8. Audience for the Histrionic - 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 8: AUDIENCE FOR THE HISTRIONIC


The classic existential question offers insight into the individual with histrionic personality disorder.  “If the tree in the forest falls and no one hears or sees it fall, then does it exist or did it really happen?”  For the histrionic individual, it becomes “If I am, and no one hears or sees me, do I really exist?”  He or she becomes desperate with fear that he or she doesn’t really exist or count unless someone is present watching, experiencing, and adoring him or her.  The sun, the moon, and the stars fill the celestial heavens and captivated the attention of humanity around the world.  They exist from before time and through eternity.  This attention is confirmation of inherent value.  The individual with histrionic personality disorder doubts his or her inherent value, and thus desperately craves attention as validation.  He or she is often not content to be a part of the universe… a member of a couple, a family, a workplace, or other community, but the focal point for everyone else.  The histrionic individual is then likely to engage in extreme behaviors to gain an audience again.  Through it all, the individual appears to be unaware of the quality of his/her behavior.  From OutoftheFog.net (2012) are the following questions that may indicate that one is dealing with an individual with histrionic personality disorder.

“Do you live with a drama queen or a drama king?

Are important problems or concerns you have to face taking a back seat to the imaginary or exaggerated problems of a loved one?

Are you trying to cover up the abnormal behavior of a loved one?

Do you frequently find yourself trying to bring a family member or significant other back down to earth?

Have you ever wondered how bad it would get if a real crisis ever did strike?

Do you find yourself giving up things that you need just to placate a family member?

Are healthy relationships and activities you enjoy perceived as a distraction from your assigned role - managing the all-important concerns of a family member?

Are you trying to fill the black hole of someone else’s emotional need?

Do you find yourself hiding your needs from a family member or loved one?

Are you unable to discuss your concerns, fears, goals and dreams because to do so would only create conflict in the relationship?

Do you fear picking up the phone when a loved-one or family member calls you?

Do you wear yourself out to meet the emotional needs of a family member, only to find that your efforts are in vain?

Are you chastised for caring for others?

Are you cut off from contact with other family members, friends, people you care about?

Are you afraid to take a night out with friends?

Do you find yourself letting healthy relationships die because of the competition it creates?

Does a loved one ever promise you how much better things would be if you would just take care of their needs, only to criticize you for letting them down when you try?

Do you suspect your loved one of making up problems just to draw attention to themselves?

Do you feel trapped? alone?

Do you feel as though nobody understands what you are dealing with?

If the answer to any of these questions is “yes” then it’s possible you may be in a relationship with someone who has Histrionic Personality Disorder - or HPD.  HPD is a serious condition that isolates those who surround the people who have the disorder.  HPD is characterized by a tendency to draw an inappropriate amount of attention - whether good or bad - to oneself.  A mnemonic that is sometimes used to describe the criteria for histrionic personality disorder is ‘PRAISE ME’:

P - provocative (or seductive) behavior

R - relationships, considered more intimate than they are

A - attention, must be at center of

I - influenced easily

S - speech (style) - wants to impress, lacks detail

E - emotional liability, shallowness

M - make-up - physical appearance used to draw attention to self

E - exaggerated emotions – theatrical” (OutoftheFog.net, 2012).

Out of the Fog includes an extensive list of histrionic personality disorder characteristics and traits.  While the individual may not exhibit all these characteristics and traits, a preponderance of them may indicate at least strong histrionic tendencies if not histrionic personality disorder.  The list follows.

Acting Out - Acting Out behavior refers to a subset of personality disorder traits that are more outwardly-destructive than self-destructive.

“Always” & “Never” Statements – “Always” & “Never” Statements are declarations containing the words “always” or “never”.  They are commonly used but rarely true.

Anger - People who suffer from personality disorders often feel a sense of unresolved anger and a heightened or exaggerated perception that they have been wronged, invalidated, neglected or abused.

Baiting and Picking Fights - Baiting and Picking Fights is the practice of generating a provocative action or statement for the purpose of obtaining an angry, aggressive or emotional response from another person.

Belittling, Condescending and Patronizing - Belittling, condescending & patronizing speech is a passive-aggressive approach to giving someone a verbal put-down while maintaining a facade of reasonableness or friendliness.

Blaming - Blaming is the practice of identifying a person or people responsible for creating a problem, rather than identifying ways of dealing with the problem.

