Customer Reviews

Psychotherapy for Borderline Personality: Focusing on Object Relations

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I loved and hated this book. Starts out great in its attempt to provide a description of an object relations approach to treating Borderline Personality. When steps are re-traced to dig deeper, I felt the book began to fall apart in the sense of being disorganized and redundant. Had to force myself to finish something that began very well.

This book is the product of years of clinical experience and training of psychiatrists/psychologists in the use of an object-relations psychoanalytic psychotherapy for treatment of patients with underlying borderline personality organization. Borderline in this sense means patients with primitive defense mechanisms (e.g., splitting, projective identification), identity diffusion, and other features, and such organization is seen in several personality disorders in addition to "borderline personality." Examples include narcissistic disorder and antisocial personality. The book presents a very clear picture of the value of ORT (object relations theory) in clinical practice, with many case examples and detailed explanations of their psychological significance for the individual patient. Particular attention is given to the importance of maintaining "technical neutrality" (i. e., functioning as an "observing ego" and not siding with a particular component of a patient's intrapsychic conflict.) In addition, emphasis is placed on the resolution of primitive defenses via interpretation. The authors have conducted extensive research on the training of therapists, and recognize that detailed supervision and discussion of case material with trainees is of utmost significance. Perhaps for this reason, their book is filled with insights of great potential value to practicing therapists. (I have never seen such a clinically useful book.) The treatment approach the authors recommend is time consuming (2 sessions per week) and can take several years (with severe cases). However, it offers serious promise that very significant change is possible with borderline patients. This book goes well beyond an account of ORT--it is a major contribution to those interested in the psychoanalytic psychotherapy of patients with underlying borderline personality organization.