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Borderline Personality Disorder, Second Edition

A Clinical Guide

John G. Gunderson, M.D.
With Paul S. Links, M.D., F.R.C.P.C.

  • ISBN 978-1-58562-335-8
  • Item #62335

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Covering the range of clinical presentations, treatments, and levels of care, Borderline Personality Disorder: A Clinical Guide, Second Edition, provides a comprehensive guide to the diagnosis and treatment of borderline personality disorder (BPD). The second edition includes new research about BPD's relationship to other disorders and up-to-date descriptions of empirically validated treatments, including cognitive-behavioral and psychodynamic approaches. Compelling new research also indicates a much better prognosis for BPD than previously known.

A pioneer in the field, author John Gunderson, M.D., director of the Borderline Personality Disorder Center at McLean Hospital, draws from nearly 40 years of research and clinical experience. The guide begins with a clear and specific definition of BPD, informed by a nuanced overview of the historical evolution of the diagnosis and a thoughtful discussion of misdiagnosis. Offering a complete evaluation of treatment approaches, Dr. Gunderson provides an authoritative overview of the treatment options and describes in-depth each modality of treatment, including pharmacotherapy, family therapy, individual and group therapy, and cognitive-behavioral therapies.

Unlike other works, this book guides clinicians in using multiple modalities, including the sequence of treatments and the types of changes that can be expected from each mode. The discussion of each treatment emphasizes empirically validated therapies, helping clinicians choose modalities that work best for specific patients. In addition, Borderline Personality Disorder: A Clinical Guide, Second Edition, also outlines therapeutic approaches for multiple settings, such as hospitalization, partial hospitalization or day hospital programs, and levels of outpatient care.

Complementing the well-organized treatment guide are a series of informative and intriguing sidebars, providing insight into the subjective experience of BPD, addressing myths about therapeutic alliances in BPD, and questioning the efficacy of contracting for safety. Throughout the book, Dr. Gunderson recommends specific do's and don'ts for disclosing the diagnosis, discussing medications, meeting with families, starting psychotherapy, and managing suicidality.

A synthesis of theory and practical examples, Borderline Personality Disorder: A Clinical Guide, Second Edition, provides a thorough and practical manual for any clinician working with BPD patients.


  • About the Authors
  • Introduction
  • Chapter 1. The borderline diagnosis
  • Chapter 2. Differential diagnosis: Overlaps, subtleties, and treatment implications
  • Chapter 3. Overview of treatment
  • Chapter 4. Case Management: The primary clinician
  • Chapter 5. Levels of care: Indications, structure, staffing
  • Chapter 6. Pharmacotherapy: Clinical practices
  • Chapter 7. Pharmacotherapy: Selection of medications
  • Chapter 8. Family interventions and therapies
  • Chapter 9. Group therapy
  • Chapter 10. Individual psychotherapies: Getting started
  • Chapter 11. Cognitive-behavioral therapies: Dialectical behavior therapy and cognitive therapies
  • Chapter 12. Psychodynamic psychotherapies
  • Chapter 13. Future considerations
  • Appendix: Psychoeducational resources
  • Index

About the Authors

John G. Gunderson, M.D., is Professor of Psychiatry at Harvard Medical School in Boston, Massachusetts; Director of Psychosocial and Personality Research and Director of the Borderline Personality Disorder Center at McLean Hospital in Belmont, Massachusetts.

Paul S. Links, M.D., F.R.C.P.C., is Professor of Psychiatry at the University of Toronto, Toronto, Canada.

Borderline Personality has been one of the most important subjects in contemporary psychiatry. Gunderson reviews the history, the early psychodynamic formulations, the several treatments (both those that work and those that do not), new developments in research, and the immense progress in our understanding and treatment of borderline syndromes in the past few years. His masterful skill in integrating this complex story is enriched with many clinical vignettes, and demonstrates the excitement and challenge of the community that is doing the work, and Gunderson's continuing leadership of it.—Robert Michels, M.D., Walsh McDermott University Professor of Medicine and Psychiatry, Cornell University

Long the leading American expert on borderline personality disorder, John Gunderson has produced a must-read new book for clinicians. He has masterfully synthesized new data reported since the last edition, making this volume the best up-to-the-minute account of BPD available. He is even-handed in his examination of the various treatments, pointing out their strengths and weaknesses while also leaving a string of clinical pearls along the way. The clarity of the prose style makes this book equally useful for trainees and experienced clinicians.—Glen O. Gabbard, M.D., Brown Foundation Chair of Psychoanalysis and Professor of Psychiatry, Baylor College of Medicine

Gunderson's new edition of his 2001 classic text is the definitive source to help us understand patients with borderline personality disorder. The broadening scope of effective treatments for patients with this highly disabling condition is presented in detail, augmented by Gunderson's invaluable clinical wisdom. This edition is filled with new vignettes illustrating critical aspects of treatment, and the overall message of this book is one of hope. To paraphrase Gunderson, patients with borderline personality disorder can be understood, they can be helped, and they can recover. All clinicians who work with patients with borderline personality disorder should have this book on their shelves.—John M. Oldham, M.D., Senior Vice President & Chief of Staff, The Menninger Clinic; Professor & Executive Vice Chair, Menninger Dept of Psychiatry & Behavioral Sciences, Baylor College of Medicine

This is an essential book for both clinicians and researchers. There are many books on borderline personality disorder but this is the only one which comprehensively integrates current understanding of the disorder with empirical evidence and systematically links it with daily clinical practice. In the first edition of this book John Gunderson provided an exemplary clinical guide to the treatment of the disorder. In this up-dated edition, he excels. As a master clinician, he draws on a lifetime's experience to answer common but complex clinical questions; as a master researcher, he assesses the relevance of research to daily practice; and as an authority he brings balance, clarity and scholarship to his discussion of competing approaches to treatment. This is an exceptional book which should be read by every practitioner treating patients with borderline personality disorder.—Prof Anthony W Bateman M.A., FRCPsych, Consultant Psychiatrist and Psychotherapist, Halliwick Unit, Barnet, Enfield, and Haringey Mental Health Trust; Visiting Professor University College, London.

Dr. Gunderson was instrumental in the identification and understanding of borderline personality disorder. This book synthesizes his invaluable experience and wisdom with the most up-to-date clinical data. The two chapters on psychopharmacology are highly informative. In this well written book, Dr. Gunderson exhibits a sensitivity to all concerned in treatment — patients, clinicians, families — that is rarely seen. I would highly recommend this book for any clinician, therapist, patient, or family member touched by borderline personality disorder.—Doody Enterprises, 8/1/2008

If you treat borderline personality disorder patients and want to deepen your understanding of these patients, read this book. This recommendation applies whether you are a resident, a clinician in private practice, a teacher, or a supervising administrator. There is something here for everyone.—American Journal of Psychiatry, 8/1/2008

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