Histrionic personality disorder - treatment in the clinic

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Hysterical personality disorder (hysterical psychopathy) is a disease that is manifested by demonstrative behavior and a person’s need for attention and positive assessments from others. The first symptoms appear in childhood and persist throughout life.

Psychotherapy is used to eliminate personality disorders. You can undergo treatment for mental disorders at Dr. Isaev’s Clinic. Traditional methods of psychocorrection and innovative developments in psychiatric practice are used here. The activities of the psychiatric department are licensed and approved by the Ministry of Health of the Russian Federation.

General information about the disease

Hysterical psychopathy is classified as a personality disorder. Characteristic manifestations are egocentrism, thirst for attention from others, demonstrative behavior and infantilism. Symptoms of the pathology are detected in 3-6% of the population of Russia and other countries. It occurs equally often in men and women.

People with hysterical personality disorder may not seek medical help. The pathology often does not affect their professional life, and they can achieve success in creative activities. However, in some patients, psychopathy progresses and leads to negative consequences: divorce, loss of property, loss of friends and loved ones.

General information

Hysterical personality disorder is a mental disorder in which the patient is extremely emotional, requires constant attention to his person and cannot react correctly to the world around him. Such a person values himself too highly, not considering neurotic disorders to be a disease.
In psychoanalysis, hysterical personality disorder is a condition of a person with a hysterical personality type, which is at the borderline level of personal organization. The movements of a person suffering from hysteria are sharp, the voice is very loud, sometimes inaudible. Behavior is feigned and unnatural. For example, psychologist Kernberg calls people suffering from this type of personality disorder impulsive and superficial . And Jaspers says that the hysteric feels the need to appear greater to others and to himself than he really is. Such symptoms of hysterical personality disorder are common to all patients.

These people constantly feel like they are “on stage”; when describing the most ordinary events, they resort to active gesticulation and theatrical gestures. For them, the main thing is to be the center of attention, for this they behave provocatively and defiantly, and dress brightly. At the same time, they are easily influenced by others.

The main goal of these people is to attract everyone's attention , to achieve this they constantly change, trying to impress. In fact, they may simply not understand what they are, they do not have their own views on life, they lack maturity and seriousness. Their main task is to gain approval and praise from others, “ a thirst for attention .” They are selfish, vain and very annoying, because they cannot delay receiving pleasure for a long time. Some even try to commit suicide, but only in order to manipulate others. These people have little substance, are empty, for them the most important thing is external impressions, they dramatize the most ordinary situations. If people suffering from this disease are not in the center of everyone's attention, they feel uncomfortable.

Hysterical psychopathy is characterized by a certain personality type; at a young age, child psychology identifies several signs of the disease.

In the preschool period, hysterics are characterized by a tendency to imitate, make up inventions, and have a rich imagination. During adolescence, egocentrism, frivolity, wastefulness, and participation in all sorts of adventures manifest themselves. Young people suffering from hysterical personality disorder are simply unable to work hard, do not fulfill their promises, and get involved in all sorts of adventures. They lead an idle life, rich in entertainment and new experiences. Such people follow fashion, often go to popular films and theater premieres, and love famous artists and acclaimed books. At a young age, hysterics easily fall in love, have numerous short-term affairs, show their feelings very violently, but quickly cool down to the object of passion. The same thing happens in friendships; they have many superficial acquaintances, but are not capable of deep affection. And usually in life they cannot find a person who would understand them and whom they could trust. Such people often enter into early and unhappy marriages.

Hysterics do not see the boundary between reality and their fantasies, between the objective world and their dreams, and the world around them takes on bizarre shapes. According to psychoanalytic data, hysterical disorders appear at the age of four to six years.

Hysterical personality disorder in women manifests itself in emotional lability. Such women easily come into contact with others and are distinguished by their theatrical and emotional behavior. They are sexually inhibited, cry often, are prone to romanticism, and are able to understand complex human reactions despite the immaturity of their own personality and emotionality. Some hysterical women appear timid and shy, but at the same time explore eroticism and seductiveness. Such women use manifestations of infantility as a defense against adult sexuality . Men suffering from hysteria are prone to emotional dramatization and may behave impulsively, demonstrating outbursts of emotion. Such men behave seductively, their sexual behavior looks infantile, and they show a tendency toward flirting and promiscuity.

