Supporting Loved Ones with Histrionic Personality Disorder

Define clear boundaries. When supporting a loved one with Histrionic Personality Disorder, it's essential to set firm boundaries in your relationship. These individuals may engage in manipulative, attention-seeking, or embarrassing behaviors at unpredictable moments, which can affect you. Have an open and honest conversation about your personal limits.

• For instance, you might say, "If you attempt to manipulate me, I will step away" or "If you behave in a dramatic or embarrassing way for attention, I will leave."

Establish attainable goals. Histrionic Personality Disorder is a complex condition, and there may be limitations to what you can do for your loved one. Setting realistic expectations is crucial when deciding to assist them. Understand that you might not be able to fully help them overcome their condition, and sometimes creating some emotional distance might be necessary.

• Encourage your loved one to set their own goals. For example, you could help them set objectives related to their appearance, the types of relationships they pursue, or the frequency of dramatic or theatrical behaviors.

Reassure them of your love. Relationships with individuals with HPD can be complicated and strained. The disorder often leads to emotional conflicts and challenging dynamics. Despite this, it's important to let your loved one know that you still care. Even though you may have boundaries and occasionally need space, remind them that your affection remains.

• For example, you could say, "I care about you and want you in my life, but there are times when I can't be around because of your behavior."

Recognize when to step away. There will be moments when your loved one's behavior becomes manipulative, cruel, hurtful, or damaging. The constant need for attention can lead to actions that are overwhelming. People with HPD may resort to dramatic, provocative, or even angry outbursts to gain attention. These behaviors can have a negative impact on you. It's important to acknowledge that, for your own well-being, you may need to distance yourself from the situation.

• In extreme cases, it may be necessary to completely detach yourself and end the relationship if you are unable to cope with the emotional toll.

Stay composed. One of the most effective ways to help your loved one is by maintaining your composure. Individuals with Histrionic Personality Disorder often feed off chaos and drama. If they act out dramatically or throw a fit, responding negatively only fuels their behavior and reinforces their need for attention. Instead, stay calm and composed during these moments.

• By not engaging in their dramatic actions, you demonstrate that their behavior won't get the attention they desire.
• Taking a moment for deep breathing exercises or stepping away briefly may help you regain your calm.

Do not encourage attention-seeking behavior. Your loved one may frequently engage in dramatic actions to seek attention. The best way to handle this is by ignoring the behavior rather than reacting to it. Avoid reinforcing negative actions by giving them attention.

• Because of the chemical imbalances associated with HPD, your loved one may be unable to control their actions. Instead of arguing or encouraging the behavior, simply ignore it and let it pass.

Maintain some physical space. Individuals with HPD often form quick, intense attachments, which can lead them to cross personal physical boundaries. They may not fully understand or respect the space you need. You might find that they touch, hug, or invade your personal space more than you're comfortable with. To maintain your comfort, it's important to keep some distance.

• For example, consider sitting in a separate chair if they’re on the couch, or sitting further away on the same couch. When standing, keep a respectful distance.
• Be mindful to avoid any actions that might seem suggestive or inappropriate to your loved one. Always ensure that your behavior reflects the boundaries you’ve set.

Offer alternatives for your loved one. One common symptom of HPD is wearing attention-grabbing, provocative clothing. However, this might not always be appropriate, especially in professional settings. You can help your loved one by suggesting alternative attire for specific occasions.

• Start with a compliment to avoid any negative reaction, as those with HPD are sensitive to criticism. Compliments can pave the way for a more positive response.
• For example, you might say, "I love that outfit on you! It’s perfect for a night out with friends. How about wearing this one to work instead? It looks fantastic and will give you that classy vibe everyone will appreciate."

Request support when your loved one shares an opinion. Individuals with HPD may offer strong opinions or engage in arguments simply for attention and drama. Often, these opinions lack substance or support. In such cases, ask your loved one to provide reasoning for their views.

• For instance, you could say, "What is the basis for that opinion?" or "Can you provide examples to back up what you're saying?" Alternatively, you might ask, "That doesn't seem accurate. Can you provide evidence for your viewpoint?"
• If your loved one cannot support their opinion, gently remind them that opinions should be based on facts or evidence. Encourage them to research before forming opinions.

Encourage independent thinking. Those with HPD can be highly suggestible, often agreeing with others without much thought. If you notice that your loved one is blindly following others or adopting their opinions, encourage them to think for themselves.

