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Management of Countertransference With Borderline Patients

Glen O. Gabbard, M.D., and Sallye M. Wilkinson, Ph.D.

  • ISBN 978-0-88048-563-0
  • Item #8563

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Management of Countertransference With Borderline Patients is an open and detailed discussion of the emotional reactions that clinicians experience when treating borderline patients. This book provides a systematic approach to managing countertransference that legitimizes the therapist's reactions and shows ways to use them therapeutically with the patient.

This comprehensive volume

  • includes an overview of common countertransference feelings that arise in treating borderline patients
  • describes various aspects of countertransference management
  • illustrates these aspects with detailed clinical vignettes
  • covers gender issues in countertransference
  • presents a detailed examination of countertransference when the therapist is pregnant

Management of Countertransference With Borderline Patients serves as a clinical guide for all mental health professionals seeking to avoid boundary violations in their clinical work.


  • Introduction. Overview of countertransference with borderline patients. Establishment of optimal distance. On victims, rescuers, and abusers. On holding, containment, and thinking one's own thoughts. Reactions to rage and hatred. Sexual feelings and gender issues. Use of therapist self-disclosure. Splitting. Supervision and consultation. Therapeutic aspects of managing countertransference. Index.

About the Authors

Glen O. Gabbard, M.D., is Professor and Director of the Baylor Psychiatry Clinic at the Baylor College of Medicine and Training and Supervising Analyst at the Houston-Galveston Psychoanalytic Institute in Houston, Texas. He was previously Director of the Menninger Hospital in Topeka, Kansas. Dr. Gabbard is the author or editor of sixteen books and currently is joint Editor-in-Chief and Editor for North America of the International Journal of Psychoanalysis. His numerous awards include the 2000 Mary Sigourney Award for outstanding contributions to psychoanalysis.

Sallye M. Wilkinson, Ph.D., is Staff Psychologist and Assistant Unit Director in the Children's Division of The Menninger Clinic and a candidate in the Topeka Institute for Psychoanalysis.

This book's value derives from the examination of a myriad of countertransference reactions under high-power magnification, describing them in lucid, easily understood language, and making the whole subject come alive with dramatic and convincing clinical vignettes. . . . All therapists will profit greatly from reading it, and it belongs in the bibliography of any seminar on borderline patents or countertransference. This volume is a valuable contribution to the literature.—Bulletin of the Menninger Clinic

Management of Countertransference with Borderline Patients offers a good overview of the basic, and most clinical pertinent, literature on borderline personality. Since most books are not specific about how patients behave and how therapists should respond, the book makes a contribution by offering reasonable advice and information that clinicians can actually use.—Psychoanalytic Books: A Quarterly Journal of Reviews

Management of Countertransference With Borderline Patient is a masterful work. Gabbard and Wilkinson write with elegant simplicity and yet with great clinical and the oretical sophistication, bringing to bear the most advanced conceptions of primitive mental processes and intersubjective phenomena. It is a rare event indeed to find clinical accounts of the richness of those included in this volume. Gabbard and Wilkinson present the details of their moment-to-moment experience with the patient and their methods of attempting to make sense of their own thoughts, feelings, fantasies, and sensations in the service of developing an understanding of the internal world of the patient. This book is a major contribution to the development of our understanding of the treatment of borderline patients. It will be of great interest to all clinicians working with borderline patients whether the therapist is a beginning student or an experienced practitioner.—Thomas H. Ogden, M.D., Author of The Primitive Edge of Experience & The Matrix of the Mind, Supervising Analyst, Psychoanalytic Inst of Northern CA, Co-Director, Ctr Advanced Study of the Psychoses

There have been many fine books on the borderline personality, but this is the first work that intelligently addresses the effect of borderline patients on the psychotherapist or psychoanalyst who works with them. It is a profoundly informative, vivid, and compelling read, because the authors have skillfully inserted riveting clinical vignettes that evoke the presence of the personality they address, thereby establishing a rather remarkable triangular drama: this extraordinary patient, contemporary psychoanalytic theories on the borderline patient, and the clinician who must carry his patient and his own beset-upon self to psychic change and well-being.—Christopher Bollas, Ph.D., Author of Being a Character

Gabbard and Wilkinson have written a book of such lucidity, clinical soundness, and highly readable scholarliness that it deserves to become a standard and enduring textbook for anyone involved in doing individual psychotherapy with borderline patients. The variety of individual therapy that they portray is psychoanalytic therapy, but the lucidity with which they write is such that the reader need not be a psychoanalyst, nor a candidate in an analytic institute, to make good use of their teaching. Furthermore, practitioners of even many years of experience in this field will find, here, illumination and enrichment. I personally have learned much from my reading of this book by Gabbard and Wilkinson.—Harold F. Searles, M.D.

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