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1. Strengths Based
Biopsychosocial Approach
to Recovery from
Histrionic Personality
Dr. Dawn-Elise Snipes PhD, LPC-MHSP, LMHC, NCC
Executive Director, AllCEUs
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2. Objectives
 Review the characteristics of Histrionic Personality
 Explore the functions of these symptoms
 Identify what may cause these symptoms to develop
 Explore what is maintaining these symptoms
(benefits to the client)
 Explore the effects of these symptoms on significant
others
 Identify interventions to help the person more
effectively manage emotions and relationships

3. First Step
 Address Emotional Dyscontrol
 Identify and prevent vulnerabilities
 Identify what works to help self-soothe
 Identify helpful distraction techniques
 Develop a safety plan
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4. Next Step
 Identify the most salient symptoms
 Their function (and alternate ways to meet that need)
 What it looks like
 How that behavior is being maintained (what are the benefits
and other ways to get the same benefit)
 Mnemonic
 Provocative (or seductive) behavior
 Relationships are considered more intimate than they actually are
 Attention-seeking
 Influenced easily by others or circumstances
 Speech (style) wants to impress; lacks detail
 Emotional lability; shallowness
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5. Provocative (or seductive) behavior
 Function
 Makes the person center of attention
 Provides as sense of control and power
 What Does it Look Like
 Make-up; physical appearance is used to draw attention to self
 Theatrical or exaggerated emotions
 Uncomfortable when he or she is not the center of attention
 Origins
 Conditional love
 Oversexualization
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6.  Effects/Benefits
 Relationships are often based upon shallow, dramatic
behavior
 Relationships are unstable when the person is not the
center of attention
 May have a more difficult time with the aging process
 Interventions
 Develop a positive self-concept based on more than
appearance
 Explore the origins of messages that the person had to
be attractive/sexual to be lovable
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7. Relationships are considered more
intimate than they actually are
 Function: Allows the person to feel loved and
important
 What does it look like
 Oversharing
 Lack of boundaries
 Believing oneself to be indispensable to another
 Origins
 Often from an overly enmeshed (modeling) or
disengaged (reacting) family
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8. Overly Intimate
 Effects
 The person with HPD generally over shares and expects
too much out of other people from the beginning.
 The perception of relationships being overly intimate
can also support the person’s need for attention
(name-dropping)
 Benefits
 For a short time the person may be able to exist in a
glamorous fantasy world (escape)
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9. Attention-seeking/Theatrical
 Function: Allows the person to believe themselves to
be the center of attention
 What does it look like
 Hugely dramatic displays to maintain your status as the
center of attention, whether it's negative or positive:
Starting screaming matches in public, making up stories
about alien abduction, always the life of the party
 Origins
 This behavior may have been developed as a way of
distracting from interpersonal chaos within the family
 It may have also been developed as a way to get attention in
a neglectful situation
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10. Theatricality
 Effects
 Presents an image of a drama-queen/king
 Certainly gets people’s attention, but not always for
the best
 Benefits
 Attention = Importance
 Drama/Chaos = Focusing on something “out there”
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11. Influenced easily by others or
circumstances
 Function: Chameleon like in order to remain the
center of attention…will jump on the popular
bandwagon
 What does it look like
 Opinions regularly change
 Often deferring to opinions of others
 Origins
 This can be reinforced in situations in which it is not
“safe” to have personal opinions (abandonment,
punishment, disapproval)
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12. Easily Influenced
 Effects
 Person can easily be taken advantage of
 Person may be viewed as untrustworthy
 Benefits
 Can be “liked” and “popular” in the moment
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13. Speech (style) grandiose; lacks
detail
 Function: Vague references make it easier to
change positions, manipulate information to be
the center of attention or maintain approval
 What does it look like
 Politicians
 Choosing extreme language … “I always…”
 “I am just so busy. I’m not sure when I will find the
time”
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14. Grandiose
 Effects
 Helps create a grandiose image of the person
 Like relationships that are overly intimate, this turns
simple events and feelings into huge productions
 Benefits
 Being vague and grandiose often keeps people from
asking too many questions
 The person may be able to avoid unpleasant things by
being “too busy” “exhausted” “totally crazy”
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15. Emotional lability; shallowness
 Function: Allows the person to use the most
effective emotion and change when necessary
 What does it look like
 I feel therefore I am
People with HPD tend to regard everything through the
lens of emotion, which in turn drives their dramatic
actions.
 Origins
 People start viewing feelings as facts
I feel angry, therefore I am justified in being angry (now
who can I blame)
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16. Emotional
 Effects
 Unpredictable emotions makes it very exhausting to be
in a relationship with this person
 The inability to separate facts from feelings often leads
to overgeneralization and keeps the person stuck in
misery and negativity.
 Benefit
 Since their actions and thoughts are based on how they
feel, people who have to be around them spend a good
deal of time trying to keep them happy
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17. Interventions
 Develop a stable, positive sense of self
 Use distress tolerance, mindfulness and coping skills
to deal with overwhelming emotions (usually anger
or fear)
 Examine and address beliefs that are contributing to
distress
 Learn about healthy relationships
 Mindfulness and self-awareness
 Unconditional positive regard
 Empathy
 Effective communication

18. Summary
 HPD belongs to the group of disorders
characterized by
 A lack of a sense of self
 Difficulty forming authentic relationships
 High levels of anxiety and emotionality
 People with HPD are often thought of as “drama
queens”
 One of the first goals of treatment is to identify
the client’s dysfunctional behaviors and their
function
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19. Summary cont…
 HPD symptoms are very common in today’s society which
may make it more difficult for the person to identify them
as problems or issues
 Therapists can assist the client in identifying target
behaviors by examining the effect of these behaviors using
motivational enhancement techniques
When you…..
 How does it impact
 Your mood/health/energy & why
 Your relationships & why
What types of things cause conflict or problems in your
relationships? Why? Is this something you want to
address?
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20. Summary cont…
 Most personality disordered behavior is
egosyntonic.
 Help the patient identify the behaviors they
exhibit which may be problematic
 Discuss in session what triggers those behaviors,
what function the behavior served and other ways
to meet that need.
 While it is true the behaviors characteristic of
personality disorders cannot be completely
erased, they can be boxed up and stored in the
archives
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