To summarize all of the above, we can identify several signs that indicate the disease. If these 4 signs are present, we can talk about hysterical personality disorder.

if a person is not the center of attention, then discomfort is felt;
increased emotionality, emotions are not deep and changeable;
theatricality, too strong expression of emotions, dramatization of events;
exposure to other people's influence;
behavior is provocative, sexually provocative;
very emotional speech, inattention to detail;
increased attention to one's own appearance in order to draw attention to oneself.

The disease occurs on average in 2-5% of the adult population of the world, equally in men and women. Such disorders often occur among relatives.

Origins of the disease

The specific causes of the development of hysterical personality disorder have not been established. Psychiatrists believe that the occurrence of the disease is associated with three factors: genetic characteristics, the family upbringing system and organic brain damage in childhood.

Inherited character traits are different, but with hysterical psychopathy, transmission from parents of increased impressionability, emotionality and inability to notice small details is often detected. Damage to brain structures may be associated with pregnancy, childbirth, or early childhood.

In psychoanalysis, it is believed that a hysterical personality is often formed when parents transmit to their children attitudes that people initially have different power depending on their gender. status, social position. This occurs in a child’s childhood, including when adults refuse to accept his emerging sexuality. Not all psychiatrists agree with the opinion of psychoanalysts.

Features of a hysterical personality type

These people are easily suggestible. They can turn into whiners. They prefer to show off their body, although they themselves are ashamed of it and feel worse than others. They have a lot of unconscious anxiety, guilt and shame. Easily suppressed. They resort to dissociation to reduce affectively charged impulses. For example, “charming indifference” - confidence when remembering something that did not actually happen; the tendency to believe blatant lies that they themselves tell.

In such individuals one can note insatiable eating habits and attacks of hysterical rage. A hysterical personality, as a rule, reacts affectively. They can accumulate discontent and internal tension for some time, and then, at some point, they immediately throw out everything that has accumulated. If we look at how they perceive relationships between people, then they have unequal values for different genders. They may notice in childhood that parents or teachers pay more attention to their brothers or, if we are talking about boys, then sisters.

In their minds, there is unequal power between the sexes. Other people's attention is drawn to external manifestations. Boys, for example, were shamed for their feminine traits in the presence of girls. And she perceived femininity as some kind of power over a man. It has been noted that often the fathers of hysterical individuals were both fearsome and seductive. A loving father can instill fear in a little girl with his behavior. The girl perceived her dad as both an exciting and fearsome object. And if a girl sees that he dominates his wife (her mother), then the girl can conclude that people of her gender are valued less in society, and men should be approached with caution.

Boys raised in a matriarchy, where their maleness was denigrated, could also be contrasted with “real men.” Among persons with a homosexual orientation in families, such dynamics were observed.

A woman wants tenderness and love from a man's partner, but when he provides it to her, she may devalue this love, considering this man not masculine enough.

Clinical manifestations of histrionic personality disorder

Symptoms of hysterical psychopathy appear in childhood or adolescence. The main clinical manifestations include:

The appearance of psychological or physical discomfort in the absence of attention from people around.
Emotional manifestations are superficial.
Emotional lability is combined with frequent mood swings.
Extravagant and provocative appearance. Patients strive to attract the attention of other people.
Speech and gestures are pretentious, expressive, and different from the signs of normal reactions.
Patients try to provoke people to pay attention and talk about themselves. Provocations are of a different nature, including often having sexual overtones.
Events of the past are viewed through the prism of drama.
Hyperactivity and enthusiasm, which quickly pass and are replaced by apathy.
The sense of responsibility is reduced, and sometimes completely absent.
Patients with hysterical personality disorder are easily suggestible; it is easy for them to put some thought into their heads in order to use them for their own purposes.
Relationships with people and the degree of one’s own importance are assessed inadequately.

In psychiatry, it is believed that to make a diagnosis, it is sufficient for a person to have three or more of the above symptoms. It is important to understand that clinical manifestations of hysterical psychopathy do not always lead to antisocial behavior. The patient's desire to please people and receive their attention can be manifested by sociability, a desire to help, and general charm. Patients love to speak publicly and can interest others with their stories.

As psychopathy progresses, egocentrism and psychological infantilism intensify. The patient exhibits immaturity of judgment, perversion of behavior and emotional reactions, as well as lack of initiative.

Behavior of hysterics

As a rule, hysterics are inspired, capable of leading and captivating. However, this interest can quickly give way to another.

The hysterical monologue is endless, the interlocutor is drowning in word constructions that do not add up to a logically coherent text. “Well, don’t you understand, this is how it feels?”

They can talk about the same event that happened to them for hours. In terms of content, this text, if we convey only the essence, could fit in a few minutes.

