Hysterical personality disorder - Causes, symptoms and treatment. MF.

People with a hysterical personality disorder are extremely emotional and constantly get attention. As a rule, they are described as "emotionally charged".An immoderate, rapidly changing mood can greatly complicate their lives, they are always "on stage": even when describing everyday events, they resort to theatrical gestures and fanciful speech. These people are constantly changing, trying to attract the attention of others and make an impression on them;it seems that they have no sense of what they really are. Their speech is rather poor in essential details, and they often follow the latest fashion cry, trying to make others admire.

Endorsement and praise are the meaning of the lives of these individuals;they must make those around them witness their emotional upliftment and manifestations of their mood. They are not able to save pleasure for a long time. Vain, self-centered and persistent, they react excessively violently to any insignificant event that rises in the way of their search for attention. Some commit suicide attempts, mainly in order to manipulate others.

Until recently, it was thought that this disorder is more common in women than in men. Recent studies suggest that this personality disorder occurs in 2-3% of adults, with men and women being equally affected by it( ARA, 1994; Nestadt et al., 1990).

Symptoms of hysterical personality disorder

The peculiarity of hysterical psyche is the absence of clear boundaries between the production of your own imagination and reality. The real world for a person with a hysterical psyche acquires peculiar bizarre outlines;an objective criterion for him is lost, which often gives an excuse for others to blame such a person at best in lies and pretense. Just inaccurate hysterical perceives and processes in their own body and their own psyche. Some experiences completely elude his attention, while others, on the contrary, are evaluated extremely thinly. Because of the brightness of some images and representations and the pallor of others, a person with a hysterical mentality does not often see the difference between fantasy and reality, between a waking happen and a dream, or, to be more precise, unable to do so.

They are incapable of systematic, hard work, prefer to do amateurish activities when choosing a kind of employment and pass before tasks that require perseverance, thorough knowledge and solid professional training. Most of all they like an idle life with an outward, ostentatious pomp, various entertainments, frequent changes of impressions. They willingly and selflessly perform rituals of festivities and banquets, in everything they strive to follow fashion, attend successful performances, "idolize" popular artists, discuss sensational books, etc.

Most of them are trustful, easily attached to people. At the same time, there is often a tendency to eroticize interpersonal relationships;quickly fall in love, planting numerous, often short novels, accompanied at first by violent displays of feelings. However, being unstable in their hobbies, they also cool down just as quickly. In more rare cases, stable ecstatic attachments are formed, formed by the type of overvalued formations.

People with this personality disorder can attract attention by exaggerating their physical ailments or feeling their own weakness. In addition, they tend to exaggerate their relationship - for example, they may consider themselves close friends of people who in fact view them as mere casual acquaintances.

Causes of hysterical personality disorder

Most psychodynamic theorists believe that as children, people with this disorder have experienced unhealthy relationships in which cold and powerful parents made them feel unloved and caused fear of being rejected. To protect themselves from the hidden fear of loss, these individuals began to dramatize the situation, inventing crises that would encourage others to take care of them.

Cognitive explanations, in turn, pay particular attention to the lack of meaningfulness and extreme suggestibility found among people with hysterical disorder. According to theorists of the cognitive direction, when people become more and more self-centered and emotional, they have few opportunities to acquire knowledge about the events taking place in the world. Because they lack detailed memories of what they have never studied, they have to rely on intuition or on other people. Some cognitive theorists also believe that individuals with this disorder generally adhere to the attitude that they are not capable of taking care of themselves, and therefore constantly seek to find other people who will satisfy their requests.

Sociocultural theorists hypothesize that hysterical personality disorder can be rooted in the norms and expectations of society. Modern society often encourages people to attract attention, to attach the features of the theatrics of their appearance and to seek admiration from others. Sociocultural theorists argue that such values ​​can also become a prerequisite for the emergence of hysterical and narcissistic disorders.

