Histrionic personality disorder: the other Cluster B disorder

Histrionic personality disorder (HPD) is the forgotten step-child of the Cluster B group of personality disorders, which also includes the Borderline, Narcissistic and Antisocial personality disorders.

HPD: the “other” Cluster B disorder.

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NPD is of course the King of the Cluster B disorders (which is exactly the way a narcissist would have it). It’s one of the hottest topics on the Internet right now, with ACONs everywhere (adult children of narcissists) rising from the silence of abuse like vampire slayers on a mission of justice. In addition, there are probably hundreds of blogs and forums about NPD and the damage people with that disorder inflict on everyone else. If you Google the word “narcissist” or “narcissism” you will see thousands of articles, personal stories, quotes, videos and support groups for victims of narcissistic abuse (but only a sprinkling of the same for people WHO HAVE the disorder–because NPD normally hurts its victims more than its sufferers).

Borderline personality disorder (BPD) is also widely discussed on the web, and it appears to be a common catch-all diagnosis, especially for women who were victims of abuse or sexual abuse and show emotional instability resulting from that. People diagnosed with BPD may actually be suffering from an array of other disorders (such as PTSD) and labeled BPD because the experts have so little understanding of BPD and it might not even be a real disorder anyway. Or maybe it is a real disorder but is a lot rarer than you’d think because so many people (mostly women) are erroneously diagnosed with it. In any case, there are blogs, support groups and forums all over the web for people with BPD and those who love them (or must cope with them).

And finally, if you’re like me and enjoy reading about psychopathic and sociopathic murderers, serial killers, mass murderers, cult leaders, and other violent (and non-violent) criminals, you are going to find out a lot about Antisocial personality disorder (ASPD), which is actually at the top of the narcissistic spectrum if you’re of the school of thinking that believes narcissism runs on a continuum from merely manipulative to heinous beyond words. Sociopath World is an interesting website that features blog posts written by ASPD writers. If you like this sort of stuff, or are just curious to find out what the inside of a sociopath’s head is like, I recommend checking out the site.

A fourth (and rather interesting) Cluster B disorder, HPD or Histrionic personality disorder, somehow got lost in the Cluster B shuffle. You don’t hear much about it and there’s very little written about it either, except for cursory mentions in the psychological and psychiatric literature, and it’s rarely featured by itself–it’s only mentioned in articles about the Cluster B disorders in general. But while it’s not widely talked about, Histrionics (mostly women) are frequent characters in movies, novels and TV shows because they make good theater.

histrionic_symtoms

People with HPD crave attention, so much that Sam Vaknin speculates that HPD may actually be the somatic, “female” form of NPD–or at least resembles it a lot. Most (but not all) Histrionics are women. A woman with HPD will act very much like a somatic narcissist, but may show somewhat more empathy or genuine (but shallow) emotion than a true narcissist. In fact, showing emotion is what Histrionics do best–hence their name. Their exaggerated emotional displays are over-the-top and dramatic. They are the original drama queens. I’m going to go out on a limb here and speculate that a lot of male HPD’s are probably flamboyantly gay men of the type who have exaggerated feminine affectations and interests (this is certainly not a slur on gay men, just an observation). Histrionics are also easily bored and besides attention, crave constant activity or social interaction. They tend to smother those they become attached to.

For convenience’s sake (and because most histrionics are women), I’ll describe a hypothetical woman with this disorder.

Histrionic Haley.

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Haley was the youngest child of her family of origin, and also the prettiest. At the age of 12, her parents divorced and her mother remarried. Haley’s stepfather appeared to love her–but that was just how things appeared. In actuality, he came into her room at night and forced himself on her, telling her how pretty she was and what a beautiful woman she was turning into. He made her strip naked and lie down on the bed while he fondled her developing breasts. When Haley questioned him about why he did this, her stepfather told her he was just “checking to see how she was developing.”

Haley was spoiled by both her mother (a narcissist who actually hated Haley for “seducing my husband” but still needed her because Haley made HER look good) and her stepfather, who constantly bought her clothes, mostly revealing outfits that showed off her adolescent curves.

Haley was never encouraged to think for herself or develop her mind or any skills other than her physical appearance and flirting ability. Her mother, a somatic narcissist, taught Haley that acting helpless and exaggeratedly feminine was the most effective way to attract a boy. Haley was spoiled rotten but abused at the same time. She was attractive, obsessed with clothes, makeup and shopping, and used her “feminine wiles” to attract boys, who she proceeded to manipulate (usually using sexy smiles, skimpy outfits, exaggeratedly demure behavior, or tears) to get whatever she wanted.

Haley was highly romantic–besides being obsessed with cheap romance novels, she was constantly “in love” with someone. Unfortunately she never learned how to love anyone on a deeper level because she didn’t know how to give, only take. She learned that sex was the best way to obtain what she wanted, and that’s all most of her lovers wanted her for anyway, so she was more than happy to oblige. Due to her immaturity and emotional instability, she was prone to drawn out, over the top tantrums when she didn’t get her way. Of course, her frequent temper tantrums, crying jags, unreasonable demands, and general high-maintenance behavior caused all her relationships to be short lived. With each breakup, Haley got worse, and upped the ante for the next relationship, believing she hadn’t asked for enough the last time. It never occurred to Haley that she might be too demanding and high maintenance. She never learned from her own mistakes, because being needy and demanding was all she had ever been taught.

