This volume gives psychodynamic psychotherapists a view of how their colleagues actually treat severely disturbed borderline patients and how treatments proceed over the course of several years.

Patients with borderline personality disorder (BPD) or borderline traits are among the most difficult for mental health practitioners to treat. They present an incredible range of symptoms, dysfunctional interpersonal interactions, provocative behavior in therapy, and comorbid psychiatric disturbances. So broad is this array that indeed the disorder constitutes a virtual model for the study of all forms of self-destructive and self-defeating behavior patterns. Psychotherapy With Borderline Patients: An Integrated Approach fills the need for a problem-focused, clinically oriented, and operationalized treatment manual that addresses major ongoing family factors that trigger and reinforce the patient's self-destructive or self-defeating behavior. In it, David Allen draws on the theoretical ideas and techniques of biological, family systems, psychodynamic, and cognitive-behavioral therapists to describe an integrated approach to adults with BPD or borderline traits in individual therapy. Innovative, practical, and specific, the book * helps therapists teach their patients, through the use of various role-playing techniques, strategies to alter the dysfunctional patterns of interaction with their families of origin that reinforce self-destructive behavior or chronic affective symptoms; * explains the nature and origins of the characteristic oscillation of hostile over- and underinvolvement between adults with BPD and those who served as their primary parental figures during childhood; * elucidates the nature and causes of the dysfunctional communication patterns in patients' families that lead to misunderstanding; and * provides concrete, clearly spelled out advice for therapists about how to deal with provocative patient behavior, how to minimize distorted descriptions by patients of significant others, how to avoid patients' misuse of medications, and how to respond to managed care restrictions on patients' insurance coverage. Psychotherapy With Borderline Patients: An Integrated Approach will be welcomed by all clinicians who work with these patients, whatever their training or theoretical orientation.

Transference focused psychotherapy (TFP) is a sophisticated new variant of psychodynamic interventions centering on the analysis of the transference. Its main goal is to bring a patient's unconscious conflicts to the surface so that they can be actively worked through by the client and therapist within a rigorous clinical framework. In Psychotherapy for Borderline Personality, the authors describe TFP principles and methods and provide clear guidelines on how to apply them to individual patients on a session-by-session basis. With the help of numerous vignettes and case examples, they clearly outline the various stages of the TFP therapeutic process, from initial assessment to termination. Readers learn techniques for seeing past the wall of behavioral and cognitive dissonance typically thrown up by the borderline patient and to identify and label a patient's radically conflicting self-conceptions and object representations. Psychotherapy for Borderline Personality is an important professional resource for all mental health professionals.

Explore and understand new approaches in Borderline therapy. Borderline Personality Disorder (BPD) lags far behind other disorders such as schizophrenia in terms of research and treatment interventions. Debates about diagnosis, etiology, neurobiology, genetics, medication, and treatment still persist. Borderline Personality Disorder: Meeting the Challenges to Successful Treatment brings together over two dozen of the field’s leading experts in one enlightening text. The book also offers mental health providers a view of BPD from the perspectives of sufferers as well as family members to foster an understanding of the experiences of relatives who are often devastated by their loved ones’ struggles with this common disorder. Although there has been an increasing interest in BPD in terms of research funding, treatment advancement, and acknowledgment of family perspective over the last decade, the fact remains that the disorder is still highly stigmatized. Borderline Personality Disorder: Meeting the Challenges to Successful Treatment provides social workers and other mental health clinicians with practical access to the knowledge necessary for effective treatment in a single volume of the most current research, information, and management considerations. This important collection explores the latest methods and approaches to treating BPD patients and supporting their families. This useful text also features handy worksheets and numerous tables that present pertinent information clearly. Chapters in Borderline Personality Disorder: Meeting the Challenges to Successful Treatment include: an overview of Borderline Personality Disorder confronting myths and stereotypes about BPD biological underpinnings of BPD BPD and the need for community - a social worker’s perspective on an evidence-based approach to managing suicidal behavior in BPD patients Dialectical Behavior Therapy supportive psychotherapy for borderline patients Systems Training for Emotional Predictability and Problem Solving (STEPPS) Mentalization-based Treatment fostering validating responses in families Family Connections: an education and skills training program for family member wellbeing and much more! Full of practical, useable ideas for the betterment of those affected by BPD, Borderline Personality Disorder: Meeting the Challenges to Successful Treatment is a valuable resource for social workers, psychologists, psychiatrists, and counselors, as well as students, researchers, and academics in the mental health field, family members, loved ones, and anyone directly affected by BPD.

