The histrionic partner

-“Doctor…My husband is always the center of attention—so exhausting.”

Marietta X. is an attractive, intelligent middle-aged lady that has a major problem in her life, besides taking care of a household with four children.  Her husband Tom, who is a loyal and affectionate bread-winner, has the unique knack of seeking and getting people’s attention at all times, even when it is inappropriate or annoys other people. The ultimate “show-off.”

The “histrionic personality disorder” (HDP) is listed in the Diagnostic and Statistical Manual (DSM) as a Cluster B (dramatic, emotional or erratic) personality disorder. The APA’s manual describes it as “a pervasive patter of excessive emotionality and attention seeking, beginning in early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

  1. Is uncomfortable in situations in which he or she is not the center of attention
  2. Interaction with others is often characterized by inappropriate sexually seductive or provocative behavior
  3. Displays rapidly shifting and shallow expression of emotions
  4. Consistently uses physical appearance to draw attention to self
  5. Has a style of speech that is excessively impressionistic and lacking in detail
  6. Shows self-dramatization, theatricality, and exaggerated expression of emotion
  7. Is suggestible, i.e. easily influenced by others or circumstances
  8. Considers relationships to be more intimate then they actually are

Even though most of us have displayed one or more of these narcissistic traits sometimes in our lives, the unrelenting “self-marketing” of these patients can make living with them a particularly exhausting, humiliating and frustrating experience. They seem to never learn from their experiences. It is four times more common in females than males but we believe that the feminine plight seems to be particularly dramatic for the following reasons.

Romantic cheating. As the individual is always seeking the attention of ladies and misjudges the signals they emit back, he is statistically bound to eventually land in a romantic affair in spite of all his failed attempts. Worse, as he wants to show off with his friends, he will not keep it quiet, provoking emotional frustration to his wife and children. When confronted with the feat, he will make all kind of excuses but rest assured that he will not repent.

Social engulfment. The spouse or romantic partner of these individuals usually shows an unhealthy level of dependency on them, that goes beyond the financial dimension. They can only imagine their existence in the company of their histrionic partner as they wrongly believe that people are only attached to them; many of their acquaintances feel pity for them and are willing to help her start over in a new life. Sadly they never ask for help. Ultimately their friends will tire of his narcissism and avoid both of them. ]

Hoovering back. When the abused individual—we are using this gender-neutral term on purpose as we have lately seen this problem in the LGBT as well—tries to assert his/her/ihr own rights by limiting the abusive behaviour or threatening to quit the insane relationship. That’s when the sick partner usually engages in a charm offensive promising “to change once and for all.” The forgiving partner gets sucked back into the bad relationship as if it were a malicious vacuum cleaner with an irresistible power to control emotions.

What do you think? Please tell us.

Don’t leave me alone.

Il ricambio di cuore

-“Grazie mille per I complimenti (che ricambio di cuore)!”

Paola C., an Italian blogger that lives and works in ultra-cosmopolitan London, put up an excellent article about the importance of the baritones in completing the acoustic holy trinity together with the tenor and the soprano. I put a simple commentary praising her work and wishing Happy Holidays. Somehow that little message gave her an emotional boost at the right time.

Her original allusion to a change of heart as if we were talking of a tire is somehow very illustrative of a major predisposition and also eventual flaw. In general women are always ready to work tirelessly for the sake of their loved ones and, in times of need, they are the healers that clean our wounds. Beginning with our dear mothers, there is always a woman around to listen to our troubles, suggest remedies and at the very least offer us some comfort. Whoever has a woman at his side will never lack some spiritual support.

But how about them? Did we stop one minute to consider their own needs?

Continuing with Paola’s pointed comparison with tires, those hearts get worn out after burning a certain amount of rubber in the twisty Life roads. Women need to take a break and change their hearts in order to keep going. Husbands, boyfriends, sons, even plain friends, have to be vigilant for those needs and offer them a word of solace, some compliment and even flowers.

On a regular basis we must remind them how much they mean in our lives and how grateful we are for their company with us in those critical junctures. Don’t wait for any special occasion or event, just say: “thank you” and “I love you” whenever you become aware of her irreplaceable presence. Do it.

Our fellow blogger might not have consciously intended to inspire this article with her words but as Jacques Lacan, the French psychologist, said:

“Dans tout acte manqué, il y a un discours réussi.”

Whatever the initial motivation was, the important thing is that we listened.

What do you think? Please tell us.

Don’t leave me alone.

The Impossible Love

-“Doctor…I think of him all the time—sadly our love was not meant to be.”

Victoria X. is a successful and enchanting middle-aged lawyer that has a beautiful family of five, a loving husband and four gifted children. However she still longs for that older man that seduced her while she was a college student with his wits and poise; they had a tumultuous love affair but it ended when he refused to leave his wife for her. Hr own Impossible Love.

Considering that I have heard many similar stories during my medical practice, I decided to use that concept in my novel “Madame D.C.” as one of the plot drivers. Maurizio, one of the three main protagonists, is being coached by a uniquely mellifluous counsellor that camouflages as an innocuous bank clerk in Coral Gables. The maliciously manipulative character aims to give him a unique emotional compass in the treacherous path to reach Emily’s heart so he would become inevitably, tragically beholden to “it.”

