So I just got my diagnosis. What now?

The more i learn about HP, the more I think that much of it is related to how god made you versus how god made me.... but i think much of it may be due to the way you were made.... As 99 percent of us were made a little differently from you.....

There is a lack of research on the causes of HPD. Even though the causes for the disorder are not definitively known, it is thought that HPD may be caused by biological, developmental, cognitive, and social factors.

NEUROCHEMICAL/PHYSIOLOGICAL CAUSES. Studies show that patients with HPD have highly responsive noradrenergic systems, the mechanisms surrounding the release of a neurotransmitter called norepinephrine. Neurotransmitters are chemicals that communicate impulses from one nerve cell to another in the brain , and these impulses dictate behavior. The tendency towards an excessively emotional reaction to rejection, common among patients with HPD, may be attributed to a malfunction in a group of neurotransmitters called catecholamines. (Norepinephrine belongs to this group of neurotransmitters.)

DEVELOPMENTAL CAUSES. Psychoanalytic theory, developed by Freud, outlines a series of psychosexual stages of development through which each individual passes. These stages determine an individual's later psychological development as an adult. Early psychoanalysts proposed that the genital phase, Freud's fifth or last stage of psychosexual development, is a determinant of HPD. Later psychoanalysts considered the oral phase, Freud's first stage of psychosexual development, to be a more important determinant of HPD. Most psychoanalysts agree that a traumatic childhood contributes towards the development of HPD. Some theorists suggest that the more severe forms of HPD derive from disapproval in the early mother-child relationship.

Another component of Freud's theory is the defense mechanism. Defense mechanisms are sets of systematic, unconscious methods that people develop to cope with conflict and to reduce anxiety. According to Freud's theory, all people use defense mechanisms, but different people use different types of defense mechanisms. Individuals with HPD differ in the severity of the maladaptive defense mechanisms they use. Patients with more severe cases of HPD may utilize the defense mechanisms of repression, denial , and dissociation.

•Repression. Repression is the most basic defense mechanism. When patients' thoughts produce anxiety or are unacceptable to them, they use repression to bar the unacceptable thoughts or impulses from consciousness.
•Denial. Patients who use denial may say that a prior problem no longer exists, suggesting that their competence has increased; however, others may note that there is no change in the patients' behaviors.
•Dissociation. When patients with HPD use the defense mechanism of dissociation, they may display two or more personalities. These two or more personalities exist in one individual without integration. Patients with less severe cases of HPD tend to employ displacement and rationalization as defenses.
•Displacement occurs when a patient shifts an affect from one idea to another. For example, a man with HPD may feel angry at work because the boss did not consider him to be the center of attention. The patient may displace his anger onto his wife rather than become angry at his boss.
•Rationalization occurs when individuals explain their behaviors so that they appear to be acceptable to others.
BIOSOCIAL LEARNING CAUSES. A biosocial model in psychology asserts that social and biological factors contribute to the development of personality. Biosocial learning models of HPD suggest that individuals may acquire HPD from inconsistent interpersonal reinforcement offered by parents. Proponents of biosocial learning models indicate that individuals with HPD have learned to get what they want from others by drawing attention to themselves.

The cause of this disorder is unknown, but childhood events such as deaths in the immediate family, illnesses within the immediate family which present constant anxiety, divorce of parents and genetics may be involved. Histrionic Personality Disorder is more often diagnosed in women than men; men with some quite similar symptoms are often diagnosed with antisocial personality disorder.
Little research has been conducted to determine the biological sources, if any, of this disorder. Psychoanalytic theories incriminate authoritarian or distant attitudes by one (mainly mother); or both of the parents of these patients, or love based on expectations from the child that can never be fully met.

The exact cause of histrionic personality disorder is not known, but many mental health professionals believe that both learned and inherited factors play a role in its development. For example, the tendency for histrionic personality disorder to run in families suggests that a genetic susceptibility for the disorder might be inherited. However, the child of a parent with this disorder might simply be repeating learned behavior. Other environmental factors that might be involved include a lack of criticism or punishment as a child, positive reinforcement that is given only when a child completes certain approved behaviors, and unpredictable attention given to a child by his or her parent(s), all leading to confusion about what types of behavior earn parental approval.

Watchman wrote:People should be more careful of the words they use especially on sensitive topics. It takes but a single word to throw people off.

I think Alice has the right idea; even if reality WAS how Musician said (which the jury is out on), it's sort of a high-handed way of writing off PD people. 'Sorry but you are wired this way...' Being confronted with having a PD is a MASSIVE event for those who suffer it. It's devastation to the very core they have had rocked a billion times already. It's earth shattering to learn the news. To tell them, further, they are PERMANENT? ###$ that.

I understand the painful places where those kinds of judgements are born (I spent time there after my relationship with an HPD). Being angry and judgmental is easy. It's pure and raw.

HPD need people to [b]believe in them (while in their minds they want people to want them... important distinction). Believing in people is free and helpful. You may never be able to forgive your histrionic and believe in them, but you can do it for the others[/b].

Musician924 wrote:Hi Mistaben:
Firstly, Wisdom provides some excellent insight to you on how you may move forward now that you have obtained a diagnosis. Secondly i found what you wrote about peoples reactions and pre-programmed black boxes being very interesting. Know that you shall only ever to a certain point be able to control another persons actions and reactions. People are complex, and the more buttons you push to get what you want, the less i think you shall get a reaction you require or expect longer-term. In itself, controlling how another person acts and reacts should never be anyones objective, no person has the right to act/react explicitly with the objective of in-direct or open direct coervice manipulation.

Now about you moving forward. The more i learn about HP, the more I think that much of it is related to how god made you versus how god made me. Sure there are often common features in cases of HP related to up bringing (Relationship with Mother and Father comes out often...), but i think much of it may be due to the way you were made. As 99 percent of us were made a little differently from you, you run into difficulties in your daily life. At least now that you know how you were made, you can moderate yourself to obtain the best from your life. I don't think that any amount of Psychotherapy shall change you fundamentaly however. This is just my opinion based upon my own experiences, many people may not agree with me.

I think Musicain has a lot more "weight" to what he said than he is being given credit for. First, anyone can copy and paste a study or a collection of opinions as to the cause of HPD. Both people who agree with Musician or those who disagree with what he said.

There has been a lot of recent speculation as to certain "genes" being involved with all cluster "b" disorders. Yes, as Alice posted, there is the belief that they are learned behaviors. But there is also the belief that BOTH are correct, meaning, that there are certain "genes" that people with a cluster "b" pd have...but that these genes--or the behavior of these genes--isn't activated or integrated into their neurology until they encounter a certain experience. This belief would mean the pd lies dormant until certain events or experiences in life happen that empower the genes to develop into a reality (a learned behavior).

I recently have read a scientific study where people (both nons and those with the pd) sat down under M.R.I. brain scans to partake of an experiment. THE M.R.I. BRAIN SCANS WERE ALL CONCLUSIVE THAT THE BRAINS OF THE CLUSTER B WERE WIRED DIFFERENTLY. The non's brain and the cluster "b" brain all fired off different neurology to the point where this was considered a "recent breakthrough".

I don't know what the answer is...in all honesty. But to exclude what Musician said just because it doesn't sound "pleasant" is not going to help one discover solutions any better--especially if we are "candy coating" the problem.

Some people are born blind, some born deaf. Some peopel are born with mental handicaps, some born mentally retarted.

It is sad, but it happens--




Good luck,
Musician