Expressive. The hysteroid gesticulates a lot, and there are constant changes in intonation during the dialogue. It is not always clear what exactly he wants. The story is lively and full of colors, but it is impossible to trace a clear beginning and end.

If the task is to have a pleasant and eventful time, then the hysterical personality type is perfect.

The hysterical personality type lives by emotions and can be quite active and impulsive. This happens if he is interested in something.

Language for a hysteroid is a description of the emotions that he feels in large quantities. All activities that require an emotional and vivid monologue will be successful with hysterics.

Complications

These symptoms often lead to a person developing a tendency toward self-deception, which can reach an exaggerated degree. As a result, the patient always considers himself to be right, even if he commits antisocial acts or crimes. Hysterical personality disorder is typical for thieves, swindlers, rapists and other criminals.

Without treatment, hysterical psychopathy in women can lead to frigidity. At the same time, the patient arranges sexual provocations, flirts and shows sympathy for men. However, lasting relationships between them are not formed. Against the background of hysterical disorder, autonomic disorders are possible. These include nausea, increased body temperature, asthma attacks, movement disorders and other signs.

The main reason for their appearance is psychosomatics, which occurs as a reaction of the nervous system to severe psychological disorders. People with a hysterical personality are prone to a promiscuous sex life and abuse of alcohol and drugs. They are at increased risk of developing psychosis and depression, as well as other mood disorders.

Description

The concept of hysteria has a long history, spanning more than four thousand years (see summary in Vieth, 1977). The use of the term is controversial, and the concept of "hysteria" was rejected by feminists as a sexist label, often used to downplay women's issues whenever they made complaints that were not easily explained, or when they made demands that seemed excessive. The term hysteria has been used to refer to such disparate phenomena as temporary loss of control due to severe stress, conversion disorder, Briquette's syndrome, personality disorder and personality trait. It was perhaps most often used to describe patients who were easily excitable and difficult to treat. In a review of the phenomenon, Temoshok & Heller (1983) argue that "the diagnostic label 'hysteria' is impression-based, labile, vague, changeable, and superficially appealing like the various phenomena with which it has been associated" (p. 204 ). In an attempt to reduce confusion (and possible sexist connotations) regarding the use of the term hysteria, the American Psychiatric Association did not include the term in DSM-III (APA, 1980). Instead, separate categories of somatization, conversion disorder, hypochondriasis, dissociative disorder, and histrionic personality disorder (HPD) were designated.

Diagnosis of histrionic personality disorder

Patients with this disease often seek psychological and medical help on their own, as they remain self-critical in the first stages of the development of the pathology. This distinguishes them from patients with other mental disorders. Psychiatrists working at Dr. Isaev’s psychiatric clinic identify general criteria for psychopathy and specific manifestations of hysteroid disorder.

Common manifestations, according to the International Classification of Diseases (ICD-10), include:

altered thinking and perception of one’s own personality;
increased excitability or inhibition;
problems in personal life typical for psychopathy;
abnormal behavior persists from childhood;
behavior negatively affects adaptation in society;
a feeling of constant mental tension, which can lead to physical discomfort;
social and professional maladjustment, progressing over time.

Signs of hysterical personality disorder include theatrical behavior, demonstrative emotional reactions, excessive preoccupation with appearance, the need to be the center of attention and to feel recognized by other people. The diagnosis of hysteroidal psychopathy is made if a person has three or more general signs of psychopathy and 3 manifestations of hysteroidal personality changes.

When examined by a psychiatrist, the specialist examines the person’s complaints. As a rule, he may complain of discomfort in the area of the heart and chest. These symptoms are a manifestation of psychosomatics and require psychological treatment. To exclude organic causes of personality changes, electroencephalography (EEG), computer or magnetic resonance imaging of the brain is performed.

Treatment process

The sequence of treatment methods used for hysteroid disorder does not differ from similar mental disorders. There is no single medicinal way to completely get rid of problems. First, specialists establish contact with the patient and prescribe medications to normalize the functioning of the nervous system. In particular, a course of antidepressants is prescribed as one of the stages of cognitive behavioral therapy. In addition, conversations are held to determine the reasons for deviations. Based on this, the specialist prescribes various exercises for the brain and normalization of the psyche.

Treatment of hysterical personality disorder in Moscow

Treatment is not provided during the compensation period. Preventive measures are recommended for children and adolescents, which can be carried out by a child psychologist at an educational institution. These include psychological support, working with parents, and assistance in choosing a profession. This helps prevent decompensation of psychopathy.

