Introduction - Male HPD

Hi. I just wanted to introduce myself. I'm a male, 49 yo, recently married (first anniversary last weekend) for the first time, recovering HPD. I am MBTI INFP and was in therapy for over 15 years (3 y psychoanalytical, 6y transference focused psychotherapy). I consider myself to be out of therapy since 1994. I tried to go back a couple of times but just never got anything out of it. I work for the government doing research. I thought if anyone had any questions I might possibly be able to answer them, but I have seen that almost all the HPD interactions are with females.

tstrobaugh,

I have a few questions regarding the eventual path of a male HPD and your personal experiences in relation.

During your haydays of histrionic behavior, were you a heavy drinker?
How long was your longest relationship and how did it end?
Did you manage to keep any friends along the way?
When was the first time you sought therapy/counseling?
Why did you seek it at that point in your life?
Do you wish you had done it sooner or not at all?

Thanks for the insight, it's nice to have another HPD male on the forums, especially someone with some experience.


-hystrio

H:During your haydays of histrionic behavior, were you a heavy drinker?
T:Didn't drink at all in HS, not too much before age 21. Was a bartender at Penn State, part of the crowd was drinking. Drank 3-4 nights a week till about age 24. During this time I wondered if I was addicted so I stopped for several months just to find out. Didn't seem to bother me. Drink 2-3 drinks a week now, usually wine.
H:How long was your longest relationship and how did it end?
T: Tricky question. Remember we have "idealized" relationships. I've had relationships in my head with one girl for about 15 years, but in reality was probably never "with" her. I mean we had sex but I don't know if we had a relationship. She was probably a Narcissist. I have a real relationship now. I'm married, for one year, and we've been exclusive for about 7 years. Before that usually about 3-4 years with each girlfriend, all of those are after the "first" who was the "idealized" one, and after therapy also.
H:Did you manage to keep any friends along the way?
T: I have all my original friends. I'm going on vacation this week with I guy I met in 2nd grade and his wife and another guy I met in 7th grade and his wife. One was my best man and the other also in the wedding.
H: When was the first time you sought therapy/counseling?
T: I always knew I had "emotional problems" or now I know that it's called "emotional dysregulation". It started when i was in 7th or 8th grade (11-12yo).I was always seeking someone to help me with it, guidance counselors, etc. I don't think it was until I was about 24 or so that I started serious therapy.
H:Why did you seek it at that point in your life?
T:Trouble with the law. Took "identity diffusion" a little too far and got a fake identity, opened accounts, wrote bad checks, good plan, but someone saw me in one of the stores and recognized me. Was "court ordered", but I didn't see it as punishment because I wanted it anyway. Three years of twice a week Psychoanalysis.
H:Do you wish you had done it sooner or not at all?
T: Wish I had done it sooner. Well always wanted someone to "be" with me. Always felt alone with no one to turn to. Always wanted a "friend". Needs were denied for so long, that, and attachment issues are what lead to HPD (http://www1.appstate.edu/~hillrw/Histri ... iology.htm).

tstrobaugh,

Thank you for taking the time to answer those questions. I'm about half your age but I already see some important similarities in the way we live our lives. I had my first idealized relationship from about 15-18 and then I went on a string of two consecutive 2-3 year relationships that had much more substance than the first.

Although I know it's probably best, I'm somewhat terrified of going to a therapist on a regular basis. As the usual center of attention amongst my family and friends I don't know if I could take having to tell them I was attending therapy. I'm also nervous that what I'm going to hear is nothing short of "you don't really care about your current girlfriend, you're just in love with the attention she gives you". Whether I've fooled myself into leading a double life when I'm not with her or whatever the case may be, it's obvious to me that I only appreciate the little things we do. I'm missing that fundamental good feeling you get about being with someone you love just because you love them. If any of this sounds familiar please let me know as I'm all ears at this point.