• If you see them agreeing without evaluation, ask questions to help them reflect on the situation. For example, if they repeat a political opinion as fact, ask, "What’s the evidence for that? How did they come to that conclusion? Why do you agree with them?"
• If your loved one is following someone else's advice, prompt them to question their motivations. For instance, if they change their clothes based on someone’s suggestion, ask, "Do you really want to do this? Would you make this choice if they hadn’t suggested it? What would you do if they hadn’t brought it up?"

Avoid making excuses for their behavior. You may feel tempted to cover for your loved one’s actions, explain them away, or clean up the consequences of their behavior. However, this only enables their behavior and takes a toll on you. It's important not to excuse or mitigate their actions.

• Although their behavior might be embarrassing, it’s healthier to practice emotional detachment or to walk away when necessary. Prioritize your own well-being.

Assist your loved one in finding solutions. People with HPD often focus on the drama of a situation rather than looking for solutions. Encourage them to shift their focus towards problem-solving.

• For example, when they become overly dramatic about a problem, listen and acknowledge their feelings. Then say, "I understand this is tough, but dwelling on it won’t help. Let’s work together to find a solution."

Redirect their focus. To reduce attention-seeking or manipulative behavior, try shifting the conversation or activity to something else. Don’t allow your loved one to monopolize the attention or linger on their problems.

• For example, you could say, "We’ve been focusing on you for a while now; I’d like to share something about my own life."
• If they are in the middle of an attention-seeking episode, try changing the topic, starting a TV show, or suggesting a walk or movie outing to divert their focus.

Avoid trying to teach your loved one a lesson. Occasionally, loved ones of individuals with HPD might attempt to abandon them in order to teach them a lesson. This often occurs when the person with HPD manipulates you too much or when it feels like nothing you do has any effect. However, this approach is ineffective with people who have HPD, so it’s best to resist this temptation.

• If you abandon them, your loved one may feel rejected and react with an exaggerated emotional outburst.
• You might also find yourself feeling helpless and manipulated if you try to use these tactics. Instead, focus on being direct and honest with them, rather than playing games.

Label their behaviors. People with HPD often lack awareness of their own harmful behaviors, which means they might not realize when they’ve crossed a line. Observing and pointing out their actions can encourage them to reflect on what they're doing.

• "It looks like you're spiraling."
• "Are you trying to manipulate me right now?"
• "This seems like a self-destructive pattern."
• "It seems like you're making everything about you again."

Remind them of the consequences of their actions. People with HPD may not fully consider the consequences of their actions or understand how their behavior affects others. Calmly remind them of the potential outcomes of their actions.

• "You're making me uncomfortable. If you keep doing this, I may need to walk away."
• "Today is John's special day. If you behave this way at his party, it will hurt his feelings."
• "What you're doing could lead to real harm."
• "When you act like this, it makes me not want to spend time with you."

Try empathizing with them, then setting boundaries. Individuals with HPD often struggle with rejection due to their deep-seated insecurities. By helping them identify their emotions, you help them better understand what they are feeling and reassure them that you are not rejecting them—you're simply asking for a change in behavior.

• "I understand you're feeling lonely. However, pretending to be injured isn't a healthy way to get attention. How about we do something simple together, like going for a walk or playing a board game?"
• "I know you're excited to hang out with friends. But please remember to give Jamal a chance to speak too."
• "I can tell you're upset, but I'm really exhausted. I can't talk about this right now. Would it be okay if you called your sister or we talked in the morning?"

Communicate feelings and limits calmly and clearly. People with HPD often respond well to clear, direct boundaries. Using "I" language to express your feelings can help them understand the impact of their behavior. This approach gives them a chance to pause and reflect on their actions.

• "When you ______, I feel ______. Because of this, _________."
• "Please stop interrupting me. I’m feeling frustrated."
• "That really hurt my feelings."
• "You're embarrassing me, and it makes me want to leave."

Follow through with consequences if your loved one ignores your boundaries. It's important that they understand you mean what you say when you set limits. If you tell them you'll leave if they continue a certain behavior and they don't stop, then follow through with your actions by leaving.

Address inappropriate behavior without attacking their character. People with HPD often act out because of their insecurity, so it's important not to be cruel or escalate the situation. Focus on their actions and the consequences of those actions rather than labeling them as bad or selfish. This can help them reflect and learn from the experience.

