Histrionic and Narcissistic Personality Disorders

Last week we looked at Cluster B personality disorders which are the dramatic and emotionally erratic types.   We covered the antisocial and borderline personality disorders which are all around us as neighbors, family members, children, co-workers and spouses.  “Maybe it’s even me?”

Knowing how to recognize dominating and relationally maddening behaviors is the first step in creating a loving intervention to help bring the wounded person’s attitudes and behaviors into check.

This week we will examine “Histrionic Personality Disorder” and “Narcissistic Personality Disorder” as well as continue our reading of God’s Word in Romans 6.

“Histrionic Personality Disorder” is a pattern of excessive and pervasive emotionality and attention seeking behavior. In the general population the prevalence is 2-3% and in outpatient and inpatient settings, the percentages increase to 10-15%.  A diagnosis can be made if at least five of the following criterion.

  • Is uncomfortable in a variety of contexts unless he or she is the center of attention.
  • Interaction with others can be characterized by inappropriate sexual seductive or provocative behavior.
  • Rapid shifting and shallow emotions.
  • Uses physical appearance to draw attention to self.
  • Style of speech that is excessively impressionistic (generalized and vague) lacking detail.
  • Shows self dramatization, theatricality and exaggerated expression of emotion.
  • Is suggestible, that is easily influenced by others or circumstances.
  • Considers relationships to be more intimate than they actually are.

“Narcissistic Personality Disorder” has some similarity to Histrionic Personality disorder in that there is an excessive desire for attention.  Yet can best be described as having a grandiose sense of self importance, need for admiration and a lack of empathy for others.  Five or more of the following criterion are required to make a diagnosis.

  • Has a grandiose sense of self importance and expects to be recognized as superior.
  • Is preoccupied with fantasies of unlimited success, power, brilliance, beauty or ideal love.
  • Believes he or she is special or unique and can only be understood by other people of high status.
  • Requires excessive admiration.
  • Has a sense of entitlement, unreasonable expectations of others, favorable treatment and automatic compliance with his or her expectations.
  • Interpersonally exploitive and takes advantage of others to achieve his or her ends.
  • Lacks empathy for others and is unwilling to recognize or identify with the feelings and needs of others.
  • Is envious of others and believes others are envious of them.
  • Shows arrogant and haughty behaviors or attitudes.

Light bulbs going on?  Recognize anyone?  See yourself in a mirror? We’ll discuss more over the next two weeks as to how we create interventions in others and in ourselves.  What does God’s word say about change and transformation?  Do we have to stay stuck for a lifetime?  No we don’t.  While miracles don’t take place overnight in personality disorders, we do believe in slow miracles.   It starts with truth, acceptance and the realization that our position in Christ gives us a platform upon which to build a new growth track.

“What then?  Shall we sin because we are not under law but under grace?
May it never be!
Do you not know that when you present yourselves to someone as slaves for obedience, you are slaves of the one whom you obey, either of sin resulting in death, or of obedience resulting in righteousness?
But thanks be to God that though you were slaves of sin, you became obedient from the heart to that form of teaching to which you were committed,
having been freed from sin (The Cross)
you became slaves of righteousness (Romans 6:15).”

Thanks and blessings,


Milan & Kay

Next week: Cluster C:  Fearful and anxious personality disorders.