Bullying - Bullying is any systematic action of hurting a person from a position of relative physical, social, economic or emotional strength.

Bunny Boiling - Bunny Boiling is a reference to an iconic scene in the movie "Fatal Attraction" in which the main character Alex, who suffers from Borderline Personality Disorder, kills the family's pet rabbit and boils it on the stove.  Bunny Boiling has become a popular reference to how people sometimes exhibit their rage by behaving destructively towards symbolic, important or treasured possessions or representations of those whom they wish to hurt, control or intimidate.

Catastrophizing - Catastrophizing is the habit of automatically assuming a "worst case scenario" and inappropriately characterizing minor or moderate problems or issues as catastrophic events.

Chaos Manufacture - Chaos Manufacture is the practice of unnecessarily creating or maintaining an environment of risk, destruction, confusion or mess.

Cheating - Cheating is sharing a romantic or intimate relationship with somebody when you are already committed to a monogamous relationship with someone else.

Circular Conversations - Circular Conversations are arguments which go on almost endlessly, repeating the same patterns with no real resolution.

Compulsive Lying - Compulsive Lying is a term used to describe lying frequently out of habit, without much regard for the consequences to others and without having an obvious motive to lie.  A compulsive liar is someone who habitually lies.

Denial - Denial is the practice of believing or imagining that some painful or traumatic circumstance, event or memory does not exist or did not happen.

Depression - When you feel sadder than you think you should, for longer than you think you should - but still can't seem to break out of it - that's depression.  People who suffer from personality disorders are often also diagnosed with depression resulting from mistreatment at the hands of others, low self-worth and the results of their own poor choices.

Domestic Theft -Domestic theft is consuming or taking control of a resource or asset belonging to (or shared with) a family member, partner or spouse without first obtaining their approval.

Emotional Blackmail - Emotional Blackmail describes the use of a system of threats and punishments on a person by someone close to them in an attempt to control their behaviors.

Engulfment - Engulfment is an unhealthy and overwhelming level of attention and dependency on a spouse, partner or family member, which comes from imagining or believing that one exists only within the context of that relationship.

Entitlement - Entitlement or a 'Sense of Entitlement' is an unrealistic, unmerited or inappropriate expectation of favorable living conditions and favorable treatment at the hands of others.

Escape To Fantasy - Escape to Fantasy is sometimes practiced by people who present a facade to friends, partners and family members.  Their true identity and feelings are commonly expressed privately in an alternate fantasy world.

False Accusations - False accusations, distortion campaigns & smear campaigns are patterns of unwarranted or exaggerated criticisms which occur when a personality disordered individual tries to feel better about themselves by putting down someone else - usually a family member, spouse, partner, friend or colleague.

Favoritism - Favoritism is the practice of systematically giving positive, preferential treatment to one child, subordinate or associate among a group of peers.

Frivolous Litigation and Frivolous Lawsuits - Frivolous Litigation and Frivolous Lawsuits are methods of withholding support, harassing or prolonging conflict by bringing unsubstantiated accusations, meritless appeals or diversionary process into a relationship or a former relationship using the court system as a proxy.

Hoovers & Hoovering - A Hoover is a metaphor, taken from the popular brand of vacuum cleaners, to describe how an abuse victim, trying to assert their own rights by leaving or limiting contact in a dysfunctional relationship gets "sucked back in" when the perpetrator temporarily exhibits improved or desirable behavior.

Hysteria - Hysteria is inappropriate over-reaction to bad news or disappointments, which diverts attention away from the problem and towards the person who is having the reaction.

Impulsiveness and Impulsivity - Impulsiveness - or Impulsivity - is the tendency to act or speak based on current feelings rather than logical reasoning.

Infantilization - Infantilization is the practice of treating a child as if they are much younger than their actual age.

Munchausen's and Munchausen by Proxy Syndrome (MBPS) - Munchausen's Syndrome is a disorder in which an individual repeatedly fakes or exaggerates their own illness or medical symptoms in order to manipulate the attentions of medical professionals or caregivers.  Munchausen by Proxy Syndrome (MBPS) is a similar syndrome in which another individual, commonly a child, is substituted for the patient and made the focus of inappropriate medical attention.

Mood Swings - Mood swings are unpredictable, rapid, dramatic emotional cycles which cannot be readily explained by changes in external circumstances.

