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Doctor Blake
Doctor Blake, Psychologist
Category: Mental Health
Satisfied Customers: 146
Experience:  Ph.D., Ed.S., NCSP Clinical Psychologist; 15+ years of experience; dual licensure
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Please can you give me some advice. I am male and have been

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Please can you give me some advice. I am male and have been in a relationship with a woman for the past 2 1/2 years. I first noticed after a couple of months that i had a gut feeling something wasn't right with this woman. I couldn't explain it but it never went away. Subsequently i have been watching and learning about her during our relationship. She is very shallow, has a since of entitlement, likes to be called "Princess", is the life and soul of the party, loves and craves attention and flirts alot when she is out with her friends with the intention of getting male attention. She does not like it if i am not paying attention to her and gets quite upset if i am engrossed in a tv programme. She has also said that she loves the "constant drama" she creates and thinks i do to, which isn't true. she admits to all the above! She is never wrong and always blames everyone else for her problems. She appears fake and not genuine in things she says about feelings etc. She seems to have no concept of give and take or boundaries in relationships. She also lacks empathy and constantly blameshifts. She constantly lies about drug use and other matters, and carries on until proof is given to her of her lies. She is never wrong and very very rarely says sorry for any offensive actions. She has a problem with canabis use (smokes lots of it every day) and has done for the past 13 years. She also seems to have an "all or nothing" attitude, when she goes out drinking with friends she always gets very badly drunk. She is a very pretty girl aged 38. I am aware of a condition called Histrionic disorder and she seems to fit the bill but for one thing. She does not get mad and angry very often at all and does not appear "highly emotional" in stead she seems to be at a constant flat level if that makes sense. She is on anti depressants for the last 8 months after we broke up previously. But she was never highly emotional before that anyway. The anti depressants seem to have helped slightly giving her a small sense of empathy but the core problems are all still there. Is it possible that she could be Histrionic even without the high emotions, not crying all the time etc etc. I have tried to speak to her about this and occassionally she will admit that she has problems, and doesn't "get" things and that she is "clueles" when it comes to relationships but then the next day she is back to "there is nothing wrong with me, its you". Is she likely to be Histrionic and if so what is the best course of action i can take? i also forgot to mention, she has a strained relationship with her mother (who left when she was in her early teens) she was brought up by her father who gave everything she wanted. She has often said that she just wants someone to look after her and i have always got the impression she wants a replacement father figure for when he is no longer around.
Submitted: 3 years ago.
Category: Mental Health
Expert:  Doctor Blake replied 3 years ago.

Doctor Blake :

Good morning (or for you, afternoon).

Doctor Blake :

I have read your query... lots of very useful information.

Doctor Blake :

To clarify, what question(s) can I try to address today?

Doctor Blake :

Feel free to contact me when you're ready.

Customer:

Obviously i know it is not possible to make a diagnoise but does this seem to fit the Histrionic disorder?

Customer:

What course of action is best to help her?

Customer:

How would i go about getting help i.e what would be the first port of call?

Doctor Blake :

Hi. Thanks for writing back.

Doctor Blake :

1. As you note, it is impossible (and unethical) to diagnose through a 3rd party without having done (at minimum) a diagnostic history and clinical interview. Nevertheless, your description may be consistent with one of the "Cluster B" personality disorders (which includes Histrionic Personality Disorder). Other Cluster B disorders include Antisocial PD, Borderlinr PD, HPD (as noted), and Narcissistic PD. It is worth noting that Personality Disorders are classified on Axis II of the DSM system unlike most mental disorders (like, say, Depression or Anxiety, or ADHD). It is also worth noting that there are some mental health professionals (MHP) who do not believe in Axis II disorders. There are also some MHP who do not believe in the concept of "personality" in general.

Doctor Blake :

2. Unfortunately, "treatment" of an Axis II disorder is, traditionally, lengthy and rarely effective. Why? Well, you'll note that I reported that some MHP don't believe in Axis II disorders because you're essentially trying to change something (the personality) which either cannot be changed as it is likely permanent (for those who believe in personality) or which doesn't exict (for those who do not believe in personality). There are no medications available to treat personality. And while some traditional "talking therapies" (typically insight-oriented/psychodynamic therapy) claim to be able to make structural changes to individual's "personality" there is no proof of this whatsoever.

