11. Histrionic PDO in Cple and Therapy - RonaldMah

Ronald Mah, M.A., Ph.D.
Licensed Marriage & Family Therapist,
Consultant/Trainer/Author
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The Sun, the Moon, and the Stars, Dependency and Histrionics in Couples and Couple Therapy
Chapter 11: HISTRIONIC PERSONALITY DISORDER IN COUPLES AND COUPLE THERAPY


The Hunter and Brandon (or the Hunter and the guy-of-the-moment) story is not an accidental meeting of two random individuals.  The pairing involves two individuals neither of which feels like a complete person- much less a competent person.  Each partner feels deficient when involved in important aspects of normal functioning.  As incomplete individuals, they look in others for what is absent within themselves.  Most people consider relationship possibilities based on healthy matches of mutual and shared interests, values, life goals, and perspectives.  However, an individual with histrionic personality disorder and a potential partner “underemphasize such factors and place a disproportionate emphasis on finding a mate who seems able to function in life in ways in which they personally feel incomplete and inadequate.  It is as if each had a ‘private pact’ (Sperry, 1978; Sperry & Carlson, 1991) that says, in effect, ‘Alone I can’t make it in life, but if I can find someone who makes up for my deficiencies, perhaps together we can function as one whole, competent individual.’  The histrionic partner conducts a search for the ideal mate with a number of expectations.  Perceiving herself to be fundamentally weak, helpless, and incapable of adequately conducting her own affairs, she searches for an ideal caretaker who can help her navigate the stressful vicissitudes of life” (Sperry and Maniacci, 1998, page 191).  Despite extravagant behavior, the histrionic may be self-aware enough to realize that emotional compulsivity drives behavior that ignores practical issues.  The individual struggles with rational consideration and adaptive actions that result in continual life crises and stress.  As a result, the stable “rock” of a partner is needed.  He or she compensates for the instability created by histrionic behavior by remaining intellectually collected, see things with clarity and rationally, and makes practical effective choices.  This search and the chosen candidate however is often a disaster in the making.  Ironically, the practical, rational, and intelligent candidate first shows his or her impractical, irrational, and unintelligent qualities by choosing to be with the histrionic person.  And, further proves that he or she is the right wrong choice by staying with the histrionic person.  And even further shows dysfunctionality by keeping on trying to be the partner the histrionic individual requires, despite continual mistreatment and neglect.

HISTRIONIC AND OBSESSIVE PARTNERS
While Hunter shows classic histrionic behaviors, Brandon may not warrant a personality disorder.  Low self-esteem or anxious adult attachment style could be sufficient motivators for his behavior.  Or, if a personality disorder were considered for Brandon, perhaps dependent personality disorder because of his willingness to submit to Hunter.  As presented in my book “Scorpion in the Bed, The Narcissist in Couples and Couple Therapy” (2013), a histrionic-narcissistic partnership is another possibility.  The narcissistic dominates but gives status and a vehicle for the histrionic individual’s need for attention.  In return, the flamboyantly attractive but shallow histrionic individual provides the requisite “eye candy,” flash, or charm on the arm of the narcissist.  Research has shown a common pairing of an individual with histrionic personality disorder with an obsessive partner that shows up for couple therapy.  Since women are more often diagnosed as histrionic, there the prevalence of histrionic-obsessive partner pairings shows more female histrionic partners and male obsessive partners.  “...the histrionic-obsessive couple is... still seen with regularity in clinical practice.  Martin’s research (1976, 1981) showed a preponderance of obsessive husbands and histrionic wives- represented by a couple he dubbed the ‘love sick wife and cold sick husband’- yet his data also showed a sizeable number of marriages with histrionic husbands and obsessive wives, which he called ‘in-search-of-a-mother’ marriages” (Sperry and Maniacci, 1998, page 187).