Name-Calling - Name-Calling is a form of Verbal Abuse which people sometimes indulge in when their emotional thought processes take control from their rational thought processes.

Panic Attacks - Panic Attacks are short intense episodes of fear or anxiety, often accompanied by physical symptoms, such as hyperventilating, shaking, sweating and chills.

Projection - Projection is the act of attributing one's own feelings or traits onto another person and imagining or believing that the other person has those same feelings or traits.

Push-Pull - Push-Pull is a chronic pattern of sabotaging and re-establishing closeness a relationship without appropriate cause or reason.

Raging, Violence and Impulsive Aggression - Raging, Violence and Impulsive Aggression are explosive verbal, physical or emotional elevations of a dispute. Rages threaten the security or safety of another individual and violate their personal boundaries.

Sabotage - Sabotage is the spontaneous disruption of calm or status quo in order to serve a personal interest, provoke a conflict or draw attention.

Self-Aggrandizement - Self-Aggrandizement is a pattern of pompous behavior, boasting, narcissism or competitiveness designed to create an appearance of superiority.

Self-Harm - Self Harm, also known as self-mutilation, self-injury or self-abuse is any form of deliberate, premeditated injury inflicted on oneself, common among adolescents and among people who suffer from Borderline Personality Disorder.  Most common forms are cutting and poisoning/overdosing.

Self-Victimization - Self-Victimization or "playing the victim" is the act of casting oneself as a victim in order to control others by soliciting a sympathetic response from them or diverting their attention away from abusive behavior.

Targeted Humor, Mocking & Sarcasm - Targeted Humor is any sustained pattern of joking, sarcasm or mockery which is designed to reduce another individual's reputation in their own eyes or in the eyes of others.

Testing - Testing is the practice of repeatedly forcing another individual to demonstrate or prove their love or commitment to the relationship.

Threats - Threats are written or verbal warnings of intentional, inappropriate, destructive actions or consequences.”

An individual with histrionic personality disorder is unlikely to have every characteristic and trait on this extensive list.  Many characteristics or traits are exhibited in individuals with other personality disorders or between otherwise non-disordered individuals, especially during intensive interactions.  However, when an individual shows a pattern of several of these characteristics and traits, it may be from histrionic personality disorder.

CHARMING AND FLATTERING
Brandon and Hunter have been dating for about half a year.  Brandon is ready to take the big step.  However, he has not been able to get Hunter to commit to a monogamous relationship, much less engagement and eventually marriage.  Brandon is a software engineer in an information technology startup that is moving towards an IPO (initial public offering) that should richly reward him for his involvement in building the business.  He is in his early thirties.  Hunter called herself an "actress/performer," but mainly she waited tables at a semi-fancy Italian restaurant.  Hunter wouldn’t say how old she is, but although she acts “young” she is closer to reaching thirty than just leaving twenty.  Hunter lit up with a huge smile, a cheery hello, and an exuberant handshake in the waiting room when the therapist came out.  She made an entrance into the office with Brandon trailing behind.  Hunter immediately praised the décor of the office… and kept the conversation on décor, shifting it shortly to her decorating plans for her apartment.  Within fifteen minutes, it became clear to the therapist that Hunter loved being a performer and is probably histrionic.  The therapist’s, that is anyone’s attention just filled her up with energy.  In the session, Hunter eagerly described in great detail the new performance art piece that she is doing in a small club in San Francisco.  Whenever the therapist’s attention moved away from Hunter, she seemed to lose interest in the interchanges.  She even looked off around the room instead of keeping eye contact on the therapist or Brandon.  Her body language indicated disconnection whenever she was not attended to.  When the therapist interacted with Brandon, Hunter would attempt to bring the conversation and attention back to her in any way possible.  Being loud, funny…grandiose facial, hand, and body gestures worked well to draw the attention to her.  Hunter acted as if Brandon was competing for the attention of the therapist.  When the therapist spoke, it was acceptable only to the extent the communication was directed towards or about her.  However, if the therapist spoke to Brandon or Brandon was speaking, Hunter became uncomfortable having lost being the focus of conversation.   It may be okay for a short period if Brandon was talking about Hunter, but it became intolerable to her if the therapist got Brandon to talk about his own experiences.  Even when cutting off Brandon’s words, Hunter did it in a charming manner that obscured the fact that it is an interruption.  

