How to Help Loved Ones with Histrionic Personality Disorder

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1Establishing Clear Boundaries

2Dealing with Your Loved One

3Communicating Clearly

4Helping Your Loved One Get Treatment

5Taking Care of Yourself

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Histrionic Personality Disorder (HPD) is a personality disorder where the person is overly emotional and engages in attention-seeking behavior. These people always want to be the center of attention, act in overly provocative ways, and tend to have extreme feelings of inadequacy or inferiority. If you have a loved one who has Histrionic Personality Disorder, you can learn how to help them.

Things You Should Know

• People with HPD tend to struggle with routine, so be consistent and encourage them to stick with whatever treatments, hobbies, or scheduled events they have.
• Folks with HPD engage in a lot of attention-seeking behavior, so it’s important to not reward negative and unproductive outbursts by reacting strongly to them.
• People with HPD often have co-occurring conditions, with depression and borderline personality disorder being especially common, but your loved one will benefit tremendously from therapy.
• Remind your loved one that you care deeply about them frequently; it’s essential that they feel supported while they’re in treatment.

Steps

Part 1

Part 1 of 5:

Establishing Clear Boundaries

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1. 
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   Set limits. When your loved one has Histrionic Personality Disorder, you need to establish strict boundaries for your relationship. Your loved one may engage in attention-seeking, manipulative, or embarrassing behavior at any time, which in turn affects you. Have an open, honest discussion with them about your personal limits.

   • For example, tell your loved one, "If you start manipulating me, I will leave" or "If you start acting out or embarrassing yourself to get attention, I will leave."
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   Set realistic goals. Histrionic personality disorder is a complicated condition. There may be limited things that you can do for your loved one. Therefore, you want to set realistic goals when you decide to help them. Be aware that you may never be able to help them with their condition and you may have to place some space between you.

   • Help your loved one set their own goals. For example, you may want to help them set goals related to the way they dress, the types of sexual relationships they have, or the amount of times they act out in a dramatic or theatrical way.
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   Make sure your loved one knows you still love them. Your relationship with a loved one with HPD can be complicated and tense. The personality disorder may lead to major problems that cause hurt feelings and complicated relationships. Due to this, you should let your loved one know that you still love them. Tell them that even though you have limits and may sometimes leave, you still love and care for them.

   • You can tell them, "I love you and want you in my life. However, there are times I cannot be around you because of your behavior."
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   Know when to distance yourself. You may find yourself in a situation where your loved one is being manipulative, cruel, hurtful, embarrassing, or harmful. Your loved one's actions may be overwhelming to you. People with HPD often do anything to be the center of attention. This means they manipulate, act in dramatic ways, or play the victim. They may act in an overly provocative way, or act out in a hateful or angry way to gain attention. All of this can negatively affect you. You should be aware that you may have to distance yourself from your loved one to protect yourself and your own well-being.

   • Some people just aren't equipped to help a person with HPD. Be aware that as a last resort, you may have to completely remove yourself from the situation and sever all ties.
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Part 2

Part 2 of 5:

Dealing with Your Loved One

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1. 
   1
   Remain calm. One of the best things you can do to help your loved one is to stay calm. A person with Histrionic Personality Disorder thrives on chaos and drama. If they get dramatic or have a fit, reacting to them in a negative way will play into what they want and encourage the behavior. Instead, remain calm during these fits.

   • By not responding to your loved one’s dramatic actions, you help them realize that they will not get the attention they want by acting out.
   • You may need to engage in deep breathing exercises or step away from your loved one for a few moments to collect yourself.
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   Don't reward attention-seeking behavior. Your loved one may engage in dramatic, attention-seeking behavior on a regular basis. One of the best ways to deal with this is to ignore it. Refrain from engaging with the behavior or reinforcing the negative behavior with attention.

   • Your loved one has a chemical imbalance, which means they may not be able to help their behavior. Instead of getting into an argument or encouraging behavior, just ignore it and let it pass.
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   Put physical distance between you and your loved one. People with HPD form intimate attachments very easily, which means they may cross physical boundaries. They may not be able to understand or respect the boundaries you have set for yourself. You may find your loved one hugs you, touches you, or invades your space more than you wish. Your loved one may interpret your actions as threatening or inappropriate. To help with this, keep physical distance between you and them.

   • For example, you may want to sit in a chair if your loved one is on the couch, or sit on the other end of the couch. When standing, keep a few feet between you and your loved ones.
   • You should be mindful not to do anything that might be suggestive or interpreted as inappropriate. You don’t want your loved one to misinterpret what you are doing. Always be mindful of your boundaries.
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   Suggest alternatives for your loved one. One of the main symptoms of HPD is wearing provocative clothing to get attention. This type of attire is not suitable for all situations, such as work. You can help your loved one by suggesting they dress differently for certain situations.

   • Make sure to start any suggestion with a compliment. Those with HPD respond extremely negatively to any criticism. By complimenting them, you can help yourself get a positive response.
   • For example, you may say, “I really love that outfit. You should wear that tomorrow night when you go out with your friends! Why don’t you wear this to work instead today? It looks great on you, and everyone will think you look classy."
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   Ask for support when your loved one states an opinion. Oftentimes, people with HPD will just talk or argue with people because they like the attention and drama. They may offer strong opinions while offering no support. When this happens, ask your loved one to back up his or her opinion.

