Article 13: Emotional Regulation and Rational Emotive Behavior Therapy for Histrionic Personality Disorder

6. Histrionic personality disorder

People with this personality type are affected, overly emotional, lack depth, and live like actors, craving attention. They are superficial in their actions, always seeking others' approval and feeling uncomfortable if ignored, resorting to extreme tactics to achieve this. While performative personalities are often endearing, their volatile and insincere emotions only win fleeting favor; yesterday's friends may become today's enemies. Therefore, their interpersonal relationships are generally poor.

Such individuals often complain of poor health, such as weakness and headaches, and sometimes even experience subjective feelings of depersonalization. When under excessive stress, they may exhibit temporary psychotic symptoms.

Common treatment methods include:

(1) Emotional Adjustment Method

People with this personality trait should listen to how others evaluate them, and what their true opinions and attitudes are towards them. They can start by surveying and asking their relatives and friends; they may have the following opinions about you:

● To laugh out loud at something that isn't particularly funny.

● He gestures wildly and unsteadily while speaking.

● They often burst into tears to express their excitement.

● Doing things intentionally to attract attention and feel smug about it actually annoys others.

Patients should not argue with these statements, but rather calmly analyze their own behavior. They should examine whether they frequently exhibit these behaviors in their daily lives, whether their reactions are truly excessive, and whether others share similar personality traits. Through reflection, patients can develop a more objective evaluation of their behavior and adjust any excessive actions. Patients should correct their exaggerated emotional expressions as follows:

● They often make witty remarks and tell humorous stories to make people laugh.

● Be mindful of your behavior when speaking to avoid excessive gestures.

● When emotional, use appropriate words instead of tears.

● Learn to be more grounded and earn the respect of others through your maturity.

Repeatedly reminding and urging yourself to consciously control excessive emotional expressions, and sincerely asking friends and family for feedback on your behavior. For the parts they can accept, it means you've improved; for the parts they can't accept, continue to correct them. Observe the words, actions, and emotional expressions of others to make your own emotional responses more natural and appropriate, thus becoming increasingly natural.

(2) Rational Emotive Behavior Therapy

Every negative emotion arises from underlying negative cognitive beliefs. It's not that event A causes the negative emotion C, but rather the evaluation B of event A directly triggers emotion C. Therefore, to change negative emotion C, one must first change negative cognition B. Please calmly analyze your incorrect cognitive beliefs in each instance of exaggerated emotional expression. For example:

● Emotional reaction: Getting furious over a colleague's harsh words.

● Cognition: I absolutely will not allow myself to say this in front of others; I will fight back fiercely.

● Emotional reaction: After winning a bet with a friend, one becomes arrogant, ridicules the friend to the extreme, and boasts about it everywhere.

● Cognition: I won, which means I am amazing and better than them. I want everyone to know that I won.

These negative perceptions should be criticized and corrected. Patients can reflect on the validity of these thoughts themselves, or ask friends or elders for help in analyzing how they evaluate these matters, and then replace them with rational understanding, writing them down:

● Cognition: When faced with criticism from others, I should first remain calm and composed. I can explain and refute untrue statements, but there is no need to get angry.

● Emotional reaction: After listening for a while, he shrugged and walked away.

● Cognition: Winning a bet doesn't mean anything; I should surpass them at work. Besides, I also lose bets sometimes.

● Emotional reaction: If you win a bet, just laugh it off.

Patients should keep these points in mind, put them into practice, and reflect on their emotional reactions afterward. Whenever an excessive emotional reaction occurs in the future, they should identify the irrational cognitive beliefs and transform them into rational ones; gradually, their emotional reactions will approach normal.

Psychological abnormality

Psychopathy can be classified into two categories based on the degree of psychological disorder: severe psychopathy and mild psychological abnormality.

Severe psychopathology refers to the overall disruption of a person's mental activity and the breakdown of its coordination. It manifests as an inability to adapt to the objective environment, a lack of self-awareness regarding one's abnormal words and actions, and often causes adverse effects and harm to society. This type of psychopathology is common in severely mentally ill patients.

Mild mental disorders refer to abnormalities that occur when certain aspects of overall mental activity are impaired. Individuals with this type of mental disorder can adapt to their environment, live independently, are aware of their abnormality, and seek medical attention. Examples include neurosis, which includes neurasthenia, hysteria, anxiety disorders, obsessive-compulsive disorder, hypochondria, and depression.

Patterns are also extremely important.

Psychotherapy: Consult a doctor carefully to understand the causes, clinical characteristics, evolution, and prevention and treatment of neurasthenia. Fully understand the nature of the disease, eliminate fear of it, and actively cooperate with the doctor's treatment. Adjust your lifestyle, pay attention to the balance between work and rest, and persist in physical exercise to enhance your physical fitness and the stability of the central nervous system's functional activities.

Drug treatment: mainly symptomatic treatment. For anxiety symptoms and those who are agitated and irritable, diazepam, nitrazepam, etc. can be used first.

1. Neurasthenia

For patients, taking a longer walk (e.g., 2-3 kilometers) helps regulate the excitation and inhibition processes of the cerebral cortex and alleviate symptoms of vasomotor dysfunction (such as headaches and throbbing pain in the temples). Even healthy people will feel refreshed and in a good mood after a walk.

Those with better physical strength can participate in short-distance marches or trips, which can provide them with ideological education, shift their focus, improve their mood, and enhance their physical fitness.

Cold water bath: The stimulation of cold water helps strengthen the nervous system and improve physical fitness. Therefore, cold water baths are suitable for patients with neurasthenia, preferably after waking up in the morning. In the early stages, start by wiping the body with warm water. After a period of repeated exercise, switch to wiping the body with cold water once you get used to it. Finally, rinse or shower with cold water for about 30 seconds to 1 minute each time. Swimming can be done frequently in summer, and the effect is even better if you can continue until autumn and winter.

Other exercises: Patients with poor mood and low spirits are suitable for games or exercises that can improve their mood, such as table tennis, basketball, rowing, rope skipping, and shuttlecock kicking. They are also suitable for light outdoor labor.