Psychodynamic Personality Disorder Analysis
Imagine having a roommate that always finds a way to be the center of attention. Now try to imagine having an argument with your roommate that feels like you are arguing with a stubborn toddler, so you have to consistently become the “reasonable” one. Lastly, imagine feeling like you must serve and admire your roommate twenty-four hours, seven days a week, for their happiness. Is this hard to imagine? Unfortunately, this could be the reality of an individual living with a person who has a histrionic personality disorder (HPD). This disorder is defined as pervasive and excessive emotionality and attention-seeking behavior (Diagnostic and Statistical Manual of Mental Disorder Fifth Edition, 2013).
Similarly to modern times, HPD has been associated with the “mysterious nature of women” during the ancient era (“The "Female Mind": Hysteria”, …show more content…
n.d). In the past, hysterical neurosis (now known as conversion disorder) and hysterical character (now known as HPD) were categorized as the same concept, hysteria which was considered the first mental disorder. The word hysteria comes from Greek root word uterus and hystera which was used by various cultures to attempt to explain the female etiology of hysteria or hysterical personality (HP) (“The "Female Mind": Hysteria”, n.d). In ancient Egypt, the Egyptians believed a HP was exclusively a female disorder (Carta, Fadda, Rapetti, & Tasca, 2012). The women labeled as hysteric would have disturbances in their behavior meaning lack of control and respiratory distress (“The "Female Mind": Hysteria”, n.d). Egypt’s first description of a HP was written on papyrus. The document dated back to 1900 BC and claimed that the etiology was due to spontaneous uterus movements within the female body (Carta et al., 2012). Many Egyptians believed the uterus was a free-floating organism (wandering womb) thus the uterus could easily become dislocated and give rise to various pathologies in women (Micale, 2008). Egyptian doctors attempted to treat women with HP with medications to relocate the uterus in the correct position. Treatment practices included placing putrid and acidic substances near the mouth and nostrils or swallowing the substances to push the uterus away from the upper parts(Micale, 2008). Foremost among their practices included placing the sweet smelling substances on the vulva (Stein, 2009). This would help the uterus relocate in the correct place.
Similarly to the ancient Egyptians, the Greeks believed hysteria in women was due to the wandering womb, but the Greeks also included the womb wandered because of sexual dissatisfaction (“The "Female Mind": Hysteria”, n.d). When mature women showed HP symptoms, such a dizziness, motor paralysis, convulsions, paroxysms, sensory losses, respiratory distress, and extravagant emotional behavior. The Greeks, especially a prominent Greek physician Hippocrates, believed it was due to sex deprivation which caused their uterus to move upward (“The "Female Mind": Hysteria”, n.d). Hippocrates also believed that the lack of sex caused a female to become overly emotional, so he suggested that females should marry to live a satisfactory sexual life and placing aromas near the genital (Carta et al., 2012).
On the other hand, Soranus, a Greek physician and considered the first gynecologist in the second century, thought that hysteria came from procreation (Carta et al., 2012). He believed that females needed to abstain from sex, clean their genitals in hot baths and massages, and exercise to prevent hysteria.
In the middle ages, which includes the fifth to the fifteenth century, attitudes of hysteria changed from a physiological disorder to a demonic possession by theologians (Araujo, Godinho, & Novais, 2015). The theologians believed hysteria came from the devil entering the woman's body to possess them and turn them hysterical. Unlike the previous era treatments of hysteria, the middle age era believed hysteria was an incurable sin because the belief was “if physician cannot identify the cause of a disease, it means that it is procured by the Devil” (Carta et al., 2012), so many women accused of having hysteria was murdered by the inquisition. Most women accused of acting hysterical were either widowed or young.
In the modern age, Thomas Willis, a physician, introduced new etiology for hysteria. He rejected the belief of the wandering womb and suggested that the causes of hysteria were due to the nervous system and brain malfunction. Later on, Jean-Martin Charcot furthered the research on hysteria by suggesting that hysteria was a neurosis (Araujo et al., 2015) and not limited to merely women. Charcot also found that hypnosis was successful at relieving hysterical physical problems(Grossman, Meagher, C .Millon, T. Millon, & Ramnath, 2012). Pierre Janet, a French psychologist, suggested hysteria stemmed from the patient’s pathology and translating it into a physical disability (Hart and Kolk, 1989). Janet’s also studied various concepts such as psychological automatism, consciousness, subconsciousness, narrowed field of consciousness, dissociation, suggestibility, fixed idea, and emotion, which were then elaborated by Sigmund Freud to explain hysterical neurosis. Charcot and Janet’s work were both influential to Freud’s psychoanalytic theory of hysteria which gained popularity, but the first man to consider HPD as personality disorder was an Austrian physician named Ernst von Feuchtersleben, also known as the forgotten physician (Araujo et al., 2015). He made the first psychosocial description, of what is now known as HPD. He claimed, “hysterical women as being sexually heightened, selfish and overprivileged with satiety and boredom” (Millon, 2011).
