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Understanding and Treating Borderline Personality Disorder

A Guide for Professionals and Families

Edited by John G. Gunderson, M.D., and Perry D. Hoffman, Ph.D.

  • ISBN 978-1-58562-135-4
  • Item #62135

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Understanding and Treating Borderline Personality Disorder: A Guide for Professionals and Families offers both a valuable update for mental health professionals and much-needed information and encouragement for BPD patients and their families and friends. The editors of this eminently practical and accessible text have brought together the wide-ranging and updated perspectives of 15 recognized experts who discuss topics such as

  • A new understanding of BPD, suggesting that individuals may be genetically prone to developing BPD and that certain stressful events may trigger its onset
  • New evidence for the success of various forms of psychotherapy, including Dialectical Behavior Therapy (DBT), in reducing self-injury, drug dependence, and days in the hospital for some groups of people with BPD
  • Pharmacology research showing that the use of specific medications can relieve the cognitive, affective, and impulsive symptoms experienced by individuals with BPD, as part of a comprehensive psychosocial treatment plan
  • New resources for families to help them deal with the dysregulated emotions of their loved ones with BPD and to build effective support systems for themselves

Yet much remains to be done. Research on BPD is 20 to 30 years behind that on other major psychiatric disorders such as schizophrenia and bipolar disorder. Despite evidence to the contrary, much of the professional literature on BPD continues to focus on childhood trauma, abuse, and neglect as triggers for BPD—to the detriment of both patient and family.

Families of people with BPD must deal with an array of burdens in coping with the illness, often without basic information. The chapters on families and BPD give voice to the experience of BPD from the perspective of individuals and family members, and offer the hope that family involvement in treatment will be beneficial to everyone.

Above all, this book is about the partnership between mental health professionals and families affected by BPD, and about how such a partnership can advance our understanding and treatment of this disorder and provide hope for the future.


  • Contributors
  • Foreword
  • Preface
  • A word to the lay reader
  • Part I: Diagnosis, Treatment, and Prognosis
  • Chapter 1. The borderline diagnosis: Concepts, criteria, and controversies
  • Chapter 2. Psychotherapies for borderline personality disorder
  • Chapter 3. Suicidal and self-injurious behavior in borderline personality disorder: A self-regulation model
  • Chapter 4. Pharmacotherapy in borderline personality disorder
  • Chapter 5. The longitudinal course of borderline personality disorder
  • Part II: Family Matters
  • Chapter 6. Living with borderline personality disorder: Two firsthand accounts
  • Chapter 7. Family perspectives on borderline personality disorder
  • Chapter 8. From family trauma to family support system
  • Chapter 9. Family involvement in treatment
  • Index

About the Authors

John G. Gunderson, M.D., is Director of the Center for Treatment and Research on Borderline Personality Disorder at McClean Hospital in Belmont Massachusetts. He is also Professor of Psychiatry at Harvard Medical School.

Perry D. Hoffman, Ph.D., is President of the National Education Alliance for Borderline Personality Disorder and Research Associate at Weill Medical College at Cornell University in New York, New York.

Families, friends, and caregivers of people with borderline personality disorder have long been neglected by mental health professionals. Blamed, censured, stigmatized, they have been relegated to the anteroom of treatment, rarely being considered as a positive force to be harnessed for effective intervention. This book, taking its inspiration from a conference of the National Education Alliance for Borderline Personality Disorder, represents a turning point. Whilst there are many books on borderline personality disorder, this is the only one to consider fully the perspectives of both the family and professionals. The professionals cover basic theoretical approaches to the disorder and outline treatment methods and the consumers, the real experts, give their own compelling accounts of living with a loved one with a borderline disorder. Their point is clear. Involving families in treatment resurrects hope from despair and, far from making matters worse, is likely to improve treatment outcomes and maintain constructive family involvement. This book tells how it should be done and should be on the desk of all professionals treating patients with borderline personality disorder. It is a convincing reminder that families should not be relegated to the waiting room but positively encouraged to engage with the treatment process.—Anthony W. Bateman, M.D., F.R.C.Psych., Visiting Professor, University College London and Director, Specialist Personality Disorder Services, Barnet, Enfield, and Haringey Mental Health NHS Trust

The editors compile the wisdom of many experts into a collection that is timely, richly empathic, and informative. All chapters address questions often raised by consumers and their relatives, and several chapters focus exclusively on coping with BPD within the family context. This book has been a long time in coming; now that it's here, it will surely become a classic.—Thomas H. McGlashan, M.D., Professor, Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut

This volume is a most welcome contribution to a growing and complex literature. Its balanced and objective summaries of current knowledge should interest clinicians and help them communicate with families about the illness, treatment alternatives, and how families can help their relatives and (last but not least) themselves. Even more, by highlighting clear and simple, yet sophisticated and comprehensive statements, it manages to convey what families need to know in order to understand and to be of help to their ill relatives.—Otto F. Kernberg, M.D., Director, Personality Disorders Inst, NY Presbyterian Hosp, Westchester Div; Prof of Psychiatry, Weill Med Coll Cornell Univ; Training & Supervising Analyst, Columbia Univ

This impressive book is quite successful in clearly communicating information to a diverse audience on a complex disorder. It is a one of a kind source that provides an extensive amount of information for professionals and lay persons in a unique and manageable form by blending personal experiences with current psychiatric understanding. It will be a valuable resource for family members, patients, and healthcare professionals alike.—Marie A. Dewitt, M.D., Doody's Health Sciences Book Review Journal, 4/1/2006

[U]nderstanding and Treating Borderline Personality Disorder is one of the most complete and responsibly written books I have found on any mental illness. I recommend it without reservation to anyone who needs a comprehensive introduction to what is known-and not known-about BPD.—David A. Flory, Metapsychology Online Book Reviews

The intent of this volume on borderline personality disorder (BPD) is laudable: it seeks to offer professionals and families information and education to reduce the confusion about the disorder. Such a guide is badly needed. . . . There is clearly a niche for a readable text that explains BPD in ways that are helpful to families and parents. This volume begins to fill this niche and should help reduce false impressions, stigmatization of the disorder, and the blame heaped on patients and their families.—Canadian Journal of Psychiatry, 4/1/2006

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