Hunter presented as fun to listen to.  She was very good at charming and flattering a listener.  When Hunter asked questions of the therapist or Brandon, she did not really want an answer. She would ask, "What do you think?  Really!?” and interrupt before anyone could get a complete thought out. “Well anyway, I…"  The other people in the room- boyfriend Brandon and therapist in the room were just foils to play off of.  They were the audience to Hunter who knows she is the star!  Keeping herself in the limelight was very important.  If the attention moved away and stayed away, Hunter began to feel uncomfortable.  Hanson (2012) described an individual with histrionic personality disorder in a couple.  “Along with their distinctive emotional, relational, and intellectual styles, histrionic individuals tend to hold a certain set of largely unconscious assumptions or beliefs about themselves and what they need to do to have a good life. They believe, for example, that to have meaningful relationships with others mean they must be the center of the group with others playing the role of attentive audience.  They believe things like: ‘Unless I captivate people, I am nothing.’  ‘If I can't entertain people, they will abandon me.’  Or, ‘If I can't captivate people, I am helpless or no good!’  Because of their unrealistic views of themselves and life, people with histrionic personalities are constantly setting themselves up for failure, rejection, and frustration.  No one can always be the center of attention!  When they aren't, they either conclude that they are worthless or that other people are bad for not constantly affirming them.  So they either feel depressed or resort to crying, tantrums, assaultive behaviors, or even suicidal gestures to get their way, gain attention, or to punish a perceived offender.  Tom wept as he described his many attempts to show Christy love and affection only to be chastised and ridiculed for his efforts or incorrect timing.  Since histrionic individuals believe it is necessary to be loved by virtually everyone for everything they do, they also have an exaggerated fear of rejection.  Any hint of rejection is devastating, even when the person doing the rejecting is not actually important to the histrionic person!  Feeling basically inadequate, yet desperate for approval, they feel they can never relax and leave the gaining of approval to chance or the good will or love of others.”

People get caught up in a flamboyant histrionic atmosphere without being aware of what is going on inside the histrionic individual.  Brandon was the latest in a long line of placeholder boyfriends to love and adore Hunter.  The therapist could join the line if not sufficiently aware.  The therapist essentially let Hunter dominate the session for fifteen minutes to see if she appropriately shares or cares to share the verbal space with Brandon.  She ignored normal socially acceptable cues to take turns.  She ignored that another person wants to speak, or that others are impatient.  The therapist then used more direct therapeutic and even authoritative (sometimes rude!) instructions to let Brandon speak, to stop talking, or to stay on topic.  Hunter responded with flattering the therapist or otherwise tries to charm.  That does not work when the therapist insists on a therapeutic process.  Hunter acts offended and pouts, when Brandon brings up an issue that bothers him.  Brandon complains that Hunter still has a thing for her old boyfriend who just came back into town and is now working at the restaurant as a bartender.  When they all got together, Hunter was obviously flirtatious with the old boyfriend right in front of Brandon.  This had happened each time he had visited the last two years.  Brandon said he could blow it off since they were only visits and the ex would leave.  However, since he was always around, now it was right in his face.  When the therapist asked Brandon if it was hard for him, he responded paradoxically that he was kind of used to it.  Before he could say more, Hunter interrupted that she was just playing.  She said that she had reassured Brandon that there wasn’t anything between her and the old boyfriend.  The therapist fed back to Brandon, that he still had not answered the question if it was hard for him.  Brandon said it was ok, because he loved her.  She started to interrupt again, but the therapist told her to hold on until he finished with her boyfriend.  During this exchange, she seemed to become fidgety.   When pressed by the therapist, Brandon shrugged his shoulders and looked at Hunter.  As he deferred to her, Hunter quickly took up the space.