This book provides a systematic approach to managing countertransference when treating borderline patients. Using detailed accounts of clinical experiences, the authors demonstrate how their own thoughts, feelings, and fantasies enable them to understand their patients' internal worlds.

Transference-Focused Psychotherapy for Borderline Personality Disorder: A Clinical Guide presents a model of borderline personality disorder (BPD) and its treatment that is based on contemporary psychoanalytic object relations theory as developed by the leading thinker in the field, Otto Kernberg, M.D., who is also one of the authors of this insightful manual. The model is supported and enhanced by material on current phenomenological and neurobiological research and is grounded in real-world cases that deftly illustrate principles of intervention in ways that mental health professionals can use with their patients. The book first provides clinicians with a model of borderline pathology that is essential for expert assessment and treatment planning and then addresses the empirical underpinnings and specific therapeutic strategies of transference-focused psychotherapy (TFP). From the chapter on clinical assessment, the clinician learns how to select the type of treatment on the basis of the level of personality organization, the symptoms the patient experiences, and the areas of compromised functioning. In order to decide on the type of treatment, the clinician must examine the patient's subjective experience (such as symptoms of anxiety or depression), observable behaviors (such as investments in relationships and deficits in functioning), and psychological structures (such as identity, defenses, and reality testing). Next, the clinician learns to establish the conditions of treatment through negotiating a verbal treatment contract or understanding with the patient. The contract defines the responsibilities of each of the participants and defines what the reality of the therapeutic relationship is. Techniques of treatment interventions and tactics to address particularly difficult clinical challenges are addressed next, equipping the therapist to employ the four primary techniques of TFP (interpretation, transference analysis, technical neutrality, and use of countertransference) and setting the stage for and guiding the proper use of those techniques within the individual session. What to expect in the course of long-term treatment to ameliorate symptoms and to effect personality change is covered, with sections on the early, middle, and late phases of treatment. This material prepares the clinician to deal with predictable phases, such as tests of the frame, impulse containment, movement toward integration, episodes of regression, and termination. Finally, the text is accompanied by supremely instructive online videos that demonstrate a variety of clinical situations, helping the clinician with assessment and modeling critical therapeutic strategies. The book recognizes that each BPD patient presents a unique treatment challenge. Grounded in the latest research and rich with clinical insight, Transference-Focused Psychotherapy for Borderline Personality Disorder: A Clinical Guide will prove indispensable to mental health professionals seeking to provide thoughtful, effective care to these patients.

Built on the solid foundation of a six-year treatment comparison trial, the interpersonal group psychotherapy model fully detailed here focuses on the current relationships in the patient's life. The research study showed that individual psychodynamic psychotherapy, which emphasizes the developmental genesis of the borderline disorder, leads down a much longer and more costly road - but with outcomes equivalent to the group model. By zeroing in on the affective significance of the patient's lifelong search for more gratifying and secure relationships, the therapist can address a key feature of the disorder found in all its subtypes. With group therapy, the therapist is able to dilute the powerful transference reactions commonly found in individual therapy with borderline patients. In interpersonal group therapy, the patient is also able to form new, positive identifications with others. This guide, generously illustrated with extensive clinical examples, has been designed to be used in a broad range of treatment settings and employed by an extensive array of mental health professionals: psychiatrists, psychologists, social workers, and nurses.

