I have a profound fascination with attention-seeking behaviours. Also, I’m profoundly astute at capturing the attention of peers, family, and friends. Please make no mistake about it – I am no stranger to these histrionic red flags into a possible personality disorder.
Let us be completely honest. People spend a great deal of time fixated on getting attention. Conversely, some people couldn’t attain others attention if they tried or if their life depended on it.
The level and intensity of attention-seeking behaviour begin and ends with the ability, tenacity, and creativity of the person seeking attention. Attention-seeking actions cited in the DSM-5 are parts of larger issues to a clinical picture. In cases like the DSM-5, the issue is a mere abstraction. The DSM transformed the conversion of a neutral and non-threatening term like issue into something that needs further attention and concern: problem. In the end, the problem is the diagnosis. The illness is something that needs treatment.
Any patient reporting in a clinic or therapy office is under the psychiatrist’s lens – psychiatric assessment of your behaviour based on reporting. The informal, yet unassailable, remarks of the psychiatrist about you become an archival record – the point of departure from symptom to medical illness.
For most personality disorders including, but not limited to, narcissistic personality disorder, histrionic, and borderline, the clinician will need to evaluate the intentions or motives of the person seeking attention.
Motives, choices, and the general goals of anyone seeking attention should be the primary indicators that someone is seeking attention to make up for or satisfy a character-logical deficit. I am suggesting that if the motive is clear, the intention purposeful, and the aim is to gain others’ attention, quenching an individual’s thirst and making up for their shortcomings or lack of insight into an interpersonal situation gone awry, then beware.
In terms of NPD, the reason or rationale for seeking attention is probably, first and foremost, to satisfy a personal deficit in self-worth or self-esteem. For people carrying a diagnosis of histrionic personality disorder, the aim is to create hysteria to mask whatever set of bad decisions or personal choices occur or require concealing, to shift the focus onto something more benign and innocuous.
In terms of patients carrying a borderline diagnosis, the attention-seeking behaviours aim at splitting and causing such chaos around then, the ability to take ownership or accountability takes a backseat to the clinician focusing primarily on the week’s crisis.
These diagnoses are not the only ones in which the patients enact attention-seeking behaviour. I focus on patients with personality disorders who pass off attention-seeking actions as a necessity or an undisputed life requirement in this essay.
We, as clinicians and friends of people carrying a mental health diagnosis, need to remember why? From an epidemiological standpoint, diagnoses are merely the markers of the incidence and distribution of symptoms in patients.
From a mental health perspective, we clinicians and friends need to remember that all humans seek attention at different levels, even at cross-purposes, and always to connect with other people fundamentally. While this should be a given axiom in mental health, it is not!
Only when these behaviours create extreme distress for the person exhibiting or displaying the action and the people in their social world does it become truly diagnosable and problematic. As stated before, mastering grabbing the attention of peers and other colleagues is simple, after going to such extreme lengths to capture attention and experiencing the police show up at the door.
Rigour, persistence, and aim were so alarming and off the mark in terms of purpose that everyone was puzzled. Again, this is when attention-seeking goes awry. Over the years I have been in mental health and learning to scale back and generally decrease the intensity and viability of behaviours, I am very good at gaining a peers’ attention without making it clear as day from when I began to enter the social scene.
As a society, we have begun to truly mark, identify those seeking attention, and shame them for such behaviours. I’m not entirely sure this is the right path or the best way to handle such actions.
Collectively, we need to make it clear that such behaviour is unwelcome, unwarranted, and not necessarily appropriate. We give the person seeking such action precisely what they are looking for when displaying such untoward or visibly obnoxious scenes.
I believe people need to take a more psychologically sound and driven approach when putting the blinders up. Actively ignoring and minimising or, better yet, making it clear through our body language and words, that these sorts of displays are ineffective in capturing our attention and keeping it.
Max E. Guttman, LCSW is a psychotherapist and owner of Recovery Now, a mental health private practice in New York City.