FLIRTATIOUS INVITATION
Hunter says she loves Brandon, but still has a passion for her old boyfriend.  She does not really think there is anything wrong with it.  Brandon put up with this a long as he could, but it just became too much.  Brandon initiated couple therapy.  Being sexually provocative to therapist or anyone else is part of her arsenal that either never turns off or turns on readily.  When Brandon says it is not just with this old boyfriend, but that she flirts all the time, Hunter coquettishly smiles at the therapist.  She coyly admits to the therapist that she flirts, “I know I can be naughty, but it's all in fun!”  Her tone, eye contact, and body language flirtatiously invites the therapist to join her as a co-conspirator in the “harmless” fun.  As the therapist attempts to focus on the propriety of her behavior, she constantly tries to divert everyone’s attention.  “I’m such a drama queen!  I’m really into my look, ya know.  I just did my hair.  How do you like this color?”  Hunter often fishes for compliments, but on the other hand can be easily offended by any critical comment about her appearance.  Her language style is very dramatic, but without much depth.  After all, to Hunter it's not what she says that is important, it's just important that she is saying it- saying anything!

The therapist gets a wave of affirmative non-verbal and verbal cues and words.  Hunter seems to be really involved in the therapeutic process.  Only as the session proceeds and with greater probing, does the therapist realize that Hunter can and does talk a lot, but seldom says anything of any substance or reveals any introspection or insight.  She gave shallow evasive answers, but with a definite flair.  Her affect was animated and she spoke rapidly.  There was little space for anyone to get in.  “Those with HPD also have a style of thinking and speaking that differs from most of us.  They tend to be highly impressionistic and lacking in details and specifics.  They express strong opinions with a dramatic flair, but when asked to explain themselves, their underlying reasons are vague and without supporting facts and details.  When describing another person, for example, they may say, ‘He's incredible,’ ‘He's huge,’ or ‘I hate her.’  They are strong on impressions but weak on details, facts, and carefully thought out plans and logic.  They also tend to play hunches and adopt convictions quickly since their feelings and opinions are so easily influenced by others and by current fads.  They may consider relationships to be more intimate than they actually are, describing almost every acquaintance as ‘my dear,’ or ‘my dear friend’" (Hanson, 2012).

INABILITY TO STAY WITH PERSONAL FEELINGS
When confronted with the inconsistency between her expressed commitment to her boyfriend and her behavior with her old boyfriend, Hunter minimized the issues with a wave of her hand.  She seemed to enjoy the therapist’s continued challenges to her.  The challenges kept her squarely in the session’s spotlight.  The therapist had difficulty getting Brandon’s experience or perspective given Hunter’s unwillingness to yield the stage.  The therapist fed back to Hunter these observations of her keeping the focus on herself.  She was able to acknowledge their validity.  When asked where the behavior may have come from, she began a dramatic long-winded but colorful story of her childhood.  In fact, despite queries from the therapist, Hunter seems to be purposely avoiding talking, feeling, or thinking about anything meaningful.  Despite Brandon’s desires, the therapist’s direction, and her ostensive commitment, Hunter’s goal in therapy is not to resolve anything between her and her boyfriend.  It is not to understand him or to be understood.  Her goal in therapy as it is in life is to keep everyone watching Hunter, the "star" perform!  After a while, the therapist stopped Hunter and instructed her not to speak for 10 minutes while he talked to Brandon.  The therapist told Hunter just to focus on her own feelings during the 10 minutes so she could report on them later.  The therapist proceeded to purposely ignore her.  Hunter couldn’t stand it, and interrupted within fifteen seconds.  The therapist repeated the instructions—hushing her, and continued with Brandon.  Hunter became even more fidgety than before and began to frown.  Again, she interrupted, lasting two minutes this time.  She started to say that she didn’t like just listening.  Again, the therapist hushed her to stay with the experiment.  In another couple of minutes, Hunter interrupted again—this time with definite annoyance.  Her inability to stay with her personal feelings made her intrude upon the verbal-social dyad between Brandon and the therapist.

The histrionic individual is not interested in others… their lives, stories, feelings, or thoughts.  Hunter was interested in Brandon only for the attention he gave her.  As a partner to a histrionic individual, Brandon consistently founds his needs or feelings being over run by the drama of Hunter’s attention hogging activity.  Such a partner often gets tired of counting only as the audience (with little audience participation!) and not mattering.  When others- the partner or the therapist in couple therapy are no longer interested in the histrionic, that is attending to him/her, the psychological void the histrionic experiences becomes overwhelming.  The therapist fed back to her that she couldn’t stand not having the attention on her.  When the therapist asked Brandon for confirmation of this observation, he tried to minimize it.  The therapist confronted Brandon with his acceptance of the minimal attention he got from her.  The therapist confronted Hunter with her need to keep the attention on her.  They didn’t like it.  The therapist repeated this over the next three sessions.  They stopped coming to therapy.  Sometimes the honesty of the therapy is intolerable for couples or individuals too deeply invested in their dynamics.  The therapist should not collude in the maintaining the dysfunction of the relationship.  The therapist had to challenge it, in order to maintain the therapeutic relationships, that is, the therapy.  If the relationship is clearly harmful to both members, while it is not the responsibility of the therapist to end the relationship (that is the clients’ decision), it is his/her responsibility to reflect back as accurately as possible his/her assessment of the relationship.