“Maurizio entered the cavernous lobby of the Coral Gables bank at ten in the morning, barely one hour after it opened, with no customers in sight. Mr. Roth’s secretary had left him a message the day before, telling him that his loan had been approved and that he had to come to sign the paperwork.

Maurizio could not believe that the fastidiously staid bank would take that risk with someone like him devoid of any significant credit track record. In fact he had filled the application forms expecting a negative outcome.

It turned out differently. He had a friend inside with unusual powers.

After he was done signing, Maurizio thanked Mr. Roth’s secretary and went out to the main lobby to cash a check for his weekend expenditures. Everybody seemed to be either taking care of a sudden wave of customers or taking their breaks, for which he stood in line for the next available clerk.

-“Psst… Maurizio, come here,” said a voice carried by a rare scent.

He walked up to the far window where Lucy was waiting. “Are you free?”

Lucy smiled broadly. “I only show up for VIP customers like you—”

-“Thanks. Just want to cash this,” he said passing the check across the ledge. -“Got my loan finally…. Thanks for putting a good word for me.”

-“Don’t know the half of it… Roth first rejected it but a top dog overruled him…He owes me ‘cause I helped him get rid of his rabid mate. Sad story.”Maurizio put the dollar bills in an envelope and was ready to leave.

-“Thanks… It’s time to go back for the lunch—”

-“Wait a minute…How come you don’t have a girl-friend yet?”

-“I don’t know…Funny that you’ve asked because I just met a nice girl.”

-“Well, then don’t let her go away…Grab her…Fast… Give her what every woman secretly desires in her heart and only a few can obtain—”

-“What? A nice car? She has a Jaguar already.”


-“What? A diamond ring? She has a rock already.”


-“Mmm…What can she possibly want? I know—a Falcon jet.”

-“NO…It’s the illusion that has prodded women to go through the travails of procreation for ages…And toil so hard for their children and spouses.”

-“Don’t play that sentimental card with me.”  Maurizio twinkled his nose.

-“Er…I’ll tell you in exchange for a tiny winy favour… Deal?”

-“Sounds fair…Okay. What does that rich uptown girl covet?”

-“An Impossible Love—the more twisted, the better….Colonize her mind, hijack her dreams, confiscate all her hours—put some poetry in her life.”

Maurizio was left speechless by the logic of his Caribbean Celestina.”

What do you think? Please tell us.

Don’t leave me alone?

The compulsive gambler

-“Doctor…My husband is addicted to gambling—he’s destroying us.”

Maria X. is an educated and charming middle-aged lady with a caring husband and two teenage daughters; unfortunately the successful car dealer likes to visit almost daily all the gambling options available in South Florida to try his luck. He has won big several times but his losses are even greater. Slowly he is eroding the good financial standing of the whole family and only the firm determination of his wife prevented him from mortgaging their colonial style mansion in South Dade to pay off some outstanding debts.

The basis of this addiction is that gambling stimulates the brain’s reward system like drugs and alcohol, being closely related to some personality disorders like highly competitive, restless or easily bored individuals. Sometimes it is only another behavioural manifestation of mental health disorders like depression/anxiety, bipolar disorder, obsessive-compulsive disorder, attention deficit/hyperactivity disorder or substance abuse. It used to be much more common in men but women are catching up quickly; it appears in middle age but when it does in later stages, it worsens rapidly.

As we have already discussed in our previous articles about alcohol abuse and compulsive shopping, the addicted individual needs to increase the amount he/she/sie invests in order to maintain the same level of satisfaction. Oftentimes it is an escapist attitude to cope with family or work problems that cannot be easily shared with the individual’s intimate circle. When the addicted persons try to control or stop this addiction, they feel restless and irritable with the inevitably nefarious social and professional consequences. In a consumerist society like the USA with plenty of physical and virtual opportunities to wager on almost any kind of sports or gaming tables, this addiction is fast becoming not only a personal but also a public problem.

There are some American civic personalities that are questioning the spread of state-sponsored lotteries with the purported aim of funding education; they claim that they prey on the poor and gullible without helping them.

What do you think? Please tell us.

Don’t leave me alone.

Crying alone in the bathroom

-“Doctor…At nights I hide in the bathroom—so my children can’t hear me cry.”

Veronica X. is a nice, attractive, intelligent and hard-working mother of two small children who has had to shoulder the entire burden of her household all alone as her husband is serving a two years-sentence for a minor offense. Her family cannot help her economically and only her mother is pitching in. Oftentimes feeling overwhelmed by all her responsibilities, she puts her kids to bed, finishes her household duties and then locks herself in the bathroom to well up at ease. It is an almost daily ritual that she needs to go through in order to decompress her strained psyche and get some needed sleep.

