestation of stormy joy from the new connection from the lover. nine0003
Getting to know each person's love stories helps to understand their behavior. Hysterical personalities continue to sin and make mistakes, while denying any connection of their behavior with the family history, and believe that their femininity or masculinity developed normally. Sometimes they have no idea about the development of their own sexual role and respond to any sexual demands, making their gender identification in its various versions dependent on its evaluation by a partner. At the same time, it should be borne in mind that the development of femininity or masculinity also depends on mental and sexual maturity. nine0003
The main problems in the life of hysterics are seen in connection with love and partnerships with their illusory expectations and ideas about life, love, marriage, and in general about the opposite sex. Their demanding position in relation to others, without being ready to satisfy the needs of the partner and take care of him, leads them to new disappointments, giving them the right to conclude that the attitudes of hysterics are based on illusions and therefore disappointment is so inevitable. Passionate and active desire, combined with requests full of joyful anticipation without one's own participation in creating such relationships, is the problematic side of these personalities. nine0003
When choosing a partner, their position, opportunities, title and other external attributes that characterize their value and significance are important for them. And in this they remain children, who are impressed by external attributes, which, as it seems to them, are the source of a good life; they tend to blame their partner for their disappointments. Fear of their own inadequacy causes them to desire to confirm their ability to love, their self-worth, and they realize this attraction in their demands on the external environment. nine0003
The tendency to project one's own shortcomings naturally causes many problems in partnerships. Hysterical personalities can use various types of reproaches and find many reasons to blame a partner, making tendentious accusations, distorting facts, using "crooked logic", slander and intrigue. The relationship between hysterics and individuals with obsessive development, which are, as it were, opposite in structure, develops especially hard. The more the partner with obsessive development inexorably and consistently insists on his own and in the current situation categorically proves his case, the more the hysterical partner deviates from such a sequence, resorting to an incomprehensible "logic", jumping, as described by Schulz-Henke, from one thought to another , which resembles a completely random movement of pieces on a chessboard without established rules. At the same time, tantrums, on the one hand, tend to get rid of an annoying partner, and on the other hand, they want to dispose of him. Being flexible enough, they do not burn bridges behind them and leave an open way back. Instead, however, the obsessive developmental partner remains back against the wall, unsuccessfully trying to understand and interpret the experiences of his hysterical partner. nine0003
Schizoid partners instinctively avoid hysterical personalities, they easily guess them and show little readiness to admire them and confirm their claims. Therefore, hysterical personalities are more willing to choose partners with depressive development, who are ready to continue to fulfill the increased demands of hysterics; the duration of such an association is a good price for depressed individuals.

The relationship between two hysterical partners satisfies them only when the hysterical features are not very pronounced. Otherwise, rivalry and mutual teasing is an inevitable pitfall of such relationships.
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