In the female histrionic and male obsessive pairing, “adulthood for the histrionic female became a search for a strong, idealized father-husband who would take care of her (Horowitz, 1991).  The obsessive personality, on the other hand, is believed to arise from feelings of not being sufficiently loved and valued by parents.  Accordingly, they seek perfection and avoid making mistakes, believing that if they can be perfect and flawless they can regain the parental approval and love they missed as children.  Similarly, intimacy is often avoided by these individuals out of a fear of being overwhelmed by powerful wishes to be taken care of.  At the same time these individuals are frustrated by these wishes for nurturance not being met, resulting in feelings of hatred and resentment toward others for failing to meet their need.  Intimate relations are threatening since they fear being ‘out of control,’ and so they tend to overcontrol others and situations.  This need to control others originates from their belief that nurturance is tenuous and unpredictable (Sperry, 1995A)” (Sperry, 2004, page 149-50).  Lex with obsessive personality thus craved yet avoided deeper intimate relationships.  When Lex met Xandes at a nightclub, she was captivating.  She gyrated on the dance floor whether there was music or not, and whether there were other dancers or a dance partner.  Lex watched her the entire evening as one guy after another hit on her and tried to pick her up.  She glorified in the attention, but never focused on any one guy.  There was always another one.  At the end of the night as people had paired off and others had called it a night, Lex made his move.  He went to her, took her by the elbow and said, “It was time to go.  There’s a place that serves outrageous burgers that you’ll love.  Let’s go.”  It was the right line at the right time.  It was the authoritative dominating behavior that met Xandes’ neediness.  They struck a deal to dysfunctionally meet deep needs unconsciously.

At some level Lex knew that he was incomplete.  As an incomplete man, he felt he could not be expected to be fully available to a partner.  Someone who wanted the “whole package” could not accept him.  Someone who would settle for him as he would settle for her was needed.  “He has chosen a woman who makes him feel like a man without requiring him to be authentic and assertive- both of which he finds so difficult...  He begins to realize that he is being exploited, that their relationship is a one-way street in which his partner does all the taking and he all the giving.  Her wants and desires always seem to take priority in the relationship.  Furthermore, he has great difficult in expressing the growing anger he feels toward his partner or taking a stand against her behavior.  On those rare occasions when he is forthright, his assertiveness is met with dire consequences.  Predictably, she becomes rageful.  Ultimately, the husband concludes that it is not worth fighting or taking a stand.  Instead, he settles into other ways of expressing his anger and preserving his sense of autonomy.  Typically, he employs passive-aggressive tactics learned in his family of origin.  He withdraws more and more from his partner, often into his job, citing as his justification the requirements of the job and the increasing expenses of the family.  He makes ever greater use of the tactic of ‘stonewalling’ (Gottman, 1994) or emotional detachment.  Finally, he gets even by abdicating his relational responsibilities outside those of breadwinner, resulting in his partner’s becoming overburdened with responsibilities and enormously harried in her attempts to fulfill them” (Sperry and Maniacci, 1998, page 194).  Although someone such as Lex settles for a complementarily incomplete partner, he gets more than he bargained for.  The tendency to intensify what is not working or find a new way to do the same thing creates a cycle of often increasing dysfunction.  Lex will maintain the dysfunction dynamic under significant stress for as long as he can.  While Lex feels stuck and as the loser in the deal, neither is Xandes the winner.

TEST, BIND, ANXIETY, RAGE
Xandes was drawn in the beginning to Lex being the take-charge person who made decisions, organized things  Lex seemed so competent when she had so much difficulty keeping it together.  However, she also had anxiety about his commitment and motivations.  In their own way, histrionic individuals can be very intuitive about others.  She could sense that beneath the confident persona, Lex really was not dedicated to her as much as he was using her for his own needs.  To test him, Xandes instinctively would provoke him by getting out of control.  That could be flirting with other men, “forgetting” agreed boundaries and expectations, or purposely doing things that he did not like.  Despite failing at controlling the uncontrollable histrionic, the obsessive partner such as Lex avoids overt complaints or even showing emotional reactions.  Rather than risk confrontation by expressing his dislike or discomfort and asserting needs, he may say that everything is okay or say nothing.  Fear of losing the relationship creates a bind where failure to demand changes leads to fulfillment of low expectations and growing resentment against Xandes.

