Given that other people hold the key to survival in the world, histrionic patients tend to also hold the basic belief that it is necessary to be loved by everyone for everything one does. This leads to a very strong fear of rejection. Even entertaining the notion that rejection is possible is extremely threatening to these individuals, because this reminds the patient of his or her tenuous position in the world. Any indication of reje tion at all is devastating, even when the person doing the rejecting was not actually that important to the patient. Feeling inadequate yet desperate for approval as their only salvation, people with HPD cannot relax and leave the acquisition of approval to chance. Instead, they feel constant pressure to seek this attention in the ways they have learned are ef- fective, often by fulfilling an extreme of their sex-role stereotype. Female histrionics (as well as some of the males) seem to have been rewarded from an early age for cuteness, physical attractiveness, and charm rather than for competence or for any endeavor requiring systematic thought and planning. The more “macho” male histrionics have learned to play an extreme masculine role, being rewarded for virility, toughness, and power rather than interpersonal competence or problem-solving ability. Understandably, then, both male and female histrionics learn to focus attention on the playing of roles and “performing” for others.