Have you ever met someone colorful and dramatic yet also calculating and insincere? The kind of person who so craves attention that their clothes and even speech seem exaggerated and artificial? If so, you may have encountered a histrionic personality.
A personality disorder is different to a mental illness. Someone with manic depression, for example, or social phobia, does not necessarily have a personality disorder; they merely suffer from a particular kind of mental illness. A personality disorder, as the phrase suggests, means the entire personality is dysfunctional.
The DSM, or Diagnostic and Statistical Manual, recognizes ten personality disorders: paranoid, schizoid, schizotypal, borderline, anti-social, narcissistic, histrionic, dependent, avoidant, and obsessive-compulsive. Not everyone agrees with this list, by the way. For example, some argue that a depressive personality should be included. Others, like Theodore Millon, identify numerous varieties or sub-types of each personality disorder.
These personality disorders come in three clusters, known as A, B, and C. The first, cluster A, is made up of the paranoid, schizoid, and schizotypal. Those included in this group are eccentric and slightly detached from reality. The cluster C personality disorders – avoidant, dependent and obsessive-compulsive – are too in touch with reality. And they respond to it with fear and disgust. Some cope through the rules and rituals of OCD, some by clinging to a loved one, some by turning away from the world altogether.
Histrionics appear in Cluster B along with the anti-social, borderline, and narcissistic. All three tend to be erratic and emotional. They also struggle in their relationships. But whereas those in cluster C feel fear and disgust, those in cluster B tend to be contemptuous and arrogant. Histrionics and narcissists, for example, though they often look down on other people, also need their attention and approval. Above all, it is their odd behaviour that first strikes you.
The DSM identifies several distinct histrionic traits. Perhaps most fundamental of all, the histrionic want attention. When it is denied, or when others are dismissive, histrionics over react. And this usually begins early. The histrionic child, for example, can be insufferable: loud, attention seeking, and prone to tantrums.
Histrionics not only like to be the centre of attention, they feel uncomfortable when they are not. The histrionic's paradise would be the starring role in a stage musical: spotlights, bright clothes, garish make-up, and the rapt attention of an audience. They could indulge their love of the dramatic and be rewarded with applause.
It is worth pausing to emphasize this dramatic, emotional strain. The histrionic want attention, but they like to earn that attention through their behaviour. Such "drama queen" antics distinguish the histrionic from the merely arrogant or self-centred. An arrogant woman just assumes everyone likes her. At a party, for example, she will sit there in silence waiting to be entertained. The histrionic would never do this. They want others to be shocked, amused, or outraged by what they say and do.
The histrionic can also be flirtatious. But, once again, their flirting is dramatic and inappropriate. Indeed, their basic approach to members of the opposite sex is seductive. Again, this is a means of attracting attention. Once they gain that attention and secure their 'conquest', they move on to someone else.
Though the histrionic are emotional, these emotions tend to be shallow and insincere. Others sense this and brand them fakes or poseurs. They can also switch from one emotion to another with unnerving speed: crying one moment and laughing the next. Unsurprisingly, friends and work colleagues wonder if they really know them, if there is anyone authentic behind the tears and laughter.
If the histrionic cannot win attention through wit and intellect, they will adopt an exaggerated way of speaking and dressing. Their voice may be slightly louder than average, or they may adopt a fake accent – upper class British, for example. And their clothes and jewellery will be bright and striking.
The histrionic also struggle with intimacy. In part, this is because they do not understand how intimacy works. As a result, they over-estimate the closeness of their relationships. Then again, if you live a superficial life, more concerned with attention than depth, this is hardly surprising.
The American psychologist Theodore Millon identified no less than six histrionic personalities. Many of these sub-types appear closely related to other personality disorders. Co-morbidity is of course common. The avoidant personality disorder, for example, is closely related to the dependent, with around half those who suffer from the first suffering from the second. The histrionic is closest to the narcissistic. Histrionics are also more likely to experience depression, panic, and even anorexia.
The infantile histrionic, as the phrase suggests, is childish. Some quite literally sulk or throw tantrums. They are highly strung and demanding, but, like a child, also clingy. Work colleagues often find them unbearable and sooner or later yell at them to "grow up," which means tears, tantrums, and slamming doors. In turn, they will accuse colleagues of bullying or persecution, which also appeals to their love of drama.
With the theatrical histrionic, everything seems calculated to draw attention. This is especially apparent when they are being photographed or filmed. At such moments, they will strike absurd poses, throwing their chin back and placing one hand on their hip, etc. They also seem oblivious to the people around them.
The disingenuous histrionic is more of a schemer. As well as being self-centred and insincere, they can be manipulative. When dealing with money, for example, they make use of their theatrical skills to mislead and unnerve others. Put another way, the drama and tears form a kind of mask or smokescreen. In relationships, they will often be accused of manipulation.
The tempestuous histrionic tend to be described as "wild" or "a handful". Their partner needs to prepare for a bumpy ride, to say the least. Indeed, after a few months a new partner may find they cannot cope. The tempestuous are volatile and unpredictable. Storms of emotion can be whipped up from nothing.
The vivacious histrionic blend seduction with mania and narcissism. Still, of the six sub-types they are the most likeable. They possess a bubbly energy which charms those who hardly known them. Depressives, for example, often find them appealing. A melancholic man will be drawn to a vivacious histrionic woman like a moth to a candle flame. If the woman, or man, also happens to be physically attractive, their seductive power can be immense. Needless to say, it is rarely sincere.
Finally, there is the appeasing histrionic personality. This is close to the dependent. Such people seek to calm and smooth over disputes and arguments. If they form a relationship with a bad-tempered bully, they quickly learn how to cope with him. The appeaser understands people, knowing when to compromise or give way.
However, the attention-seeking is still there. The appeasing histrionic tend to play the martyr, sacrificing themselves to win praise. They also struggle to leave people alone. If someone is in a foul mood and behaving irrationally, friends and work colleagues usually stay away and let them sulk or burn out. The appeaser charges in, trying to placate someone who does not want to be placated. Again, by placing themselves at the center of a dispute they win attention. They also feed off the high emotional charge.
The histrionic personality disorder resembles what the late 19th century psychoanalysts called hysteria. Genetics could play a part, though at present this is unclear. Relationships with one's parents may also be key. In some cases, a parent will be distant but adored. The child longs for its mother's attention. But this is only granted on condition that the child wins and achieves. The child feels unable to do so and so shows off instead. A spoilt only child whose father worships her, on the other hand, may be shocked to discover that the rest of the world does not share his opinions! Her whole life then becomes a fight to win the attention she feels she deserves.
As for treatment, cognitive behavioral therapy may help. This teaches people to step back from their thoughts and behavior and observe them as if from the outside. Once they do so, they learn to catch the histrionic traits as they arise. Psychodynamic therapy may also help. This involves identifying the root causes, especially the relationship with parents, siblings, and school friends.
Life for the histrionic isn't always easy. Often, they experience emotional burnout, and rarely do they receive the attention they crave. Thankfully, our understanding of this, and other personality disorders, improves all the time.