Therapy and theoretically, unsuccessful therapy can reveal to Brandon the potential or lack of potential for Hunter to change. While the therapist attempts to engage Hunter in therapeutic process to address the histrionic behaviors, their effects on Brandon and the relationship, and their psychodynamic and family-of-origin roots, Brandon is constantly observing Hunter. If Brandon determines that his experience is validated by the therapist, that Hunter is unavailable to insight regarding her behavior, and that she is unable or unwilling to change, then Brandon is informed to make his decision about continuing in the relationship or not. The therapist would need to hold accountable Hunter and her histrionic compulsion to interrupt and reclaim attention. If necessary, the therapist may need to have an individual session with Brandon. Hunter would probably not like it but the therapist can insist while offering her an individual session as well. The therapist might hear a story much like the following which was posted on Histrionic Personality Disorder forum on PsychoForum.com (viewed April 7, 2012) by rukidnme Sat Oct 30, 2010 6:42 pm.
“I am recently separated from my HPD wife. I like to think we married for love...we were high school sweethearts. It was only towards the end of our marriage, the last 6 years or so, that she was diagnosed as HPD during a custody case for a previous marriage. That's is when things began to make sense for me even though she still to this day denies anything is wrong with her.
I can see that she does love me in her own way, but it’s just not enough for me. For that reason and the constant drama, I left her. She did not cheat on me, that is a fact. What she did was to cause so much freaking drama over the years that everyone believes I am an Ahole, that I beat her, and that I don't give her money or let her do anything...all lies of course! With no disrespect to those she calls her friends, there is not a shred of proof to backup her claims, yet they still believe one side of the story without even hearing mine...crazy. The problem is she attracts those types of people. Those that are smarter than that see right through her and distance themselves I found. I was the victim in this case. One time she got her mom all heated up (she is HPD too), they pulled a gun on me and then both were arrested! More recently I called the police on her for throwing a plate at me and she was nearly arrested again. Of course as usual though she told her friends it was me who threw the plate at her. Lucky my son and daughter were there to backup my story with the police. I just cannot understand how she actually believes her own stories so much so that she can convince others they are true... I apologize for the rant...just coming to terms with this.”
AS BLAND... AS FLAMBOYANT
On the other hand, the partner’s story may reveal a lack of self-esteem and resignation that the relationship is the best that can be expected. Brandon for example, was as bland as Hunter was flamboyant. Brandon admitted that his friends and family had typical reactions to his relationship with Hunter. Initially, they were surprised that he could “score” with such a vivacious partner. Hunter charmed them as she often charms most new acquaintances. The ones who saw her only occasionally or for short periods, continued to like her energy and wonder what she saw in bland Brandon. Casual acquaintances thought Brandon was a lucky guy and teased him about his great fortune to be with Hunter. It was wonderful and exciting in the beginning. Over the longer period, however, the relationship began to wear on him. “Living with a person who suffers from HPD can be an exhausting, humiliating, frustrating and isolating experience. Trying to make your loved-one happy is like trying to empty the ocean with a leaky bucket. Your loved one’s personality disorder prevents them from seeing the destructiveness of their own behaviors and keeps them from seeing or understanding your own needs and limitations. When you loved one creates chaos, it is often you who are the one who has to clean it up. When your loved one acts out in front of other people, you may feel embarrassed or humiliated to be associated with them. You may feel as though others assume that you are guilty by association. You may begin to avoid public groups, settings and situations for fear that it will not go well. When your loved one turns on you in anger, you may fear their next move. You may be afraid for your own safety or feel angry that they are not willing to just live and let live” (OutoftheFog.net, 2012).
Somehow it became Brandon’s job to keep Hunter happy. She was so volatile though that Brandon was never sure if he was adequate or screwing up. “Partners of histrionics often live a life on eggshells, not knowing when they will be smothered with superficial affection or loathed for being too predictable or dependable. This is turn can begin to undercut the partner's self-esteem. By definition, the anonymous people in the ‘audience’ of the histrionic person are less interesting or exciting than the ‘beautiful’ person holding center stage! This impact can be both subtle and cumulative, eventually leaving the partner of the histrionic filled with uncertainty and self-doubt. It can also leave partners resentful because they feel that they can never provide enough attention or admiration to fill the histrionic's emptiness” (Hanson, 2012). Brandon did not know what to do. He suffered paralysis hungering for the energy that Hunter sent occasionally his way, while being humiliated by her distain for his feelings. He couldn’t come or go. However, people who cared for Brandon and saw how she mistreated Brandon or took him for granted, tried to discourage the relationship. The therapist attempted to maintain therapeutic neutrality and not give advice. The therapist focused questions about how he felt, what he wanted, and his disappointment being with Hunter. This led Brandon to reveal that his closer friends and family thought he was being taken advantage of. His brother was the most blunt, calling him a spineless wimp to stay with Hunter when she was clearly flirting with other men in front of Brandon. She had flirted with Brandon’s brother in front of Brandon! Brandon’s brother was disgusted, and Brandon was humiliated. And Hunter dismissed it as a non-issue. “It’s not like we had sex or anything.” Since Brandon’s brother clearly despised her, Hunter declared him to be an asshole and wouldn’t let Brandon openly associate with him. Brandon had to keep his visits with his brother secret- pretty much as he had to keep anything about Hunter from his brother.
