Defined by stable, long-term, subjective distress and/or social impairment, personality disorders affect up to 18% of the population. Social impairment and health care usage are far more prevalent among people with personality disorders than among people with major depressive disorders. Personality disorders are highly prevalent, variable, and notoriously difficult to treat, and they continue to challenge the therapeutic community and represent a formidable public health concern. This volume ably addresses personality disorders as one of the top priorities of psychiatry for the new millennium, offering a thorough and updated review and analysis of empirical work to point up the issues central to developing a therapeutic model for treatment as well as current research challenges. A review of extant research yields the heartening conclusion that psychotherapy remains an effective treatment for people with personality disorders. An examination of psychodynamic treatment for borderline personality disorder speaks to its efficacy. An analysis of the rationale for combining psychotherapy and psychopharmacology emphasizes the importance of identifying temperament and target conditions. A well-documented and reasoned treatise on antisocial personality disorder makes the crucial point that clinicians must acquire a depth of understanding and skill sufficient to determine what the cut-off point is for treatable versus nontreatable gradations. With the caveat that evidence supporting the efficacy of cognitive treatments for personality disorders is slight and that such approaches require tailoring, a strong case is made for their validity. This timely volume both answers and reframes many stubborn questions about the efficacy of psychotherapy for treating personality disorders.

Borderline Personality disorder is a severe personality dysfunction characterized by behavioural features such as impulsivity, identity disturbance, suicidal behaviour, emptiness, and intense and unstable relationships. Approximately 2% of the population are thought to meet the criteria for BPD. The authors of this volume - Anthony Bateman and Peter Fonagy - have developed a psychoanalytically oriented treatment to BPD known as mentalization treatment. With randomised controlled trialshaving shown this method to be effective, this book presents the first account of mentalization treatment for BPD. The first section gives an overview of BPD, including discussion of nosology, epidemiology, natural history, and psychosocial aetiology. It additionally summarises the present state of our research knowledge about effective psychotherapeutic treatments and use of medication. The second section outlines the authors' theoretical approach and contrasts it with other well known methods, including DBT, CAT, and CBT. In the extensive final section, the authors outline their clinical approach starting with how treatment is organised. A detailed account of the transferable features of the model is provided along with the main strategies and techniques of treatment. Numerous clinical examples are given to illustrate the core techniques and detailed information provided about how to apply aspects of the mentalization based treatment approach in everyday practice. Aimedat mental health professionals, along with counsellors, psychotherapists, and psychoanalysts, the book will be a valuable tool, providing an effective means of treating those suffering from Borderline Personality Disorder.

Rather than arguing for one best approach for treating personality disorder, this pragmatic book emphasizes the benefits of weaving together multiple well-established intervention strategies to meet each patient's needs. A framework is provided for constructing a comprehensive case formulation, planning treatment, and developing a strong therapeutic alliance. The clinician is guided to utilize techniques from all major therapeutic orientations to address transdiagnostic personality symptoms and problems involving emotion regulation, interpersonal functioning, and self and identity. Showing how to pick and choose from "what works" in a thoughtful, coordinated fashion, the book features rich clinical illustrations, including a chapter-length case example. See also Handbook of Personality Disorders, Second Edition, edited by W. John Livesley and Roseann Larstone, the leading reference that surveys theory, research, and evidence-based treatments.

The interpersonal dimensions of each DSM-IV personality disorder are discussed in depth and and innovative procedures for assessment and diagnosis described.

It has been almost twenty years since DSM-III created a major shift in psychi atric classification procedures and in diagnostic and treatment practice by introducing the multi-axial system and, for our patients specifically, the Axis II: Personality Disorders. Researchers and clinicians were forced to focus on many issues related to the field of personality and its disorders. This meant an immense impetus for research, both empirical and theoretical. Many recent developments are described in this book, as reviews or as original articles. This book also covers developments in Europe as well as in North America. Important questions still remain unanswered, such as: What is the relationship between the different clusters: A, B, & C? Are we talking about dimensions, categories, or typologies? What can be done for patients who have more than one personality disorder? Is a pro typical approach required? Consequently, is a multiconceptual approach in treatment and research required? The authors contribute to this discus sion and provide guidelines for further thinking in research and treatment planning. For clinicians, it is of major importance to know whether the disorder can be influ enced by treatment, and whether permanent change is really possible. A very impor tant question is whether a person indeed has a personality disorder, and how this diagnosis affects clinical practice.

In Treatment of Severe Personality Disorders: Resolution of Aggression and Recovery of Eroticism, the influential psychoanalyst and psychiatrist Otto Kernberg presents an integrated update of the current knowledge of personality disorders, their neurobiological and psychodynamic determinants, and a specific psychodynamic psychotherapy geared to resolve the psychopathology of these conditions -- namely, the syndrome of identity diffusion and its influence on the capacity for emotional wellbeing and gratifying relationships with significant others. The author updates the findings of the Personality Disorders Institute of the Weill Cornell Medical College Department of Psychiatry, which are derived from the empirical research and clinical investigation of severe personality disorders, and addresses the effectiveness of transference-focused psychotherapy, a specific psychodynamic treatment for these disorders developed at the Institute. The volume focuses particularly on an essential group of techniques common to all psychoanalytically derived treatments and clarifies the corresponding differential features of various psychodynamic treatment approaches. In prose both precise and evocative, the author: Examines the classification of personality disorders, the way competing viewpoints have influenced the evolution of DSM-III and DSM-IV, and the impact of new knowledge on the classification of DSM-5, with emphasis on how conflicts between scientific and political considerations have hindered the classification of personality disorders in the past. Illustrates in detail how present knowledge of neurobiological structures and neurotransmitters intertwines with the psychodynamic determinants of how psychic experience is organized. Explores psychodynamic psychotherapies and contemporary developments and controversies in the field. For example, the role of interpretation in borderline pathology is examined using a clinical case, and a new formulation of supportive psychodynamic psychotherapy is described. Addresses severe narcissistic pathology -- its diagnosis, prognosis, and treatment. Specifically, the book presents an overview of treatment options for severe narcissistic personality disorder, explores the distortions in verbal communication that may arise during psychotherapy with these patients, and focuses on the differential diagnosis of antisocial behavior. Examines the diagnosis and treatment of sexual pathology, and explores the vicissitudes of the love lives of patients with severe personality disorders. Concludes with a chapter on the essential preconditions in the education of psychodynamic psychotherapists to carry out the challenging and complex psychotherapeutic work in this field. In describing both the limits and the advances in therapeutic effectiveness, the Treatment of Severe Personality Disorders: Resolution of Aggression and Recovery of Eroticism performs a great service, and it will surely become a classic of the psychoanalytic literature.