Tap to Read ➤

Histrionic Personality Disorder Treatment Guidelines

Shalu Bhatti May 6, 2019
Histrionic personality disorder affects 2-3 percent of people around the world and therefore not much is known about this condition. Here we will take you through some effective treatment guidelines for this condition, and help you understand it in a better way.
Histrionic personality disorder is defined as the condition wherein a person is constantly seeking attention from people around him/her. The American Psychiatric Association defines this personality disorder as a personality disorder which is characterized by a constant pattern which involves excessive attention seeking and emotionality.
In order to gain this attention, these individuals use tactics like seductiveness, emotional intimacy, self grooming, throwing tantrums and emotional dramas. These people long for appreciation and tend to get very uncomfortable in an environment where they fail to be the center of attention. As quoted by Sam Vaknin -
"Histrionics are quintessential drama queens. They are theatrical, their emotions exaggerated to the point of a caricature, their gestures sweeping, disproportional and inappropriate. The histrionic is easily suggestible and responds instantly and fully to the slightest change in circumstances and to the most meaningless communication or behavior by others."
The main cause of this personality disorder is not known. Experts relate it to family history, genetics and the environmental condition the person has been through in childhood. An example would be if the person has witnessed loss of a loved one, or never got enough attention and love from both or one parent.
Due to these experiences during childhood, these people tend to go out of their way and do anything to seek attention and praise. It is also observed that women are more prone to suffer from this disorder than men.

Symptoms and Diagnosis of Histrionic Personality Disorder

"As the histrionics depletes one source of narcissistic supply after another, she glides from one relationship to the next, experiencing a range of shallow feelings and commitments in the process. This shallowness is reflected in the histrionic's speech which is impressionistic, disjointed, and generalized. ...
... Concerned only with the latest conquest, the histrionic uses her physical appearance and attire as a kind of conscious bait. It is ironic that histrionics often mistake the depth, durability, and intimacy of their relationships and are devastated by their inevitable premature termination". ~ Sam Vaknin
Diagnostic Guidelines According to the Diagnostic and Statistical Manual of Mental Disorders (DSM IV-TR)

The guidelines stated in the DSM IV-TR, referred by experts worldwide to diagnose a mental disorder, lay out the 8 symptoms, 5 out of which should be present, to be diagnosed with HPD. Have a look if symptoms appear to be similar to those mentioned ahead.
1. Being uncomfortable at places or situations where the person is unable to seek all the attention.

2. Approaching or interacting with others in a provoking or seducing manner which appears to be inappropriate.
3. Being very conscious about one's physical appearance so that one is able to draw attention of others.

4. Rapid shifting of emotions that may appear to be shallow to others.

5. Speaks in a very impressionistic manner which lacks factual details and information.
6. Being very theatrical, drama queen, and expressing emotions and feelings in a very exaggerated manner.

7. Is easily influenced by other people or circumstances.

8. Considering that relationships are more intimate than they actually are in reality.
Diagnostic Guidelines According to The World Health Organization's ICD-10

The World Health Organization lays about 6 symptoms, 3 out of which should be present in the patient so that the person can be diagnosed with histrionic personality disorder. These symptoms are as follows.
1. Being very theatrical, involving a lot of self-dramatization, and expressing emotions in an exaggerated manner.

2. The ability to get influenced by other people or circumstances very easily.

3. Obsessed with one's physical appearance and attractiveness.
4. Behaving seductively in words and appearance which is considered to be inappropriate.

5. Expressing shallow emotions or extreme emotions like uncontrollable crying or laughing, known as labile affectivity.

6. Constant seeking or looking for exciting and refreshing ways to be the center of attention.

Treatment Guidelines for Histrionic Personality Disorder

When it comes to the various treatment methods for this disorder, the point to be noted is that most of the time, people suffering from this condition are left untreated. The symptoms of histrionic personality disorder occur only during the early adulthood and tends to diminish with age.
The only condition wherein such people may actually seek medical attention is when they are suffering from conditions like depression because of being unable to get the attention that they want or if their condition is posing problems for them to live their life normally.
Though these people are very difficult to treat, there are various approaches that can help the patient live a more stable and normal life.


Psychotherapy is considered to be the most important and effective approach when it comes to curing histrionic personality disorder. A private counseling session with a therapist can actually prove to be of help in understanding the behavioral patterns of that patient.
This starts off really well as these patients are looking for someone to cater their emotional needs. On the other hand, there are chances that these patients might try to attract their therapist sexually.
However, the therapist has to act as a guide or rescuer, and clearly make the patient understand the right way to conduct oneself as a part of the therapy. The therapist should help the patient in a step by step manner and focus on the short term overcoming of problematic issues rather than long term.


Usually medications are not a part of the treatment plan unless the patient is suffering from certain physical symptoms that can be minimized with medications. Although, one should be really careful when it comes to prescribing medications to people suffering from this condition, as they can use the medication to harm themselves, mostly to gain attention!

Group Therapy

There is a mixed effectiveness of group therapy or family therapies when it comes to using these techniques to treat HPD.
While some experts state that using these therapies will help the patient learn how to control themselves from the self-dramatization and emotionality when in a group, there are other experts that state that these therapies are of no use as these patients will end up displaying a fake and shallow self to seek attention, which is not of any help.
These were some treatment guidelines that can actually help a person suffering from this condition recover, and live a much more stable and normal life. The main purpose behind the treatment is to bring a sense of stability in a person's physical and verbal conduct.
People who are suffering from this condition end up living a very unsatisfied and shallow life because of their dramatic and attention seeking nature. However, proper counseling with an experienced therapist can definitely bring about some change and cure, which of course, will take place slowly and steadily.
Which is why it is important for the family and friends of such people to be very patient and calm with them. Give the treatment a little time, and have faith. Your patience can help them live a much better and stable life.