• Unhelpful: "You're such a drama queen! I can't deal with you anymore! I’m never taking you anywhere again."
• Helpful: "I'm really disappointed and embarrassed that you flirted with my boss, despite me asking you not to. It makes me hesitant to bring you to work events because I’m unsure how to handle it."
• Unhelpful: "You're so embarrassing! If you keep acting like this, you'll end up lonely and sad."
• Helpful: "You really embarrassed me in the grocery store today. I feel bad about it, and I’m not sure what I’ll do next time we run into Mrs. Alvarez in public."

Encourage them to seek treatment. The most effective way for someone with HPD to improve is through professional treatment. However, many people with HPD either avoid seeking help or stop treatment after a short time. It's important to gently encourage your loved one to pursue treatment. If they're already in therapy, remind them to stick with it, even if they become disinterested or feel like quitting.

• "I care about you, and I can see how your actions are hurting both you and me. Would you be open to continuing your treatment?"
• "I understand you feel that therapy has lost its appeal or that you're doing better, but this is a serious condition, and it won't go away overnight. Can we talk about going back to therapy?"

Help them access psychotherapy. Psychotherapy is one of the most effective ways to treat HPD. It involves engaging with a therapist who can use various therapeutic techniques, such as cognitive behavioral therapy, to support your loved one's progress. People with HPD may struggle to maintain commitment to therapy, as they may lose interest or feel they no longer need help.

• Cognitive behavioral therapy helps address issues like impulsiveness, manipulative tendencies, and dramatic behavior.

Address any underlying conditions. Many people with HPD also experience other mental health concerns, such as depression. Due to feelings of insecurity, inadequacy, and abandonment, they may experience depression and require treatment for it.

• If this is the case, your loved one might benefit from selective serotonin reuptake inhibitors (SSRIs) to help manage their depression, which can improve their overall mood. SSRIs like Zoloft, Celexa, and Prozac are commonly prescribed for depression.

Monitor for destructive behavior. HPD can sometimes lead to self-destructive actions, such as suicidal threats or self-harm. While some individuals with HPD may use these behaviors to attract attention, it’s crucial to assess the seriousness of these threats.

• People with HPD may engage in self-harm or suicide attempts to seek attention. Pay attention to signs that your loved one may be approaching this dangerous phase.
• They may also exhibit harmful behavior toward others. Stay alert to any signs of aggression or violence towards those around them.

Consider seeking therapy for yourself. Talking to a therapist about the emotional challenges you face in dealing with a loved one who has HPD can be a valuable form of self-care. A therapist can help you develop effective coping strategies, improve communication with your loved one, and manage your feelings. Incorporating therapy into your self-care routine can provide much-needed support during difficult times.

Reach out to friends and family for support. Caring for a loved one with HPD can be emotionally draining. You might feel overwhelmed, trapped, or unsure of how to cope. Lean on your friends and family for support when things get tough. Take time away from your loved one to reconnect with others, which can offer a much-needed break and emotional encouragement.

• Share your struggles with those close to you, and don’t hesitate to ask for advice when you feel the burden is too heavy.

Don’t let your loved one control your other relationships. Individuals with HPD may react with jealousy or emotional outbursts when you form relationships with others. It's important to stand firm and not allow them to dictate your friendships or other connections.

• Your loved one may perceive someone else in your life as a threat. It's essential to remain firm in your boundaries. For example, you could say, “I value my friends and occasionally invite them over. This doesn’t change how I feel about you.”
• Even if your loved one feels threatened by your involvement in activities without them, resist the urge to abandon those pursuits. It's crucial to maintain your social life outside the relationship.

Understand that your loved one may not recognize your needs. People with HPD often focus on their own emotions, which means they may struggle to understand or respect your needs, even if you communicate them clearly. They may not realize how their behavior affects others.

• It may be necessary to accept that your loved one will not always treat you the way you deserve. This is why setting clear boundaries and limits in your relationship is vital for maintaining your emotional well-being.

• At times, individuals with HPD may exhibit abusive behavior. You are under no obligation to tolerate abuse. It’s essential to recognize that you have the right to distance yourself or sever the relationship entirely. Prioritize your own well-being and make the decision that best suits your needs.