The histrionic individual often does not offer enough depth for relationships to really progress, thus creating problems developing real intimacy.  On the other side, Xandes knows that Lex cannot be happy with poor treatment and obvious violations of commitments in the relationship.  Yet he does not really respond to either her deeper needs or to being mistreated.  “The realization that her obsessive partner can respond to her need only superficially is devastating for her.  Although her partner displays an endless willingness to listen to her troubles, to provide reassurance, and to present logical solutions to her difficulties, he offers little else.  Consequently, she feels overburdened and overwhelmed.  This state of affairs provides even more reason for the histrionic partner to experience an increasing sense of abandonment and rage as the months and years go by” (Sperry and Maniacci, 1998, page 194).  This leads Xandes to decide that Lex is not honest or trustworthy with her.  Perhaps she thinks, he does not react because he does not care enough about Xandes or the relationship.  Despite still attracting the obsessive individual’s attention, “The histrionic feels increasingly unloved, emotionally, abandoned, and unable to make intimate contact with his or her mate.  Furthermore, the histrionic partner experiences an increasing sense of rage” (Sperry, 2004, page 153).  Although, the partners seek each other to soothe vulnerabilities, they end up doing so in manipulative rather than cooperative ways.  “The histrionic misrepresents facts, dishonestly seduces, and exaggerates his or her feelings, whereas the obsessive pretends to have not personal needs or desires, or is not bothered by the histrionic’s behavior.  In addition, the histrionic pretends utter helplessness, feigns illness, threatens suicide, and finds other unfair means of exerting enormous pressure on the obsessive.  The obsessive may resort to passive-aggressive tactics, such as physical and emotional withdrawal, feeling avoidance, procrastination, and indecisiveness.  Through all of this, both partners remain remarkably uninfluenced by the rather extreme means taken by the other.  By their actions each is saying to the other that they will not be controlled” (Sperry, 2004, page 158).  Xandes begins to distrust Lex, but is not candid with herself about her motivations, nor is Lex with his.  Neither partner will own their need to maintain control.  “...both the histrionic and the obsessive partners are often dishonest in their attempts to control each other... The goal of getting each partner to abandon such tactics and to employ more honest, forthright, and fair measures in relating to each other is central in the treatment of this relationship” (Sperry and Maniacci, 1998, page 197).

When both partners have significant characterological issues, couple therapy is much more complicated.  Therapy may need to fundamentally shift from focusing on the interactions between the partners to simultaneously include individual psychodynamic work.  “The interlocking of… histrionic personality dynamics with… obsessive-compulsive dynamics would likely neutralize a systemic couple therapy approach.  Accordingly, a combined individual and couples approach that focused on these interlocking personality dynamics was indicated” (Sperry, 2004, page 160).  These dynamics play out within each partner and between partners at unconscious or semi-conscious levels.  Neither partner is likely to reveal the underlying vulnerabilities and anxieties that he or she is replicating from formative developmental experiences.  Xandes is likely to verbally assault Lex, which would ordinarily suggest communication work.  However, the communication therapy normally would not help Lex or Xandes understand what is not working between them and what can be done about it.  Communications training therapy to express or not express in certain ways is often waylaid by unarticulated intense emotions and projections.  Directions for gentle respectful language is acknowledged and then, forgotten as either partner- Xandes, in particular is triggered.  Instead “these attacks are often marked by scathing, global indictments of the partner’s character.  The histrionic assaults his or her partner simultaneously on numerous fronts” (Sperry, 2004, page 153).  The histrionic person may make extravagant purchases beyond any budget, have sexual liaisons, or become hypochondriac to try and trigger some response.  If the obsessive partner does not respond particularly to provocation, the histrionic may try the most intense manipulation- threatening or attempting suicide.

