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Table 84-2 Phase 1 in the treatment of histrionic personality disorder: clarifying symptomatic phenomena and establishing a therapeutic alliance

Table 84-2 Phase 1 in the treatment of histrionic personality disorder: clarifying symptomatic phenomena and establishing a therapeutic alliance
Objective: Stabilize states and then focus on maladaptive interpersonal patterns.
1. List all important psychiatric symptoms and then include impairments of life activity in terms of patterns of intimacy, caretaking, friendships, and work relationships.
2. Listen empathically without regarding suffering as "shallow" or expressions of anxiety, depression, rage, and loneliness as "theatrical."
3. Label cloudy experiences with words and check for aptness of these words.
4. Carefully question to establish sequences of cause and effect in terms of temporal events and the onset of particular symptoms.
5. Encourage attention to internal (mental) events as well as external happenings.
6. Include discrepancies and polarities in the list of problem behaviors (e.g., being both too active and too passive, both too demanding and too compliant).
7. Avoid common pitfalls: do not rush to prescribe medications or social engineering solutions in response to demands to end urgent problems, but do not appear cool and indifferent to suffering.