   • For example, you may say, "What are you basing that opinion on?" or "Do you have any examples to support your opinion?" You may also say, "That doesn't sound like a correct statement. Can you give me some evidence to support your position?"
   • If your loved one cannot support their opinion, tell them they need to only provide opinions based on facts or details. Encourage them to research issues so they can make informed opinions.
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   Encourage your loved one to evaluate what other people say. Some people who have HPD are highly suggestible and will just go along with what other people say. If you notice that your loved one is blindly agreeing with people or doing what other people tell him or her to do, then try to encourage your loved one to think for him or herself.

   • If you notice that your loved one is agreeing with someone without evaluating the statement, then you could try asking some questions to help you loved one evaluate what the person said. For example, your loved one might repeat a political opinion as a fact because they heard someone else say it. You could then ask your loved one questions like, what is the evidence for that? How did they come to that conclusion? Why do you agree with them?
   • If your loved one is doing something because someone has suggested it, then you can also use questioning to help. For example, your loved one might start dressing differently because someone suggested it. You might ask your loved one questions like, do you really want to do that? Would you be doing that if he or she had not suggested it? What might you be doing if he or she had not suggested that?
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   Refrain from making excuses. When your loved one has HPD, you may find yourself wanting to make excuses for their behavior, cover up their behavior, or clean up any messes they have made. This is not your job, and can take a toll on you. Try not to make excuses or mediate any messes your loved one has made. This may just enable your loved one’s behavior.

   • Your loved one’s behavior may be humiliating for you. However, learning to walk away or detach yourself may be the best way to take care of yourself.
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   Help your loved one come up with solutions. Often, people with HPD ignore solutions in favor of focusing on the drama of the problem. One way you can try to help your loved one is by encouraging them to come up with solutions and focus on problem-solving techniques instead of the problem.

   • For example, when your loved one gets dramatic about a problem, listen to what they say about the problem. Then say, “I understand you have a problem, but dwelling on it will not help you or anyone else. Let’s work together to find a solution.”
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   Explore other things. To help keep your loved one’s attention-seeking or manipulative behavior at a minimum, you should talk about or do other things with them. Don’t let your loved one dwell on problems or dominate the spotlight. Talk about yourself or suggest that the two of you do an activity together.

   • For example, you may want to say, “We have been talking about you for a long time now. I would like to share with you things about my life.”
   • You can try to distract your loved one if they are in a middle of an attention-seeking or manipulative episode. You can change the subject, start watching television, or suggest that you go for a walk or to a movie.
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    Avoid trying to teach your loved one a lesson. Sometimes, loved ones of those with HPD abandon the person to teach them some sort of lesson. This can arise when the person with HPD manipulates you too much or you feel nothing that you do is working. This kind of punitive behavior does not work with people with HPD, so you should avoid the temptation.

    • If you do this, your loved one may feel abandoned and throw a dramatic fit since you abandoned them.
    • You may end up feeling helpless and manipulated if you try to use this kind of manipulation on your loved one. Avoid using games with your loved one. Stay direct and open with them instead.
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Part 3

Part 3 of 5:

Communicating Clearly

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Good communication can help people with HPD, especially since they may have limited self awareness.

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   Try labeling their behaviors. People with HPD report being somewhat oblivious to their destructive habits, meaning that they may not realize when they are out of line. Make an observation or question about what they're doing. This encourages them to step back and re-evaluate what they're doing.

   • "You're spiraling."
   • "Are you trying to manipulate me?"
   • "It looks like you're starting something self destructive."
   • "Honey, you're making it about you again."
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   Remind them of the consequences of what they're doing. People with HPD may not think things through, or realize that their actions could have destructive consequences. Calmly remind them of what could happen if they act, or keep acting, a certain way.

   • "You're making me uncomfortable. If you keep doing this, I will leave."
   • "This is John's special day. If you do that at his party, he'll feel really hurt and upset."
   • "You could get seriously hurt if you do that."
   • "When you do this, it makes me not want to spend time with you."
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   Try empathizing with them, and then setting a limit. People with HPD may feel sensitive to rejection, because they're deeply insecure. Helping them label their feelings allows them to better understand how they're feeling, and know that you aren't rejecting them (just asking them to stop doing something).

   • "I get that you're feeling lonely. But faking an injury isn't a healthy way to get attention. If you want, we could do something simple together, like taking a walk or playing a board game."
   • "I know you're excited to be with friends. Please remember to let Jamal talk, too."
   • "I can tell that you're upset. I'm exhausted, though, and I don't have the energy to talk about it. Could you call your sister, or talk to me in the morning?"
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   Express feelings and boundaries clearly and calmly. People with HPD can benefit from explicit boundaries and reminders. Try using "I" language to explain how their behavior makes you feel. This can serve as a warning so that they can slow down and think.