Today, psychoanalysis and cognitive theories of HPD are the most accepted theories. Freud’s psychoanalytic theory of hysteria developed after he published his famous case study of Anna O. At first, Freud brought forth the seduction theory. He believed that individuals with HPD were victims of actual abuses, but he abandoned that belief due to the lack of candidness from his patients (Bogousslavsky & Dieguez, 2014). Then, Freud adopted the theory of hysteria, which claimed HPD was due to the re-experience of past psychological trauma (Araujo et al., 2015). Freud also believed HPD was the result of a defense mechanism which stemmed from early development. The defense mechanism helped protect the individual from stress due to the individual's caregiver lacked the expression of unconditional love (Bogousslavsky & Dieguez, 2004). Cognitivists theory suggests that individuals with HPD believe they are too inadequate to handle life by themselves, so their attention seeking behavior is due to an internal belief that they are incapable of existing without the help of others. Also, these individuals are desperately seeking attention and approval while believing it is more important to be seen than liked (Freeman, 2014). Theodore Millon, a prominent personality psychologist conducted extensive research on personality disorders. He believed a biosocial-learning model that included individuals with HPD developed the disorder from an unconscious pattern of reinforcement by the parents or caregivers (Araujo et al., 2015). Millon also created a trait theory (six subtypes) for HPD which is still accepted today.
He created six subtypes of HPD and concluded anyone with HPD may exhibit none or one the following subtypes (Grossman, Meagher, C .Millon, T.
Millon, & Ramnath, 2012). The first subtype Millon mentions is appeasing which has dependent and compulsive features. This person might attempt to please people by compromising when there is a disagreement. The second subtype is vivacious which have narcissistic features. A person under this category is typically energetic, charming, and bubbly. The third subtype is tempestuous which involves negativistic features. (Grossman, Meagher, C .Millon, T. Millon, & Ramnath, 2012)An individual under this category is usually stubborn, impulsive, and moody. The fourth subtype, disingenuous, involves antisocial features. A person in this subtype is often egocentric, deceitful, and insincere. The fifth subtype, theatrical, involves a variant of “pure” histrionic. An individual under this category can be theatrical and dramatic. Last, the sixth subtype, infantile, has borderline feature. This person may be child-like, hysteric, and overly attached (Grossman, Meagher, C .Millon, T. Millon, & Ramnath,
2012).
Similarly to modern times, HPD has been associated with the “mysterious nature of women” during the ancient era (“The "Female Mind": Hysteria”, …show more content…
n.d). In the past, hysterical neurosis (now known as conversion disorder) and hysterical character (now known as HPD) were categorized as the same concept, hysteria which was considered the first mental disorder. The word hysteria comes from Greek root word uterus and hystera which was used by various cultures to attempt to explain the female etiology of hysteria or hysterical personality (HP) (“The "Female Mind": Hysteria”, n.d). In ancient Egypt, the Egyptians believed a HP was exclusively a female disorder (Carta, Fadda, Rapetti, & Tasca, 2012). The women labeled as hysteric would have disturbances in their behavior meaning lack of control and respiratory distress (“The "Female Mind": Hysteria”, n.d). Egypt’s first description of a HP was written on papyrus. The document dated back to 1900 BC and claimed that the etiology was due to spontaneous uterus movements within the female body (Carta et al., 2012). Many Egyptians believed the uterus was a free-floating organism (wandering womb) thus the uterus could easily become dislocated and give rise to various pathologies in women (Micale, 2008). Egyptian doctors attempted to treat women with HP with medications to relocate the uterus in the correct position. Treatment practices included placing putrid and acidic substances near the mouth and nostrils or swallowing the substances to push the uterus away from the upper parts(Micale, 2008). Foremost among their practices included placing the sweet smelling substances on the vulva (Stein, 2009). This would help the uterus relocate in the correct place.
Similarly to the ancient Egyptians, the Greeks believed hysteria in women was due to the wandering womb, but the Greeks also included the womb wandered because of sexual dissatisfaction (“The "Female Mind": Hysteria”, n.d). When mature women showed HP symptoms, such a dizziness, motor paralysis, convulsions, paroxysms, sensory losses, respiratory distress, and extravagant emotional behavior. The Greeks, especially a prominent Greek physician Hippocrates, believed it was due to sex deprivation which caused their uterus to move upward (“The "Female Mind": Hysteria”, n.d). Hippocrates also believed that the lack of sex caused a female to become overly emotional, so he suggested that females should marry to live a satisfactory sexual life and placing aromas near the genital (Carta et al., 2012).
