This volume offers guidelines for managing the therapist-patient relationship during crisis intervention and longer-term therapy with patients who exhibit borderline symptoms. Since to do no harm is the primary goal of any therapist who encounters such a patient, an appropriate therapist-patient relationship is crucial; moreover, skillful management of this relationship can, in itself, be the most effective and safe treatment. The authors present a conceptual model, based on self psychology and interpersonal theory, for reframing the borderline symptoms and the therapist's reactions. Case examples demonstrate effective relationship management and therapeutic interventions.

This volume focuses on treatment issues pertaining to patients with borderline psychopathology. A section on psychoanalysis and psychoanalytic psychotherapy (with contributors by V. Volkan, H. Searles, O. Kernberg, L. B. Boyer, and J. Oremland, among others) is followed by a section exploring a variety of alternative approaches. The latter include psychopharmacology, family therapy, milieu treatment, and hospitalization. The editors' concluding essay discusses the controversies and convergences among the different treatment approaches.

For the average clinician, individuals with borderline personality disorder (BPD) often represent the most challenging, seemingly insoluble cases. This volume is the authoritative presentation of dialectical behavior therapy (DBT), Marsha M. Linehan's comprehensive, integrated approach to treating individuals with BPD. DBT was the first psychotherapy shown in controlled trials to be effective with BPD. It has since been adapted and tested for a wide range of other difficult-to-treat disorders involving emotion dysregulation. While focusing on BPD, this book is essential reading for clinicians delivering DBT to any clients with complex, multiple problems. Companion volumes: The latest developments in DBT skills training, together with essential materials for teaching the full range of mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance skills, are presented in Linehan's DBT Skills Training Manual, Second Edition, and DBT Skills Training Handouts and Worksheets, Second Edition. Also available: Linehan's instructive skills training videos for clients--Crisis Survival Skills: Part One, Crisis Survival Skills: Part Two, From Suffering to Freedom, This One Moment, and Opposite Action.

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.

Treating borderline patients is one of the most challenging areas in psychotherapy because of the patient's extreme emotional expressions, the strain it places on the therapist, and the danger of the patient acting out and harming himself or the therapeutic relationship. Many clinicians consider this patient population difficult, if not impossible, to treat. However, in recent years dedicated experts have focused their clinical and research efforts on the borderline patient and have produced treatments that increase our success in working with borderline patients. Transference-Focused Therapy (TFP) is psychodynamic treatment designed especially for borderline patients. This book provides a concise and comprehensive introduction to TFP that will be useful both to experienced clinicians and also to students of psychotherapy. TFP has its roots in object relations and it emphasizes that the transference is the key to understanding and producing change. The patient's internal world of object representations unfolds and is lived in the transference with the therapist. The therapist listens for and makes use of the relationship that is revealed through words, silence, or, as often occurs in the case of individuals with some borderline personality disorder, acting out in subtle or not-so-subtle ways. This primer offers clinicians a way to understand and then use the transference and countertransference for change in the patient.

Borderline Personality Disorder: Tailoring the Psychotherapy to the Patient explores the challenge of treating patients with borderline personality disorder. These patients make up a large segment of the difficult-to-treat population. The instability of their relationships, the intensity of their affective responses, and their proneness to paranoid reactions all contribute to their difficulty in working consistently and constructively in the psychotherapeutic situation. When one adds these difficult patient problems to the therapist's quandary about how expressive or supportive to be, therapists are indeed often confronted with a challenging therapeutic task. The book begins with a review of the clinical and research literature pertaining to the treatment of borderline patients. It presents a unique, empirically based intensive study of three borderline patients, based on transcripts of audiotaped therapy sessions. The research methodology is reviewed, and clinically oriented descriptions of the three patients, their psychotherapy processes, and their outcomes are included. Following an overall summary of results, conclusions regarding the differential indications for supportive versus expressive emphasis in psychotherapy are discussed. In their research, the authors recorded every psychotherapy session and studied a randomly selected group of sessions. Therefore, the reader is provided with increased insight into what is most effective with what kind of patient at a given point in the therapy process.