Despite compulsive histrionic behavior and compulsive manipulations, Xandes may also be aware of how unreasonable her actions are.  Since Lex as the controlling obsessive partner is also extremely attentive and giving, Xandes as “the histrionic is left with the painful notion that his or her partner is really a ‘great person’ who deserves better, that the histrionic is the helpless victim of overpowering and irrational emotions and actions, and he or she is doomed by external forces to be a “dysfunctional person.”  (Sperry, 2004, page 153).  The challenge of couple therapy is to bring the litany of subversive behaviors and choices out into the open.  Neither partner has much inclination to be or possess skills at being intrapsychically emotionally connected or psychologically insightful.  As such, the partners experience each other’s and their own compulsive behavior without awareness of the needs that they represent.  Couple therapy can seek to guide Xandes and Lex to communicate differently, but they are unlikely to do so effectively if they do not each voice their own feelings.  The therapist will uncover the depth and rigidity of each partner’s characterological survival mechanisms as he or she probes for insight and revelations.

DYSFUNCTIONAL COMPLEMENTARY MATCH
Couple therapy can delve into each partner’s needs, experiences, and resultant relational style to uncover how their relationship may be complementary.  Their attraction is likely to be based on personal aspects that are desirable and important to the other.  They mutually satisfy one another through their dysfunctional complementary match.  This works well until there is a crisis or conflict and one or the other or both partners get threatened.  “...courage begins to wane.  When cooperation and courage decrease, defensiveness increases and the attracting qualities come to be perceived in a much more negative way.  Whereas she previously viewed her partner as gentle and stable, now she describes him as weak and cowering.  Whereas previously she perceived him as being able to plan and structure things, now she sees him as domineering and inflexible.  Initially, he saw her as free-spirited, but now he views her as flighty, coquettish, and scatterbrained.  Rather than generous and giving, she is now deemed a careless spendthrift.  As courage wanes, so does trust.  The more two partners become defensive, the more they are likely to disown any responsibility for a problem and blame each other.  This is the basis of most couples’ conflicts” (Sperry, 1978) (Sperry and Maniacci, 1998, page 193).

CONVERGENCE AND DIVERGENCE
The relationship truism that opposites attract may be appropriate.  The professional experience and observations of the author is that while this is often true that opposites attract or that individuals with complementary traits are often drawn to each other, two extensions of the principle also seem relevant: convergence and divergence.  Partners who do well as a couple, over time become more like each other.  Each partner moves from his or her extreme stances to a more modulated position.  In other words, the partners converge and each partner becomes more like the other partner.  The overall dyadic sum balance may remain essentially the same but metaphorically as a +5 and -5 pairing rather than a +10 and -10 pairing.  The partners will find themselves able to reach a middle ground without as much personal challenge or distress from plus or minus “5” stances versus plus or minus “10” stances.  On the other hand, partners who do not do well as a couple, over time they tend to push each other and diverge to even more extreme relative positions.  Metaphorically, the partners become more extreme from a +8 and -8 pairing to a +15 and -15 pairing.   Reaching consensus from the more extreme plus or minus “15” is more difficult.

In the dynamic of a histrionic-obsessive couple getting more negative, the negative progression or divergence occurs as the histrionic partner becomes more and more flamboyant, self-centered, and provocative.  That is, the individual becomes more histrionic.  And, the obsessive partner becomes more controlling.  In the couple that gets closer, the positive progression or convergence occurs when the histrionic partner is more balanced attending to self and the partner and becomes less compulsively flamboyant.  At the same time, the obsessive partner becomes better able to let things go and more honest expressing his or her feelings and needs.  Couple therapy attempts to break down the blaming game and enable each partner to take responsibility.  Identification that their opposite or complementary characteristics were and possibly or probably still are beneficial to one another helps remove blame.  Each partner needed the other.  Conscious admission of needing the partner’s personality traits and behaviors validates their coupling.  From honoring the fundamental pairing rather than condemning each other’s personality, the therapist can guide the partners to modulate rather than eliminate behavior.  Since the behaviors in question are characterological, elimination of behavior is most probably impossible.  However adjustments are more probable.  Once again, the rigidity of the characterological traits as they resist adaptation will influence the success of this strategy in couple therapy.

ADDRESS:
433 Estudillo Ave., #305
San Leandro, CA 94577-4915
Ronald Mah, M.A., Ph.D.
Licensed Marriage & Family Therapist, MFT32136
CONTACT INFORMATION:
(510) 614-5641 or (510) 582-5788
fax: (510) 889-6553
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