Borderline personality disorder is a severe and complex psychiatric condition that, until recently, many considered nearly untreatable. But this optimistic guide to BPD provides information that will bring newfound hope to those who have this painful disorder, and to their family and friends.
People with borderline personality disorder have problems coping with almost everything, and therefore anything can provoke them to impulsive actions, angry outbursts, and self-destructive behaviors. Their personal relationships are simultaneously overly dependent and strained, if not openly hostile, and frequently explosive. Incorporating the latest research and thinking on the disorder, Johns Hopkins psychiatrists Francis Mark Mondimore and Patrick Kelly conceptualize it in an original way. They explain that symptoms are the result of biological and behavioral problems, extremes of temperament, and impaired psychological coping, all of which may have a relationship with traumatic life events.
The authors advocate a therapeutic approach incorporating compassion and optimism in the face of what is often a tumultuous disease. With proper treatment, people with borderline personality disorder can enjoy long remissions and improved quality of life.
About the Author
Francis Mark Mondimore, M.D., is a psychiatrist and member of the faculty of the Johns Hopkins University School of Medicine. His books include Depression, the Mood Disease; Bipolar Disorder: A Guide for Patients and Families; and Adolescent Depression: A Guide for Parents, all published by Johns Hopkins. Patrick Kelly, M.D., is a child and adolescent psychiatrist and the director of pediatric psychosomatic medicine at the Johns Hopkins Hospital. His research interests include borderline personality disorder development in children.
Table of Contents
I. Understanding the Problem
1. The Clinical Picture
Features of the Borderline Diagnosis
Making the Diagnosis of Borderline Personality Disorder
The Borderline Conundrum
2. "Personality" and More
What Is a Personality Disorder?
When Does "Personality" Become "Disorder"?
The Bigger Picture
3. The Four Faces of Borderline Personality Disorder
The Perspectives of Psychiatry
4. What the Person Has: The Disease Perspective
Major Depressive Disorder
Borderline or Bipolar?
Picturing Borderline Personality in the Brain
5. The Dimensions of Borderline Personality Disorder
Measuring Personality Traits
The Five-Factor Model of Personality
Traits and "States"
The "Personality" in Borderline Personality
Where Do Personality Traits Come From?
Conclusions about Personality and the BorderlineDiagnosis
6. Behaviors I: Addiction and Eating Disorders
Alcohol and Drug Addiction
7. Behaviors II: Self-Harming Behaviors and Dissociation
Cutting and Other Forms of Self-Mutilation
Why Do Individuals Self-Harm?
Dissociation Symptoms in Borderline Personality Disorder
8. The Life Story: Childhood Experiences, Development, Trauma
Childhood Experiences and the Borderline Diagnosis
Borderline Personality Disorder and PTSD
Life Events in Adulthood
9. Treating the Disease
What Do Medications Treat in Persons with Borderline Personality Disorder?
Atypical Antipsychotic Medications
Antianxiety Medications: Some Words of Caution
10. Treating the Behaviors
Stages of Change
The Talking Cure: Psychotherapy
Cognitive Behavioral Therapy
CBT: A Closer Look
Dialectical Behavioral Therapy
11. Understanding the Dimensions and Addressing the Life Story
Psychodynamic Therapies for Borderline Personality Disorder
Psychotherapy for Borderline Personality Disorder: Summing Up
12. Treatment Approaches: Putting It All Together
13. Themes and Variations
Borderline Personality Disorder in Adolescence
International and Cross-Cultural Considerations
IV. How to Cope, How to Help
14. If You've Been Diagnosed with Borderline Personality Disorder
Diagnosis, Diagnosis, Diagnosis
Assembling Your Treatment Team
Acceptance and Committing to Getting Better
The Role of Hospitalization
The Costs of Addiction
Looking for Happiness in All the Wrong Places
15. For Parents, Partners, Friends, and Co-workers
Getting Someone into Treatment
Recognizing and Addressing Abusive Behaviors
Borderline Personality Disorder in the Workplace
Appendix A: Resources and Further Reading
Appendix B: Theory and Development of the BorderlineConcept: A Primer for Students and Therapists
What People are Saying About This
Those who crave real answers about the debilitating complexities of borderline personality disorder will find them and then some in this well-crafted book. The authors avoid the subtle stigmatization of people who have BPD that is often found elsewhere. Instead, they offer compassion and hope. As one who has suffered from the illness, I can attest that their characterizations of what goes on in the heart and mind of someone with BPD are spot on. This is a great book!
Rachel Reiland, author of Get Me Out of Here: My Recovery from Borderline Personality Disorder
This exceptionally well-written book explains the many complexities of borderline personality disorder and dismantles much of the confusion surrounding the disorder. The authors are to be commended for a book that serves everyone in the BPD community: patients, family members, and professionals alike.
Perry D. Hoffman, Ph.D., President, National Education Alliance for Borderline Personality Disorder
This thorough, compassionate, and readable discussion of Borderline Personality Disorder is essential reading for patients and family members. It will also be invaluable to both new and more experienced clinicians wanting to have the most up-to-date knowledge.
Blaise Aguirre, M.D., author of Borderline Personality Disorder in Adolescents: A Complete Guide to Understanding and Coping When Your Adolescent Has BPD