Prognosis for hysterical psychopathy

The prognosis for hysterical psychopathy as a whole can not be considered unfavorable. In adulthood, with good social conditions and working conditions, in most cases, long and sustained compensation is possible. With age, they become more equal and more serious, acquire the necessary labor skills, but the elements of the theatricality remain in behavior;first of all it affects the ability to make a good impression, to excite sympathy, and if necessary, sympathy. The most complete in the case of hysterical psychopathy, compensation processes take place in the case of a preponderance of a tendency to different vegetative and hysterical paroxysms( spasms, choking sensation during excitement, nausea, vomiting, aphonia, tremor of the fingers, numbness of the limbs and other sensitivity disorders among the psychopathic manifestations).Already by the age of 30-35 years such psychopathic persons adapt to the real situation adequately, they can correct their behavior. In life, this is emphasized by obligatory people, diligent, successfully coping with their professional duties, retaining sufficiently strong family ties. However, with such variants of hysterical psychopathy, the risk of decompensation in the elderly is more likely, which is often associated with worsening of the somatic state( hypertension, IHD and other diseases) and menopause. Along with the growing depression, asthenia, tearfulness, anxious fears for one's health, a more persistent hypochondriacal symptomatology, accompanied by multiple pains, conversion and autonomic disorders, can come to the fore.

The forecast is less favorable in the case of a predominance in the structure of a hysterical personality of a propensity for pathological fantasies. Such psychopathic individuals are singled out by some authors as a separate group - pathological speculators and pseudologists, mythologists, liars and deceivers. These people lie from a young age, sometimes without any reason or meaning. Some so get used to the situations created by their imagination that they themselves believe in them. Some with rapture can talk about travel to the deep taiga as part of a geological expedition in which they have never participated;others, not having medical education, describe the complicated surgical operations that they have made. Fantasies sometimes turn into self-talk with confessions in fictional crimes and even murders. Decompensation, usually quite frequent, comes either already in school years, or somewhat later, with the transition to independent activity. In the first time after entering the workplace or moving to a new place, they produce an impression of the thoughtful, conscientious, enterprising, gifted specialists on those around them. However, soon their full inconsistency is revealed. They are extremely serious about the task entrusted, incapable of systematic work, instead of real problems, they are engaged in fantastic inventions. Compared with the usual hysterics, pseudo-scientists are more active in striving to realize their intentions. It's not always an innocent lie. More often, certain selfish goals are pursued, which leads to a clash with the law. From the number of pseudo-scientists a variegated gallery of small scammers, soothsayers, marriage swindlers, charlatans pretending to be doctors, or extortionists who receive valuable gifts and money advances for services that they will never be able to provide.

Diagnosis of hysterical personality disorder

Personality disorder, characterized by:

1. self-dramatization, theatricality, exaggerated expression of emotions;
2. suggestibility, easy influence of surrounding or circumstances;
3. surface and lability of emotionality;
4. a constant desire for excitement, recognition from others and activities, in which the patient is in the center of attention;
5. inadequate seduction in appearance and behavior;
6. excessive concern about physical attractiveness.
7. Additional features may include self-centeredness, self-indulgence, a constant desire to be recognized, ease offense and constant manipulative behavior to satisfy one's needs.

Includes:

• hysterical personality;
• is a hystrionic personality.

Treatment of hysterical personality disorder

People with this disorder, in contrast to individuals with most other personality disorders, often seek help. However, working with them can be very difficult, because such clients can bring their demands, moods and seduction methods into the process of treatment. Another problem is that persons with a hysterical personality disorder can claim that they have made important discoveries for themselves or that they have changed during the treatment period, only to make the therapist pleasant.

Cognitive therapists are trying to help people with this disorder change their view of their helplessness and develop better, more rational ways of thinking and problem solving.

Psychodynamic and group therapy is also used.

In all these approaches, therapists expect that people are aware of their excessive dependence, will find a way to get inner satisfaction and become more independent. Clinical reports show that each of these approaches is useful in certain situations.

Drug therapy is less effective, except in cases of depressive symptoms observed in some patients.