Doctor Blake :

3. So, does this leave you stuck? No. Rather than hopping down the pessimistic trail of looking at a personality disorder, why not consider a mental health disorder (Axis I) that is treatable. Is it possible that this woman's bizarre and annoying behavior is the result of underlying anxiety or depression? Both of these are entirely treatable conditions! You mention some drug use... those who are substance dependent can appear to be liars, manipulators, and monopolizers of your time and energy. There is treatment for substance abusers too! While I don't think it's likely, is it possible that this woman has an underlying neurodevelopmental problem (such as an Autism Spectrum Disorder) whereby she has absolutely no clue whatsoever about appropriate social behavior, reading social cues, and the like? There are treatments for this as well.

Doctor Blake :

4. But, your friend has to be willing to explore treatment... preferably with a Cognitive-Behavioral Therapist (CBT). A CBT will provide targetted interventions to address specific thoughts (cognitions) and actions (behaviors) which prevent your friend from maximal functioning... Traditional "talk therapy" would not only be ineffective and inefficient with your friend, I suspect that it would "keep her stuck" in her self-obsessed, manipulative, lying behavior pattern... it might even make things worse. CBT can also help with substance abuse issues... but she may also benefit from consultation with a drug/alcohol counselor.

Doctor Blake :

5. Finally, the question remains: If your friend has a personality disorder (or mental health or substance abuse disorder), may or may not have any clue about how her behavior impacts you and others, may have antisocial thoughts and behaviors, and clearly makes you agitated and confused and worried... why are you sticking around? I don't mean that just in a rhetorical sense... there must be some REASON why you are still around a person who may very well be unhealthy FOR YOU. This may be worth exploring for yourself! :)

Doctor Blake :

I hope you found this helpful... please feel free to write back if you have other thoughts or questions.

Doctor Blake :

Please accept response unless you require additional information. Thanks.

Customer:

In brief i am aware that i may have co-dependant issues, which i am working on to resolve. I have had issues with relationships in the past due problems in earlier life. I can relate to some of this girls behaviour, because i know i was emotionally distant, uncaring etc in previous relationships, but i also know that i was conscious of this and it was more a case of not being bothered about my actions and the pain they caused. The lady in question does not seem to be conscious of her behaviour or its effects on others. I have undergone sessions with a physcologist for some years which has enabled me to deal with my problems/issues. So i can see both sides of the coin to a degree and have been trying to help this women do the same with limited success. I do love her very much hence the lengths i have gone to.

Customer:

I have one more question that i would like you to answer. I am aware that i took the decision to get help in my situation. It was not suggested to me but more of an accident initially. Is it possible to help this women get help? Or am i fighting a lost cause until she decides to get help herself? I.e does she have to get to a point that she "crashes and burns" before she will admit that she may need help? And if she does admit she needs help, where should her first port of call be? I know the GP's in the UK my not recognise these particular problems etc. I am just concerned that she would end up on a "merry go round" and not be pointed in the right direction.

Customer:

I apologise for my long winded enquiry. And if you could just address the issues above that would be great. Many thanks

Doctor Blake :

Well, I'm sure you would agree that it's very difficult to predict if/how an individual will get into therapy and/or respond to therapy. I know that, generally speaking, when someone gets into therapy "because of someone else" it doesn't work. Therapy has to, to a degree, a selfish thing. The individual has to want to get better for themselves.

Doctor Blake :

As to the first "call of port," I'm not certain if, in the UK, you're required to go thru your GP to get to a mental health professional. If this is the case, ask the GP to be certain to refer to a CBT therapist (not a traditional "talk therapist"). If you're not required to go thru the GP, then I would simply google CBT in your area... or check with the local university/college Psychology Department. Many psychologists who work in academia know CBT folks.

Doctor Blake :

Best of luck to you and your friend.

Customer:

Many thanks for all your input and help

Doctor Blake, Psychologist
Category: Mental Health
Satisfied Customers: 146
Experience: Ph.D., Ed.S., NCSP Clinical Psychologist; 15+ years of experience; dual licensure
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Doctor Blake
Doctor Blake
Psychologist
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Ph.D., Ed.S., NCSP Clinical Psychologist; 15+ years of experience; dual licensure