HISTRIONIC PERSONALITY

The Case of Ms. H.

Ms. H. was a 32-year-old white, single woman who resided alone. She
had never been married and had no children. She had recently broken
up with her boyfriend. She was employed as a caseworker in a social
agency.

The Referral

A co-worker had suggested that Ms. H. contact the psychologist.

Both her physician and her mother had encouraged her in the post to
see a psychologist. When asked what prompted her contact now, she
replied, "I just felt bad and decided to call." While still an the tele-
phone, Ms. H. made a dramatic, but veiled, suicide threat. She was
equally dramatic in denying intent to harm herself when questioned
about her comment. She denied current medications or previous con-
tact with a mental health professional.

Physical Appearance

Ms. H. was a woman of average height and build. She had dark
brown hair, hazel eyes, and a smooth complexion. She was very attrac-
tive. She dressed fashionably but made slight overuse of makeup and
jewelry.

Presenting Complaints

Ms. H. complained of depression and gastrointestinal distress.

She said these symptoms had been present for two months but that
she had had similar episodes in the post.

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202 HISTRIONIC PERSONALITY

Her depression involved "bad rnoods" accornpanied by crying

episodes, mild insomnia, boredorn, low frustration tolerance, irritabil-
ity, decreased activity, decreased interest, and occasional suicidal
ideation. She denied atternpts but acknowledged several threats in the
post. She suggested inactivity and negative interactions with her rnother
as antecedents to her bad rnoods.
Her gastrointestinal complaints included starnach pain and diar-
rhea. She had seen a physician about this distress, and he had sug-
gested that the syrnptorns were secondary to tension. She denied
awareness of any antecedents.
Ms. H. also complained that herrnother interfered in her business.
Although her rnother was often very helpful in tirnes of distress and
illness, Ms. H. reported frequent argurnents between thern. She believed
her rnother's rnoods to be capricious.
She described her job as unsatisfactory and boring. She was almost
conternptuous of the clients seen by her agency. She had poor inter-
actions with rnost of her co-workers in that the warnen were jealous of
her and the rnen were not her social equals.
She had lost contact with her friends from the post. Their Jives
had changed significantly (i.e., rnarriage, children), so Ms. H. felt dif-
ferent from rnost of thern. She had difficulty sustaining friendships.
She spoke with pride about her ability to rnake anyone she was inter-
ested in notice and like her. Things always seerned to begin well enough.
At first people were a Jot of fun and appeared to wanttobe very helpful.
Sooner or Jater, though, the other people seerned to have less time for
her and to becorne boring. It appeared to her that the langer you knew
sorneone the less considerate they becarne. Her reJationships with rnen
were characterized as initially intense and exciting. The relationships
tended to be short-lived and usually ended as a result of her lack of
interest or the rnan's involvement with another wornan.

Parents
Ms. H.'s parents were divorced when she was an infant. She knew
little if anything about her father. Despite having a part-time job to
support herself and her daughter, Ms. H. 's rnother always had plenty
of time to give her attention and guidance. Ms. H. was the center of
her rnother's life. The rnother was described as a very responsible par-
ent, if emotional and opinionated.
THE CASE OF MS. H. 203

Interview Behavior
The patient was doubtful about the usefulness of seeing a psy-
chologist, but she said she was willing to let him prove himself. At the
start of the interview, her expression was a constant smile, but her
affect became more appropriate as the interview continued. Her man-
nerisms were occasionally seductive. She was generally cooperative.
Herresponses tended to be dramatic, with emphasis on the shortcom-
ings of others. She was quick to excuse her own past behavior by
referring to illness an her part or insensitivity on the part of others.
She professed confusion about why people treated her the way they
did and why she did not seem to be able to stay healthy and happy.
At several points in the interview, Ms. H. affered simplistic explana-
tions for all her problems and demanded to know if the interviewer
agreed.