Strangely enough I exhibit all the behaviors of a successful single but I'm a serial monogamist. I usually let my relationships go long term and when they end it takes me less than a month before I've found someone new. This of course doesn't help because then I have friends/flirtations knocking on my door saying "hey! now that your single..." but I never let myself take advantage of those opportunities. Add to that the fact that I just moved in with three roommates who are all seriously committed I'd be the black sheep even if I just put my current relationship on break. Talk about identity diffusion, huh? Since I can remember I've been a big dreamer and I do actually follow through on occasion. However, I never know what to do with myself when it comes to things like, moving to Japan for six months or staying in Boston with my buddies and girlfriend. Big University on the West Coast or small business school in Boston? Move to New York to make it or break it, or play it smart and start paying down my student loans? Ugh, I'm sure you know where I'm headed.

I'm usually very good day to day but when it comes to making life decisions I've always relied on the guidance of others. I guess there is your case and point example of "easily influenced". Finding someone out there who seems to have been through quite a bit of this is extremely valuable as far as I'm concerned. Please let me know if you've got any wisdom to impart.

hystrio

" I had my first idealized relationship from about 15-18 and then I went on a string of two consecutive 2-3 year relationships that had much more substance than the first."
I had my first idealized relationship in 7th-8th grade, that's what brought on the trouble, or the other way around probably. It was all in my mind, no relationship really. Had another really big one around 21-22, again, unrequited love. I don't know what all this talk about sex with HPD's is about, I was a virgin until I was 24. This plays into the idealized relationship, there can be only one. I used sex, in my mistaken belief, that I would become whole. But again was rejected (pattern of abandonment) and finally went into therapy seriously.
"I'm missing that fundamental good feeling you get about being with someone you love just because you love them."
I'm reading this right now: http://psychcentral.com/lib/2007/transf ... hotherapy/
This part really got me:"While the patient has no conscious awareness of this split internal world (and his or her ability to identify with either side of it at different moments in time), this structure underlies and determines the symptoms mentioned above, such as chaos in interpersonal relations, emotional lability, black-and-white thinking, anger, and proneness to lapses in reality testing. In psychodynamic terms, this split internal structure corresponds to the syndrome of identity diffusion and use of primitive defense mechanisms. In more phenomenological terms, this psychological structure results in an individual going through life with a subjective experience that is fragmented, discontinuous, rigid and impoverished."
I see on your tag the mirror quote. That's good you can see yourself, the hard part is to see the mirror (not sure if I can either).

I'm not sure how much wisdom I have, I want to try to present myself honestly, even for someone who's had negative interactions with an HPD who wants to get a little insight. I actually have recently started having "panic attacks", which I never had before. I had a double bypass about 4 years ago and about 2 years ago I had to go to the hospital a couple of time because I thought I was having a heart attack, but they couldn't find anything. Might be from some PTSD from childhood abuse, or the HPD exaggerating physical symptoms or just plain old middle age crisis. Anyway, just threw that in there so that you don't think that I think I'm all "cured" and perfect and everything.

Tstrobaugh and Hystrio,

My only experience is with female HPDs, but it's certainly interesting to have the male perspective here as well. I came across an article the other day; it was published in a psychoanalytic journal (I can give you the source, if you like) and was an analysis of the film "Sideways". Basically, the author argued that the two protagonists - Miles and Jack - were textbook examples of male HPD from different ends of the spectrum, one neurotic and introvert (passive-aggressive) and the other extremely outgoing.

Have you seen the film? Do you agree with the author's "diagnosis"? It would be interesting to hear your views. I remember thinking that they were quite likeable as fictional larger-than-life-characters, but that I probably didn't want to be friends with them in real life. I certainly didn't think of HPD.

I saw the movie Sideways and enjoyed it. I definitely identified with the Paul Giamatti character. I'm actually a wine snob and am on a Pinot Noir kick currently. Most professional "critics" are histrionic. Wine, Movies etc. Here is the link that talks about the movie characters as HPD: http://www.pep-web.org/document.php?id=ppsy.023.0667a

Some background info on Hysterical and Histrionic subtypes of HPD:

#######1, Leonard
Management of personality disorders in acute in-patient settings. Part 2: Less-common personality disorders
Adv Psychiatr Treat 2004 10: 100-106

Hysterical and histrionic personality disorders

Hysterical and histrionic conditions are not properly distinguished in DSM–IV. Hysterical conversion disorder is subsumed under conversion or somatoform disorder and is not related to hysterical personality disorder.