Haley had good social skills, and became the life of any party she attended. While she had no close friends (due to her inability to maintain any deep and meaningful relationship), she had plenty of acquaintances and casual friends, who though of her as a dynamic, fun and exciting woman. She had lots of charm, was very pretty, and adored being the center of attention–just as she had been in her family growing up. Each year she would throw herself a huge birthday party, and expansively invite more people than she could realistically afford to entertain. But that didn’t matter because she had so many admirers, no one cared that the food and drink always ran out. Haley kept everyone entertained. Even though she’d almost always wind up sobbing loudly and theatrically at some point due to some slight during these parties, even that in itself kept her admirers around, who became protective of her. Haley basked in all the solicitous attentions she received.

Haley also used her sexuality in inappropriate ways. On several job interviews, she wore revealing see-through tops or short shorts, or allowed her bra strap to “accidentally” fall down her shoulder from under a tight spaghetti strap tank top. She openly flirted with her male interviewers. While a couple of employers fell for the bait and hired her–Haley was never taken seriously as an employee and then she’d tearfully complain to anyone who would listen about how she was treated like a sex object and got no respect.

How HPD differs from BPD

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Histrionic personality disorder resembles BPD in some ways–but the Borderline is ambivalent about relationships and tends to alternately smother and abandon people–their tendency toward “splitting” (black and white thinking) causes them to idealize others followed by devaluation or pre-emptive rejection when they perceive a slight. A histrionic will just keep on smothering and making more demands. They lack the ambivalence of a borderline.

While a borderline may be sexually promiscuous or seductive, not all are–and they don’t use their sexuality or body to exclusively the way someone with HPD does. Borderlines also tend to be more self-destructive (cutting, eating disorders, drug abuse, compulsive gambling, etc.) than a Histrionic, and more prone to suicide or suicidal ideation, as well as having dissociative and sometimes psychotic symptoms that Histrionics lack.

6 thoughts on “Histrionic personality disorder: the other Cluster B disorder

  1. I like your phrase “rising from abuse like vampire slayers on a mission of justice”, very poetic. Remember you will need wooden stakes, silver bullets and lots of garlic to confront those narcissists that are lurking in the Transylvanian forests.

    It is interesting to read those sociopath posts. My favorite sociopath is T-Bag from the show Prison Break, have you ever seen that? T-Bag is interesting because hes 99% evil and 1% redeemable; when he’s not doublecrossing or killing people; he cares (a little) about his mom. What’s your favorite?

    I have not even heard of histrionic personality condition being discussed for years. IMO it is hardly ever diagnosed anymore and has fallen by the wayside, even in medical model circles. There are very few books about it, unlike borderline or narcissistic conditions. It was more common in the time of Freud, early 20th century, and was not considered so negative then. And yes, I’d have the same criticisms of non-validity and non-reliability against histrionic personality disorder (as against BPD/NPD), if it’s considered as a disorder that one has or doesn’t have… I’d say that HPD, the “diagnosis”, exists just like unicorns, minotaurs and griffins do; as exaggerated caricatures in people’s minds, not in the real world of nuance and ambivalence… There are degrees of histrionic traits and ways of relating that a person can have to different degrees. It’s more important to ask why the person is acting or behaving this way, understand what brought them to this point, than to label them as having or not having some disorder. As for Vaknin, his writing about these “disorders” is totally unscientific and should be taken with a grain of salt. Vaknin’s “work” splitting and projections of his own distorted views of other people written all over it. To me it’s mainly good for entertainment, because I enjoy seeing how incredibly much he can distort reality in a matter of a few sentences.

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    • That’s interesting info you just provided in this comment. I was not aware it wasn’t even taken seriously anymore by mental health professionals as a diagnosis. I also didn’t know the label had more validity back in Freud’s day. Of course I know about Freud’s famous cases of Victorian women developing “hysterical” disorders like blindness and paralysis as a result of the societal restraints they were under. Are you sure you’re not talking about that?

      I only used Vaknin’s description here because I could not find another reference to anyone describing HPD as a somatic form of narcissism (unless they were actually quoting him), but it actually makes sense to me so I used it. I think most cases of “HPD” these days are either diagnosed as BPD (for women) or either NPD or BPD for men.

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      • This is just something that Vaknin fabricated, as usual. There’s no science or evidence behind it. It must be easy to make this stuff up when you are sitting at home bored to death reading about fictitious disorders all day long on your computer.
        Yes, in Freud’s day neuroses and hysterias were the two common problems, supposedly. Ironically, there were certainly many narcissistic and borderline people then, but the labels weren’t as widely used or medicalized as today.
        Again the point is that these diagnoses are not yet reliable classifications; you know that I think that. In my view, the pressure should be on psychiatrists and the APA to prove that the classification system they’re using is reliable and valid via discovery of biological underpinnings for these “disorders” and interrater agreement much higher than the kappa (agreement level between two psychiatrists on what disorder the same person has) ratings reported in the most recent DSM 5. If they can do that, it should be accepted, but that has not occurred yet.

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        • That first bit about SV was pretty funny. 😀

          I agree that back in Frued’s day, what might be diagnosed “narcissism” or BPD now would have been diagnosed “neurosis” back then. Maybe not ASPDs though.

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