   • "When you ______, I feel ______. Because of this, _________."
   • "Please, stop interrupting me. I'm getting frustrated."
   • "That really hurt my feelings."
   • "You're embarrassing me. It makes me want to leave."
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   Follow through with consequences if your loved one doesn't heed your warning. They need to know that when you set boundaries, you mean what you say. For example, if you say that you're going to leave if they keep doing something, and they keep doing it, then leave.
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   Talk about inappropriate behavior, without criticizing them personally. People with HPD act out because they feel insecure, and you don't want to be cruel or make things even worse. Talk about their behavior, and the consequences of their behavior, without labeling them as selfish or bad. This helps them re-examine their actions and learn from them.

   • Unhelpful: "You're such a drama queen! I can't deal with you anymore! I'm never taking you anywhere again."
   • Helpful: "I'm disappointed and embarrassed that you flirted with my boss, even after I asked you to stop. It makes me not want to take you to work parties anymore, because I don't know how to deal with this."
   • Unhelpful: "You're so embarrassing! If you don't stop being like this, you'll end up sad and alone."
   • Helpful: "You really embarrassed me in the grocery store today. Now I feel bad, and I don't know what I'll do next time I see Mrs. Alvarez in public."
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Part 4

Part 4 of 5:

Helping Your Loved One Get Treatment

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1. 
   1
   Encourage treatment. The best way a person with HPD can get better is through treatment. However, most people with HPD either don’t seek treatment or they only stay in treatment for a short period of time. You should encourage your loved one to get treatment. If they are already seeking treatment, help encourage them to continue treatment, even when they get bored or want to quit.

   • "I love you, and your behavior is hurting yourself and me. Would you be willing to get treatment?”
   • “I know you feel that treatment is no longer exciting or that you are better, but this is a major condition that cannot be fixed quickly. Will you please reconsider going back to treatment?”
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   Help them get psychotherapy. Psychotherapy is the most effective treatment for HPD. This includes talking with a therapist who can use different therapeutic approaches to help your loved one, such as cognitive behavioral therapy. Most people with HPD don’t continue with their therapy after beginning because they lose interest, think they are better, or are too impulsive to follow through with their treatment.

   • Cognitive behavioral therapy can address problematic behaviors, such as impulsive actions, manipulative behaviors, and theatrics.
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   Seek treatment for underlying conditions. Often, people with HPD also have other disorders, such as depression. Because of their feelings of insecurity, inadequacy, and abandonment, they may feel depressed and need to be treated for this.

   • If this is the case, your loved one can take selective serotonin reuptake inhibitors (SSRIs) to treat the depression, which may help their overall mood. SSRIs are common in the treatment of depression, and include medications such as Zoloft, Celexa, and Prozac.
4. 
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   Watch for any destructive behavior. Histrionic personality disorder may lead to self-destructive behavior. People with HPD often exhibit suicidal behavior or behavior leading to self-harm. The person may just be threatening these behaviors to gain attention, so you need to make a decision about the seriousness of the threat.

   • Some people with HPD will harm themselves or try to commit suicide to gain attention. Try to notice when your loved one is getting to this destructive stage.
   • People with HPD may also exhibit dangerous behavior towards others. Watch your loved one to see if they exhibit any tendencies to hurt those around them.
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Part 5

Part 5 of 5:

Taking Care of Yourself

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1. 
   1
   Consider seeing a therapist. Talking with a therapist about your challenges and feelings regarding your loved one’s histrionic personality disorder is a good way to care for yourself. A therapist can help you to develop healthy coping mechanisms, learn how to communicate with your loved one more effectively, and work through your emotions. Consider talking to a therapist as part of your self-care strategy.
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   Seek help from your friends and family. Dealing with a loved one with HPD can be an emotionally exhausting task. You may feel helpless, trapped, or confused. Seek support from your loved ones when you need it. Make time to be away from your loved one, and instead, visit and interact with others. This can help you find support that you need.

   • Talk to your friends and family about your difficulties. You may even ask them for advice if things get too much to bear.
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   Do not allow your loved one to dictate your other relationships. Because people with HPD often feel inadequate or inferior, they may throw fits or act in an over-dramatic way when you form relationships and spend time with other people. You cannot let the person dictate your other relationships.

   • Your loved one may see another friend, partner, or even child as a threat. Discourage this behavior. Don’t give into any behavior where your loved one tries to discourage the relationship. For instance, you can say, “I have friends and invite them over once in a while. This does not affect my love for you.”
   • Your loved one may get jealous or threatened by you participating in activities that don’t include them. Refrain from giving up activities because of your loved one’s HPD.
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   Realize that your loved one may not understand your needs. People with HPD can appear self-centered. This means that they may not understand or respect your needs, even if you have outlined them. They do not realize their actions are wrong, or how their actions affect other people.

   • You may need to accept that your loved one will never treat you how you deserve to be treated. This is why setting boundaries and limits in the relationship is so important.
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Tips

• Some people with HPD benefit from spending time in theater or other performing arts, where they have an appropriate way to get attention and perform.
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Warnings

• Sometimes, people with HPD may be abusive. You are not obligated to spend time with an abusive person, and you have the right to distance yourself or cut contact altogether. Do what's right for you.
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