Gabbard (2000) describes both hysterical personality disorder and histrionic personality disorder. He attributes to them shared behavioural characteristics such as a tendency to labile and shallow emotionality, attention-seeking, disturbed sexual functioning, dependency and helplessness, and self-dramatisation. However, he differentiates hysterical personality as being healthier, whereas histrionic personality is more florid in every way, less subtle and more impulsive, functioning at a much more primitive level. This differentiation is often reflected in individuals’ respective success or failure to maintain relationships and work commitments, and in differences of degree of erotic transference wishes.

Although traditionally seen as female disorders, hysterical and histrionic personality disorders have also been extensively documented in men. These have fallen into two broad subtypes: the hypermasculine Don Juan, unable to commit himself to any relationship, and the passive effeminate man, homosexual or heterosexual, usually impotent. In both genders the cognitive style is impressionistic, unable to elaborate detail about the people or world around them, indicating a defensive emotional detachment (la belle indifference), although, paradoxically, they may present with shallow emotionality.

Women with histrionic personality disorder tend to have a history of maternal rejection, which draws them to their fathers for dependency needs. They become ‘daddy’s little girl’ and repress their own sexual maturation and identity.

Women with hysterical personality disorder have usually had more satisfying early relationships with their mothers, but develop intense feelings of rivalry and compete for their fathers’ attention. They are more likely to have a history of actual incest. In adulthood they appear to be unaware of their attempts at seductiveness. As a result their own sexuality and experience of intimacy are disturbed and unsatisfactory, as is their choice of partners. It is usually a relationship crisis, leading to dramatic acts of impulsive self-harm, that results in admission to an acute hospital setting by way of the accident and emergency department.

The story is similar for men. In men with histrionic personalities, maternal (and paternal) unavailability may lead them to emulate their mothers, adopting a passive, effeminate role, or their fathers, mimicking hypermasculine cultural stereotypes of masculinity. In those with hysterical personalities, feelings of sexual inadequacy keep men attached to their mothers, again either adopting effeminate or celibate lifestyles, or cause them to overcompensate by shallow efforts at becoming tough ‘real men’.

Both men and women with these disorders pose difficulties in in-patient settings, as they often engage in rivalrous relationships with other patients and erotic transferences to staff. They usually see themselves as special, tend to take over groups, where they need to be at the centre of all discussions, and take on other people’s problems as part of their own, in a self-referential manner. If thwarted in their attempts, they are likely to become increasingly dramatic, and sometimes become involved in risk-taking behaviour in order to attract attention. This often provokes negative countertransference feelings in staff, who then try to ignore their demands, which only reinforces the cycle.

Although long-term work with these patients is the province of the out-patient clinic or psychotherapy department, two principles of patient management can be applied in the in-patient unit that might help patients take on more long-term work.

First, the initial assessment should be used as an opportunity to challenge the patient’s cognitive style. However, this assumes that doctors and nurses intuitively know what is happening with these patients. History-taking (which can be a frustrating experience) is therefore extremely important, as it allows patients to describe, perhaps for the first time, their internal world, feelings and expectations.

Second, erotic transference must be effectively managed. Eroticised feelings towards staff can sometimes be very insistent and pervasive, and in an in-patient unit nursing staff are particularly vulnerable to overt or covert advances. Many careers have been blighted because of inappropriate crossing of sexual boundaries, which can also be devastating for patients.

