Psychotherapy With Borderline Patients
An Integrated Approach
Routledge – 2002 – 210 pages
Routledge – 2002 – 210 pages
Patients with borderline personality disorder (BPD) or borderline traits are among the most difficult for mental health practitioners to treat. They present an incredible range of symptoms, dysfunctional interpersonal interactions, provocative behavior in therapy, and comorbid psychiatric disturbances. So broad is this array that indeed the disorder constitutes a virtual model for the study of all forms of self-destructive and self-defeating behavior patterns.
Psychotherapy With Borderline Patients: An Integrated Approach fills the need for a problem-focused, clinically oriented, and operationalized treatment manual that addresses major ongoing family factors that trigger and reinforce the patient's self-destructive or self-defeating behavior. In it, David Allen draws on the theoretical ideas and techniques of biological, family systems, psychodynamic, and cognitive-behavioral therapists to describe an integrated approach to adults with BPD or borderline traits in individual therapy.
Innovative, practical, and specific, the book
* helps therapists teach their patients, through the use of various role-playing techniques, strategies to alter the dysfunctional patterns of interaction with their families of origin that reinforce self-destructive behavior or chronic affective symptoms;
* explains the nature and origins of the characteristic oscillation of hostile over- and underinvolvement between adults with BPD and those who served as their primary parental figures during childhood;
* elucidates the nature and causes of the dysfunctional communication patterns in patients' families that lead to misunderstanding; and
* provides concrete, clearly spelled out advice for therapists about how to deal with provocative patient behavior, how to minimize distorted descriptions by patients of significant others, how to avoid patients' misuse of medications, and how to respond to managed care restrictions on patients' insurance coverage.
Psychotherapy With Borderline Patients: An Integrated Approach will be welcomed by all clinicians who work with these patients, whatever their training or theoretical orientation.
"Allen builds on his excellent prior work on unified therapy by applying these concepts to the treatment of Borderline Personality Disorder. Clear theoretical formulations are interwoven with appropriate case material. Detailed recommendations for intervention with this extremely difficult group of patients are provided, and these recommendations often would be valuable in the treatment of a wider range of individuals with personality disorders."
—George Stricker, Ph.D.
Contents: Preface. Part I: The Relationship Between Family of Origin and Individual Dynamics of Adults With Borderline Personality Disorder. The Borderline Family. Kin Selection, Self Sacrifice, and Family Homeostasis. Parental Role Confusion. Metacommunication in BPD Families. Part II: Unified Therapy of Patients With Borderline Personality Disorder. Rationale for the Treatment Approach. Transference. Initial Evaluation. Exploration and Interpretation. Strategies for Problem Resolution. Termination.