A man walks into your house wearing a heavy gold chain around his neck and a Rolex watch. He tells you he is the mayor’s closest friend. He has come to your house to introduce himself because he has heard that you are the president of the local chamber of commerce.

A woman walks up to you on the street and says she loves your purse. She has just bought a Chanel on her most recent trip to Paris.

In either instance, chances are that you have encountered the classic histrionic personality disorder.

This person exhibits a chronic pattern of attention seeking and excessive emotionality consisting of at least five of the following:

  1. Discomfort when not the center of attention
  2. Exhibition of seductive or provocative behavior
  3. Shallow expression of emotions
  4. Drawing attention to self through physical appearance
  5. Speech that is excessively impressionistic, and lacking in detail
  6. Overly dramatic presentation
  7. Easily influenced
  8. Relatively shallow relationships

These individuals may be described as requiring “high maintenance.”

This person will often change his/her mind and requires you to abide by their changing decisions. He/she is swayed by the latest fad so that all within their sphere of influence are required to keep up with the Jones. They can embarrass you with their attention-seeking mode of dress e.g., plunging necklines or too tight pants. He/she is fickle and shallow and needs to be calmed down at times. Flattery must be constant.

These individuals are too insecure to carry on an adult relationship. They play head games. Life is one big soap opera. As a partner, you will need to instruct them as to how to display appropriate behavior and keep them calm.

I find the histrionic personality a sad person to treat. I perceive that they have an un-fillable hole of attention deficit. There is a never-ending need for attention and psychological stroking. It probably is rooted in extreme insecurity related to a past in which a parental figure either was not physically or psychologically present. This may also be that the person was raised on the shallow principle of you are what you own.

These individuals come to my office after a romantic disappointment or a financial set back. They have either alienated a significant other through inordinate demands for attention or have spent too much money to support an ostentatious lifestyle.

It is not difficult to establish a therapeutic relationship because of this client’s need for attention. They love talking about themselves. What is more difficult to do is to determine the source(s) of their insecurities. These are painful memories difficult to discuss. The therapist must also help the client to reestablish appropriate priorities.

Like most other personality disorders, the histrionic personality client may require depth therapy for two or three years. It will be a difficult task even if the therapist is experienced and empathetic. Also like other personality disorders, the histrionic personality disordered client requires the most artful of therapists to walk the line between breaking down defenses and being emotionally supportive.