Psychotherapy of the Quiet Borderline Patient: The as-if Personality Revisited [Hardcover]

Vance R. Sherwood (Author)

Book Description

Publication Date: August 1, 1994 | ISBN-10: 1568210604 | ISBN-13: 978-1568210605

Psychotherapy of the Quiet Borderline Patient is the first book-length study of the as-if personality, also referred to as the quiet borderline patient. This book offers the most detailed exposition of etiology in the literature, tracing as-if development first from an object relations standpoint and then from a family interaction perspective. In addition, this is the first work to propose a specific treatment approach for the quiet borderline patient. Half a century has passed since Deutsch's famous paper introduced the as-if category. In spite of the popularity and influence of that paper, there has been little development of the concept, apparently because subsequent writers felt there were few as-if patients. Psychotherapy of the Quiet Borderline Patient, however, suggests that there is no shortage of as-if individuals in contemporary society. The authors demonstrate that such cultural factors as changing conceptions of childrearing, emphasis on rapid adaptation to change, and an intolerance of any process requiring an investment of time are likely to promote the as-if style. As-if pathology is essentially imitative. These individuals are skilled at sensing what roles others might want them to play and matching up with those roles. The as-if individual has no stable underlying identity, and the as-if personality consists of an endless series of transient identifications with very little that stably carries over from one situation to another. That part of the personality generally called the self seems to be deficient. In therapy, as-if patients try to sense what the therapist expects of them. If they glean enough clues about how the therapist thinks a productive patient should act, they can play that role for prolonged periods of time. The therapist may have the uneasy intuition that something is wrong, without knowing what. The patient is acting as if he or she is in treatment, but therapy is actually having little impact.

Product Details

• Hardcover: 320 pages
• Publisher: Jason Aronson, Inc. (August 1, 1994)
• Language: English
• ISBN-10: 1568210604
• ISBN-13: 978-1568210605
• Product Dimensions: 8.4 x 5.8 x 1.1 inches
• Shipping Weight: 1.2 pounds
• Average Customer Review: 3.7 out of 5 stars  See all reviews (3 customer reviews)
• Amazon Best Sellers Rank: #919,996 in Books (See Top 100 in Books)

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Customer Reviews

Most Helpful Customer Reviews

36 of 39 people found the following review helpful:

5.0 out of 5 stars The Problem of Elusive Identity, May 16, 2000

By 

Eileen Galen (USA) - See all my reviews
(REAL NAME)   

This review is from: Psychotherapy of the Quiet Borderline Patient: The as-if Personality Revisited (Hardcover)

In their introduction to this orderly, accessible, and informative book, the authors define as-if pathology as "essentially imitative, a way of life built on a series of transient identifications in which the individual acts as if he or she were sensitive, empathic, conservative, religious, or even rebellious - all dependent on what others want the individual to be."

The "quiet borderline patient" is, according to the authors, an overlooked personality, having ceded psychoanalytic terrain (in the literature as well as the consulting room) to the demanding histrionics and chaos of the "noisy borderline." Completely different etiology!

Because as-if etiology includes the "appearance of normalcy, precocious ego development,and the absence of identity," (which are also chapters headings), there is no psychosis. According the the authors, a clinician who is unaware of the 'as-if' pathology may have a feeling that something is not quite right with the patient, but be continuously unable to identify it - or to treat it. To add to the elusiveness (of the pathology as well as its diagnosis), the authors write that it's a given that all persons, to greater or lesser extent, experience transient identifications - ideally, on the way to a solid, developed identity. So one of the difficulties that clinicians have in identifying this pathology is that patients often seem pretty "normal." It takes a perceptive - and educated - clinician to competently diagnose and treat these patients. This book would seem to make a sizable contribution to that education. Many examples are provided, in a fluid and readable format.

The authors rely on literature, their clinical experience,and what is obviously a great deal of their focused attention in order to describe intervention strategies and techniques. The final chapter, "As-if Trends in Culture and Therapy," strives to place this pathology in societal context.

There is an extensive bibliography and a good index. I'm not in the field, rather an enthusiastic reader - but I wouldn't hesitate to recommend this book to anyone with an interest in the subject.

21 of 24 people found the following review helpful:

5.0 out of 5 stars Altered perspective of the borderline., February 14, 1997

By A Customer

This review is from: Psychotherapy of the Quiet Borderline Patient: The as-if Personality Revisited (Hardcover)

Frustration, anger, and manipulations are often evident when attempting to work with borderline clients. My empathy increased ten-fold as I read and applied the principles of this book. Highly recommended for all mental health professional

5 of 14 people found the following review helpful:

1.0 out of 5 stars This man should be behind bars., September 24, 2009

By 

MiMatt (Nashville, TN.) - See all my reviews

This review is from: Psychotherapy of the Quiet Borderline Patient: The as-if Personality Revisited (Hardcover)

Dr. Vance Sherwood was once an employee at Peninsula Village - a long term drug rehab for adolecents, located outside Knoxville, TN.

The average stay at PV is about a year.

Kids are tortured, taught to turn against each other, and verbally and physically abused around the clock.

His liscense to practice medicine should be revoked, and shouldn't even be allowed around children. Anyone who follows the advice in his books, or even recommends them should be brought up on child abuse charges, themselves.

My son (now 34 years old) was once a patient at Peninsula Village between 1992-1993. To this day, he still has nightmares about PV, and has attempted to kill himself 3 times since his release. He is now suffering from PTSD, agoraphobia, and cannot function in crowds.

This man is a disgrace to psychatrists and should be behind bars.