Brandon did not have much sense of being attractive or being worthy as a partner. He was always academically bright, and he had confidence in his professional work as an engineer. The therapist found that Brandon had always been shy and then been sheltered from social endeavors by overprotective parents. He hid himself in his schoolwork and personal interests- usually classic nerdy stuff. He never dated until late in college and only then with set ups. Brandon was virtually comatose on these dates without any idea what to do. He could not even talk about the movie after watching the movie. One and done was his dating routine. Hunter had swept into his life unexpectedly. They had both been at a book signing of a mutual friend. Since everyone was focused on the new book and author, no one was paying attention to Hunter. Brandon was being his usual shy self in the background, when Hunter decided that he would be her audience. He had no idea that this was her normal histrionic operational strategy. He received a flashflood of her seductive charm. Brandon felt that he had hit the jackpot… and without even making a bet! As a partner, Brandon was highly attracted to Hunter’s drama and flamboyance. He initially enjoyed being in the “glow” of the Hunter’s bright “light.” And, vicariously enjoy her high activity. Brandon’s unfiltered loyalty and attention was even more than she usually got from her usual conquests. Brandon followed and chased her around like a puppy. No matter how much Hunter pushed him away or “spanked” him with hurtful words or behavior, Brandon would always crawl back and be available when Hunter needed another dose of adulation. In his more lucid moments however, Brandon despised himself for being so weak and unassertive.
MOTIVATED TO AVOID
It was Brandon of course, rather than Hunter who initiated couple therapy. It is unlikely that the histrionic partner will be the instigator of couple therapy. “Unfortunately, most people with histrionic personalities are poorly motivated to change. They have such a lifelong pattern of avoiding emotional pain through massive repression and temporary attention getting maneuvers that they rarely seek help unless they are experiencing a deteriorating relationship, depression, or some other troubling social or emotional problem. And once they receive a little relief from their presenting problem, they tend to go on their way rather than facing their deeper emotional, spiritual, and relational struggles” (Hanson, 2012). Hunter reluctantly agreed to therapy because of the threat that Brandon may not be available as he had been so far. If the partner decides to not be the audience only and begin to demand more attention or a more equitable sharing of the “stage,” the histrionic individual’s fundamental criteria for being in the relationship will be violated. If involved in couple therapy at all, Hunter focused on some simple remedy that would return Brandon to his previous attentive role. She asked for suggestions and offered simplistic solutions such as letting him come along when she had engagements or a few minutes of shared time. These remedies never worked since she would be just as self-centered as before. Hunter could get Brandon to agree to these superficial solutions as long as he was scared to lose the relationship. He knew that Hunter could permanently drop him as easily as she blew him off in their day-to-day life. Rather than repair the relationship, the histrionic individual is more likely to move on to some other activity or relationship where the “minimal” requirements of constant attention would be met.
With an individual with histrionic personality disorder, couple therapy would need to address the histrionic individual’s issues. It is also critical to address the origins of personality for someone such as Brandon, who tolerates the flawed relationship with the histrionic. The therapist should help clarify for the partner what he or she gains or can gain from the relationship with a histrionic individual… and what it costs. If Hunter is willing to honestly invest in therapy, she “can get a great deal of help. The ultimate need of histrionic individuals in therapy is to change their deeply ingrained tendency to try to fulfill all their needs by looking to others for attention rather than develop a solid sense of their own self-worth or self-esteem. To do this, histrionic individuals need to feel accepted and relatively safe and comfortable with their therapist. Gradually, they can begin to observe their pattern of avoiding their inner emotional anxiety by frantically looking for attention. In this process they need to learn to sit with their emotional discomfort instead of running from it. As people with histrionic personalities learn to bear and face their fears of abandonment and inner emptiness they can increasingly focus on their internal world rather than on ways of trying to elicit attention from others. Since histrionic individuals avoid introspection by focusing on the outside world, this can be frightening and difficult. It is essential, however, to learn to see the futility of their relational and coping style in order to think more clearly and be less impulsive and more centered. In the process, they will gain insights into their unrealistic assumptions about themselves and life. They will come to see how they concluded they had to be the center of attention to feel good about themselves and they will realize that belief is an emotionally destructive idea” (Hanson, 2012).
The therapist needs to understand the depth of terror about abandonment within the histrionic individual. The therapist who is not well cognizant of the inner world of the histrionic individual can easily be charmed. Or, he or she can get very annoyed and judgmental about the histrionic individual behavior in therapy and the treatment of the partner... and of the therapist. Rather than creating a safe therapeutic environment, a critical therapist reaction may inadvertently threaten the histrionic individual’s core anxieties. Therapist counter-transference varies as to what particular constellation of behaviors is the most problematically triggering. For the therapist, who is more accepting of dependent personality disorder presentations, understanding histrionic personality disorder’s relationship to that disorder may be productive to mitigate negative counter-transference.