``I have become convinced that many borderline patients are not helped by the psychiatric treatment they receive and even more troubling, that a fair percentage of them are made worse by it....Dr. Rockland's approach makes sense to me at a time when much of the literature on the psychotherapy of borderline personality does not....I have learned a great deal from this book and feel confident that it will have a pronounced beneficial effect on clinical practice.' --From the Foreword by Allen J. Frances Noting the potential dangers of uncovering approaches, early writers on borderline personality emphasized the value of supportive therapy. Despite these warnings, the preponderance of the current literature on borderline disorder is confined to exploratory psychotherapy and psychoanalysis. Redressing this imbalance in the literature, this important new work is the first to present an organized and detailed description of how supportive interventions are accomplished with borderline patients. With a uniquely practical focus on ``how to do it,' Lawrence H. Rockland applies the principles of Psychodynamically Oriented Supportive Therapy (POST)--an approach that he formulated--to patients with Borderline Personality Disorder (BPD). Divided in three sections, the book's opening chapters review the changing concepts of the borderline, vicissitudes in treatment recommendations, the general principles of POST, and the indications for applying this approach to BPD. The second section presents the 2 1/2-year psychodynamic supportive treatment of a patient with BPD. The four phases of treatment--evaluation and treatment planning, early phase, middle phase, and termination--are discussed in detail and illustrated with session dialogue and critical commentary by the author. The final section addresses two major problems--therapist countertransference and patient acting out. Other topics include continuous/intermittent supportive therapy, psychopharmacology in supportive therapy, and supportive aspects of inpatient treatments. Filling a significant gap in the literature, this important new volume's systematic and comprehensive exposition of supportive therapy for borderline patients makes it an invaluable resource for all practitioners who work with this difficult population. Replete with clinically useful suggestions and guidelines, it is ideal for trainees in all mental health disciplines. It is relevant to any course on dynamic psychotherapy, and serves as a text for all students of borderline pathology and its treatment.

Borderline Personality disorder is a severe personality dysfunction characterized by behavioural features such as impulsivity, identity disturbance, suicidal behaviour, emptiness, and intense and unstable relationships. Approximately 2% of the population are thought to meet the criteria for BPD. The authors of this volume - Anthony Bateman and Peter Fonagy - have developed a psychoanalytically oriented treatment to BPD known as mentalization treatment. With randomised controlled trialshaving shown this method to be effective, this book presents the first account of mentalization treatment for BPD. The first section gives an overview of BPD, including discussion of nosology, epidemiology, natural history, and psychosocial aetiology. It additionally summarises the present state of our research knowledge about effective psychotherapeutic treatments and use of medication. The second section outlines the authors' theoretical approach and contrasts it with other well known methods, including DBT, CAT, and CBT. In the extensive final section, the authors outline their clinical approach starting with how treatment is organised. A detailed account of the transferable features of the model is provided along with the main strategies and techniques of treatment. Numerous clinical examples are given to illustrate the core techniques and detailed information provided about how to apply aspects of the mentalization based treatment approach in everyday practice. Aimedat mental health professionals, along with counsellors, psychotherapists, and psychoanalysts, the book will be a valuable tool, providing an effective means of treating those suffering from Borderline Personality Disorder.

Borderline Personality Disorder: Tailoring the Psychotherapy to the Patient explores the challenge of treating patients with borderline personality disorder. These patients make up a large segment of the difficult-to-treat population. The instability of their relationships, the intensity of their affective responses, and their proneness to paranoid reactions all contribute to their difficulty in working consistently and constructively in the psychotherapeutic situation. When one adds these difficult patient problems to the therapist's quandary about how expressive or supportive to be, therapists are indeed often confronted with a challenging therapeutic task. The book begins with a review of the clinical and research literature pertaining to the treatment of borderline patients. It presents a unique, empirically based intensive study of three borderline patients, based on transcripts of audiotaped therapy sessions. The research methodology is reviewed, and clinically oriented descriptions of the three patients, their psychotherapy processes, and their outcomes are included. Following an overall summary of results, conclusions regarding the differential indications for supportive versus expressive emphasis in psychotherapy are discussed. In their research, the authors recorded every psychotherapy session and studied a randomly selected group of sessions. Therefore, the reader is provided with increased insight into what is most effective with what kind of patient at a given point in the therapy process.