On the other hand, Soranus, a Greek physician and considered the first gynecologist in the second century, thought that hysteria came from procreation (Carta et al., 2012). He believed that females needed to abstain from sex, clean their genitals in hot baths and massages, and exercise to prevent hysteria.
In the middle ages, which includes the fifth to the fifteenth century, attitudes of hysteria changed from a physiological disorder to a demonic possession by theologians (Araujo, Godinho, & Novais, 2015). The theologians believed hysteria came from the devil entering the woman's body to possess them and turn them hysterical. Unlike the previous era treatments of hysteria, the middle age era believed hysteria was an incurable sin because the belief was “if physician cannot identify the cause of a disease, it means that it is procured by the Devil” (Carta et al., 2012), so many women accused of having hysteria was murdered by the inquisition. Most women accused of acting hysterical were either widowed or young.
In the modern age, Thomas Willis, a physician, introduced new etiology for hysteria. He rejected the belief of the wandering womb and suggested that the causes of hysteria were due to the nervous system and brain malfunction. Later on, Jean-Martin Charcot furthered the research on hysteria by suggesting that hysteria was a neurosis (Araujo et al., 2015) and not limited to merely women. Charcot also found that hypnosis was successful at relieving hysterical physical problems(Grossman, Meagher, C .Millon, T. Millon, & Ramnath, 2012). Pierre Janet, a French psychologist, suggested hysteria stemmed from the patient’s pathology and translating it into a physical disability (Hart and Kolk, 1989). Janet’s also studied various concepts such as psychological automatism, consciousness, subconsciousness, narrowed field of consciousness, dissociation, suggestibility, fixed idea, and emotion, which were then elaborated by Sigmund Freud to explain hysterical neurosis. Charcot and Janet’s work were both influential to Freud’s psychoanalytic theory of hysteria which gained popularity, but the first man to consider HPD as personality disorder was an Austrian physician named Ernst von Feuchtersleben, also known as the forgotten physician (Araujo et al., 2015). He made the first psychosocial description, of what is now known as HPD. He claimed, “hysterical women as being sexually heightened, selfish and overprivileged with satiety and boredom” (Millon, 2011).
Today, psychoanalysis and cognitive theories of HPD are the most accepted theories. Freud’s psychoanalytic theory of hysteria developed after he published his famous case study of Anna O. At first, Freud brought forth the seduction theory. He believed that individuals with HPD were victims of actual abuses, but he abandoned that belief due to the lack of candidness from his patients (Bogousslavsky & Dieguez, 2014). Then, Freud adopted the theory of hysteria, which claimed HPD was due to the re-experience of past psychological trauma (Araujo et al., 2015). Freud also believed HPD was the result of a defense mechanism which stemmed from early development. The defense mechanism helped protect the individual from stress due to the individual's caregiver lacked the expression of unconditional love (Bogousslavsky & Dieguez, 2004). Cognitivists theory suggests that individuals with HPD believe they are too inadequate to handle life by themselves, so their attention seeking behavior is due to an internal belief that they are incapable of existing without the help of others. Also, these individuals are desperately seeking attention and approval while believing it is more important to be seen than liked (Freeman, 2014). Theodore Millon, a prominent personality psychologist conducted extensive research on personality disorders. He believed a biosocial-learning model that included individuals with HPD developed the disorder from an unconscious pattern of reinforcement by the parents or caregivers (Araujo et al., 2015). Millon also created a trait theory (six subtypes) for HPD which is still accepted today.
He created six subtypes of HPD and concluded anyone with HPD may exhibit none or one the following subtypes (Grossman, Meagher, C .Millon, T.
Millon, & Ramnath, 2012). The first subtype Millon mentions is appeasing which has dependent and compulsive features. This person might attempt to please people by compromising when there is a disagreement. The second subtype is vivacious which have narcissistic features. A person under this category is typically energetic, charming, and bubbly. The third subtype is tempestuous which involves negativistic features. (Grossman, Meagher, C .Millon, T. Millon, & Ramnath, 2012)An individual under this category is usually stubborn, impulsive, and moody. The fourth subtype, disingenuous, involves antisocial features. A person in this subtype is often egocentric, deceitful, and insincere. The fifth subtype, theatrical, involves a variant of “pure” histrionic. An individual under this category can be theatrical and dramatic. Last, the sixth subtype, infantile, has borderline feature. This person may be child-like, hysteric, and overly attached (Grossman, Meagher, C .Millon, T. Millon, & Ramnath,
2012).