Click here to view next page of this article

 

Histrionic Personality Disorder

Histrionic Personality Disorder: these are people who are overly emotional and tend to be disorganized. We want to increase the organization in their lives, we want to get them to be less emotional, less superficial, and have more stable relationships with others. Particularly in their marital or dating types of relations. We want to increase their capacity to delay gratification. In other words, to improve their impulsivity and often that can be done through the use of low-dose serotonin or histrionic personality disorder.

In general they are good candidates for long-term insight oriented psychotherapy, so long as the focus is on helping them organize their cognition, organize their lives and increase the depth of feeling. These are the patients you donít want to get involved in with some therapist who feels that the greatest thing in life is just to let it all hang out.

What we want them to do is to learn to control it, to contain it. To use cognitive problem solving thought mechanisms instead of emotions. Because they generally have conflicted and turbulent marriages, marital therapy is often very important. For those who have conversion disorder think that type of somatization, generally behavioral therapy is the treatment of choice rather than some type of insight oriented psychotherapy. Although insight oriented psychotherapy, I repeat, is useful for these patients on a long-term basis when we are looking at the subtle problems.

These patients are very seductive. They will try to get you involved with them socially and often sexually, and it goes both ways. Men will try to seduce their women physicians and the women will try to seduce their male physicians. This occurs a lot. Itís not just something thatís out there. It occurs a lot and it can really be disastrous for both the treatment of the patient and for you personally, if this occurs, especially as the Medical Board takes a low view of sexual contact with patients.