PSUEDO-DEEP EMOTIONAL CONNECTION
Although Hunter may seem very involved in therapy with very dramatic reactions, the underlying logic or rationale she presents is usually vague or ambiguous.  The intent with the therapist as with anyone else including Brandon is not to convince the other of the logic of the idea or issue, but to use the idea or issue to draw others attention to the herself.  At the same time, Hunter may seem very cooperative with therapy and accepting of the therapist’s feedback.  The histrionic individual is often easily influenced by other’s opinions.  Agreeing with another person tends to have that person regard the one that agrees- the histrionic or dependent individual as a supporter or ally.  In the beginning of therapy, the histrionic individual is likely to ignore the “bird-in-hand.”  The partner such as Brandon is already hooked, so the histrionic individual shifts his or her charms on recruiting the therapist.  As he or she is prone to do with any new prospect, the therapist gets targeted.  This behavior is instinctive and unconscious or semi-conscious.  It causes the histrionic individual to tend to easily trust people or quickly find pseudo-deep emotional connection.  Brandon had quickly become Hunter’s soul mate, and the therapist a “great wise” helper.  The histrionic individual may be so compulsively prone to needing and thus, finding “real connection.”  He or she can develop romantic fantasies about people who do not perceive anything close to such a deep relationship.  The therapist should carefully examine the therapeutic rapport that the histrionic professes.  The histrionic is likely to respond with the same type of unjustified shallow accolades that partners have heard previously.  The partner such as Brandon can reveal similar experiences from the beginning of their relationship.  Going through the process so that Hunter can practice her histrionic strategies and behaviors with him or her, the therapist offers Brandon the opportunity to scrutinize Hunter in action.  This can differ from Brandon’s anguished observations of Hunter flirting with her ex-boyfriend and others if the therapist is not another gullible victim vulnerable to histrionic seduction.  As the therapist allows him or herself to be engaged by Hunter, he or she can shape the interaction to reveal the depth of histrionic strategies to Brandon.

In the process of this therapy, Hunter revealed the intransient nature of her histrionic personality disorder.  While many individuals may have some histrionic qualities, the expanse and depth of the traits vary significantly from person to person.  Despite gentle to highly overt feedback and admitting histrionic behavior, Hunter could not admit or own that her life and relationships were dysfunctional.  She could not acknowledge that her behavior was destructive to her relationships and intrapsychically toxic.  The behavior had “worked” for her because Brandon had accepted it and given permission for it by staying.  And, others- men in particular… at least one at a time could be found that she could seduce with her flamboyant style.  Temporarily or for some sustainable tolerable period, one guy or another would be satisfied enough to be her audience.  She had given up the possibility of having a deeper fulfilling relationship of mutual intimacy.  All she could risk or have was a superficial relationship with someone like Brandon who would tolerate limited inconsistent but flashy dramatic energy from her.  The therapist probed to see if she could be vulnerable enough, that is honest enough about her deeper vulnerabilities that underlie her histrionic survival compensations.  Hunter was not so much deceiving the therapist or Brandon, but stuck in denial about her extremely fragile sense of self.  Hunter had been unable to admit and own her vulnerability.  For someone with less entrenched and less severe histrionic traits and strategies, therapy may have been facilitative of change for her and her relationship with Brandon.  She may have been guided to maintain the passionate demonstrative qualities that Brandon found attractive and enjoyed, while learning how to be less compulsive when they become dysfunctional.  If she evolved to better own her emotional and psychological needs, she could learn how to satisfy them in healthier ways that do not dismiss Brandon’s needs.  As she becomes more willing, able, and skilled, Brandon can intervene with boundaries and assert a balance between her and his needs.  Unfortunately, Hunter was stuck and too fragile to engage in any awareness, insight, and thus any change process.  

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