When she was telling me that anecdote in my office, I immediately felt the surge into my conscience of a stampede of sweet-sour childhood memories. In 1965 my father Mario—God bless his soul—was arbitrarily jailed for a few months to force him to pay an outstanding debt—a barbaric maneuver. My dear mother Gladys became extremely depressive and our grandmother Yolanda took us in her large suburban home so she could rest and recover. My brother and I were only 10 and 11 years old at the time but we knew that something was sorely amiss, especially when we heard her crying in the loo late at night. Those memories were painfully seared in our subconscious.

Modern women, who are employed full-time in demanding jobs, usually have to return home to complete the family tasks with little or no help from their live-in partners; to make maters worse they might not have the support offered by the female friendship. They decided to stoically hide their deep feelings of angst from impressionable children and from some relatives that might not completely share her opinions. In our digital age where most of the rooms in a house are invaded by a pinging or noisy device, they have to retrench to the bathroom as the improvised refuge for a safe, solitary exteriorization.

As sons and spouses of these most devoted women there is something we can do. We can wait until they get out of their hiding place and hug them tenderly in silence. We can tell them how much we appreciate their work and what a difference it makes in our lives. We can give them a lot of affection and moral support. And yes, we can offer to share more of the burden of homemaking with her. Chose the way you want to help (I love to cook for example) but do not ignore her suffering and extend her a hand. She’s waiting.

What do you think? Please tell us.

Don’t leave me alone.

The fat girl

-“Doctor…People stare at me all the time in the street—because I’m fat.”

Rhonda X. is a charming young woman that just happens to be overweight. She has all the right attributes to become the enchanting partner of any man, yet she is still stubbornly single, as she cannot meet a match of her liking. She attributes it to her excess weight and the social stigma attached to it. As someone who has lately battled with obesity her plight sounds very familiar.

In modern nations there is a rise of the obesity’s indexes due to many socio-economic factors that influence the diet, usually saturated with sugar and fat. Even though there are laws that prohibit the discrimination against obese people, in fact there is widespread reluctance to employ and house them. Even the airlines have joined the fray by charging extra to customers that cannot fit snugly into their ever-shrinking seat planes—a cynical diversion.

In ultra-conscious about physical appearance-France, a young obese woman called Gabrielle Deydier became a celebrity after she published a book called “On Ne Naît Pas Grosse” where she narrated her daily vicissitudes. In a country where most people pride themselves in their good image, the rising rate of obesity is a taboo subject in the mass media and in the private sphere. Following the trend of all EU nations, the French youth is eating less healthy dishes in favour of the processed preparations and commercial junk food.

A report published by the Inserm, the French equivalent of the National Institute of Health, showed that almost 16% of the population was obese in 2016 compared to 12% in 2008. In the USA, the CDC found that 36% of the population had a body mass index (BMI) of 30 or higher in a 2014 report. The worrying social trend has prompted the American media to deal with the reality of millions of Americans and to foster reasonable ways to remedy it. There is a good discussion of the dietary value of foods and the need to limit the intake of noxious material and unhealthy additives in our foodstuff. This public discussion is just beginning in France, where they are still in denial.

What do you think? Please tell us.

Don’t leave me alone.


The “shameful” menstruation

-“Doctor…We would never allow her to use that contraption—a devilish invention.”

Those harsh words—reminiscent of a tirade from Savonarola in a Firenze public square during the Inquisition—were uttered when I questioned a lady why she had not instructed her daughter how to use a tampon during her menstrual period. Due to uncontrolled bleeding she had brought her to the Emergency room where I used to moonlight for long week-ends in an isolated, quaint small town in the northern hills of Georgia. Fortunately the local gynecologist was making rounds in the hospital and he took care of the situation immediately, including a long talk with the mother.

Women menstruate and have always needed ways to contain the bleeding. There are numerous accounts sine Antiquity of several types of material used to insert in the vaginal cavity and limit the blood flow, which were also used to avoid pregnancy. Egyptian women used papyrus, Greek women used gauze, Roman women used wool—materials that were highly absorbent. In our age a tampon has of a core made of cotton covered with polyethylene. The patriarchal institutions were always leery of that necessary practice as it was solely carried out by women without any manly supervision or control.

In the beginning of the 20th century, Earle Cleveland Haas designed the first commercial tampon to help his wife, a ballerina, to control her bleeding. In 1931 Gertrude Tendrich bought his patent to create the Tampax brand; the inclusion of millions of American women in the World War II factories prodded the use of the device, in spite of the silly puritanical resistance to it. A few years later Judith Esser-Mittag, a German gynecologist, designed one that did not require an applicator, which she dubbed as “o.b.”(ohne binde)

Paradoxically, in our age of women’s liberation from the social prejudices, we can still see the resilient stigmatization of menstruation in the media. TV or radio ads about tampons tend to emphasize their “hygienic” and “aesthetic value” as if that natural biological process were a shameful disease to cure.The feminine care industry has exploited that irrational “sense of dirtiness” to relegate the use of tampons to the sphere of intimacy, not to be discussed.

Menstruation is an integral part of the uniquely marvellous biological cycle of mammals that enable us to create new life and perpetuate our species. The mendacious demeaning of women’s functions must stop in the public sphere.

What do you think? Please tell us.

Don’t leave me alone.