Psychotherapeutic and drug treatment is prescribed for decompensated personality disorder. A psychotherapist works with a patient in a psychiatric hospital or outpatient setting. Various options for psychological assistance can be used: individual, family or group psychotherapy.

Medicines are prescribed for severe disorders. If a patient develops depression that is resistant to psychotherapy, antidepressants are used: Fluoxetine, Amitriptyline and others. They require regular use and lead to a significant effect after 3-4 months.

To eliminate hysterical reactions, antipsychotics such as Risperidone and its analogues can be used. Asthenia is an indication for the use of “mild” neurostimulants. Any medications are prescribed only by the attending physician. All psychotropic drugs have an extensive list of contraindications, non-compliance with which can cause serious complications.

Dr. Isaev’s clinic provides professional treatment for hysterical personality disorder in Moscow, and an individual course of therapy is drawn up for each patient. When compiling it, the patient’s age, signs of the clinical picture of the disease, and past treatment experience are taken into account. During consultations with a doctor, it is important not to hide any facts, even if they discredit the personality of the person contacted. The more accurately the diagnosis is made and the sooner correction begins, the better the result will be.

Literature

Kernberg, Otto. Aggression in Personality Disorders And Perversions. - Moscow: Class, 2001. - 368 p. — (Library of psychology and psychotherapy). — ISBN 5-86375-103-7.
Kernberg, Otto. Love relationships, norm and pathology = Love Relations. Normality and Pathology. - Moscow: Class, 2006. - 256 p. — (Library of psychology and psychotherapy). — 2000 copies. — ISBN 5-86375-124-X.
McWilliams, Nancy. Psychoanalytic diagnosis: Understanding personality structure in the clinical process = Psychoanalytic diagnosis: Understanding personality structure in the clinical process. - Moscow: Class, 1998. - 480 p. — ISBN 5-86375-098-7.

Preventive actions

Prevention of the disease should take place in early childhood and adolescence. It is non-specific:

the family should have a friendly and supportive psychological atmosphere;
parents explain to the child how to interact correctly with people around him and perceive his own personality;
when moving, transferring to another educational institution and situations accompanied by stress, a child psychologist works with the child;
assistance in determining a future profession.

If a person is diagnosed with hysterical personality disorder, then prevention is aimed at preventing his transition to the stage of decompensation. This requires eliminating any stressful situations, taking drugs and alcohol, and also ensuring positive relationships with loved ones.

Causes of the disorder

Genetic and psychogenic factors contribute to the development of antisocial personality disorder. The mechanism of development of impulsivity and aggression towards others may be associated with the pathological functioning of the serotonin transporter gene. The hormonal apparatus of a person with sociopathy produces less serotonin, as a result of which he is not able to take the necessary emotions from communication and experience empathy.

Sociopathy is five times more common in close male relatives than in other relatives. In families of patients with dissocial personality disorder, hysterical disorders are often detected. High criminal activity of family members, the presence of relatives suffering from alcoholism and drug addiction, poverty and unfavorable social conditions are also considered as factors contributing to the development of dissocial disorder.

The presence of mental illness in close relatives increases the risk of the disorder in children. In this case, a role is played by hereditary predisposition and adoption of behavior patterns from parents (quarrels between family members, violence, divorce of parents), and much also depends on methods of education (if relatives neglect the child, use violence, are inconsistent in discipline, etc.).

The cause of sociopathy, like other personality disorders, can be a lack of parental love and care in childhood, which leads to a lack of trust in people. A person with such experience is emotionally alienated and is able to establish contact with other people only through force. In some cases, family members may unknowingly instill in a person an antisocial behavior pattern - they give in to the child in order to maintain a good relationship, in response to his aggressive behavior or stubbornness. Excessive guardianship or neglect can also have an impact.

People with antisocial disorder have difficulty accepting points of view that differ from their own. Research has shown that people with this disorder are often less anxious than other people. Individuals with antisocial disorder have been found to be less able than controls to solve laboratory tasks, such as finding the way out of a maze, where the key reinforcers are punishments, such as some form of shock or monetary fine. When punishments were made more explicit or the subjects paid attention to them, learning improved. It is difficult for a person to learn from his mistakes, this may be due to the lack of an element that is key in the learning process.

Scientists have found that subjects with this disease react to the anticipation of stress with low brain arousal (slow arousal of the autonomic nervous system, low-frequency EEG waves). Due to low brain arousal, patients may find it difficult to perceive threatening situations, so they have little impact on them. Perhaps this is why antisocial and risky activities attract people, satisfying the need for more excitement.