Psychotherapy With Borderline Patients: An Integrated Approach

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.

David M. Allen, MD, is Associate Professor of Psychiatry and Director of Psychiatric Residency Training at the University of Tennessee Health Science Center in Memphis