The management of transference involves a close examination of countertransference feelings. There are large hurdles to overcome if this is to be dealt with appropriately, as there seems to be no tradition in the UK for openly discussing sexualised feelings, which are often ignored or denied in patients and staff. Nurses in particular have no vehicle for expressing their concern and no support system to rely on, and any suggested breaking of boundaries is immediately responded to in a punitive manner, by suspension or dismissal. Sometimes staff are so frightened of these consequences that they respond to patients’ advances with aggression or aloofness, which the patients read as evidence that sexual desires are dangerous or dirty. Another common response by staff is to tell the patient that their feelings are not real, when to the patient they are extraordinarily real. A more appropriate response is to communicate to the patient that sexual or loving feelings do occur but cannot be reciprocated. This acknowledges the reality of the feelings, but places them within a therapeutic process that can help staff to understand some of the patient’s inner thoughts and feelings, even if at times it is embarrassing or painful for the patient not to have their desires fulfilled.

I would have to say I'm of the Hysterical variety. On the outside, projecting a manly image. I'm 6'2" 230lbs, work out, ride bicycle, swim, triathlon. Played 4 sports on HS, got into many fights (rivalry/attention of father). "In those with hysterical personalities, feelings of sexual inadequacy keep men attached to their mothers, again either adopting effeminate or celibate lifestyles, or cause them to overcompensate by shallow efforts at becoming tough ‘real men’." That's pretty close. I've done both. I already said I was a virgin until 24. Thought I was a Zen wander, like a Kung-Fu character or something. Don't see the attachment to my mother though.

As to not wanting to be friends in real life. I don't know about that one. I remember friendship as being one off the most important things to me growing up. Many are larger than life. See:http://infp.blogsome.com/category/famous-infps/
Note, I consider INFP to be the "personality" of HPD. It's on a continuum, one is the personality, the other the disorder.

Terry

I was diagnosed 13 years ago Axis I: Major Depression, Axis II: Histrionic Personality Disorder.

I was in individual therapy for most of the intervening time, some 12 years. The subject of HPD rarely came up in therapy. I suspect that the therapists used the diagnosis to guide them, but didn't think I, the patient, would gain much insight by dwelling explicitly on this term.

I've lately been reading as much as possible about HPD and catching glimpses of insight that might in the long run give me traction in making changes for the better in my life.

Here is a statement that resonated with me:

"They consider themselves moral in a sense, but also exceptions, and rightfully so due to special circumstances, victim status, incapacity, and external justifications."

I also found this, from tstrobaugh, very intriguing:

"In men with histrionic personalities, maternal (and paternal) unavailability may lead them to emulate their mothers, adopting a passive, effeminate role, or their fathers, mimicking hypermasculine cultural stereotypes of masculinity. In those with hysterical personalities, feelings of sexual inadequacy keep men attached to their mothers, again either adopting effeminate or celibate lifestyles, or cause them to overcompensate by shallow efforts at becoming tough ‘real men’."

I have had a couple of long (7-8 years), stormy relationships in which sexual intimacy came to a complete stop long before we split up. There was a 'secret life' of pornography that my partner very much resented. When I stopped acting out with pornography, however, it did not improve my sexual relations with my partner. I simply became celebate. I have belonged to a 12-step fellowship around the issue of sexual addiction, although I don't currently attend.

I've made good progress in the area of work, but I continue to find the relationship piece difficult. It seems to boil down to ambivalence about commitment and an inability to give.

Thanks to the other HPD men who are sharing their insights here.

Do you think the world would explode if a HPD boy and girl dated? I mean.. do you think its possible? Or do people with HPD just have to find the right one who is willing to deal/or whatever.

I was in a short-lived relationship 13 years ago with a strongly HPD female. (I didn't understand this until I recently started reading some of the posts here by people who had been in relationships with HPDs. Thanks guys!)

The relationship was "the same only more so," for having two disordered participants. Very unstable. It was preceded by high hopes and intoxicating moments, but very quickly revealed itself as wrong for 1001 reasons. Discussions about the possibility of marriage and children took place in a bubble of shocking unreality. I think that HPDs believe somewhere that "love conquers all," and that play-acting at love with enough conviction will make all the misery go away.

We were both attractive basket cases, and soon probably figured out that the other was as empty as ourself. It was like two con artists that suddenly realize that they are putting the game on another crook as impoverished and desperate as themselves.