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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.
Contents
Acknowledgments
Introduction
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
Understanding "Personality"
What Is a Personality Disorder?
When Does "Personality" Become "Disorder"?
Mood Disorders
Self-Destructive Behaviors
Traumatic Experiences
The Bigger Picture
II. Causes
3. The Four Faces of Borderline Personality Disorder
The Perspectives of Psychiatry
4. What the Person Has: The Disease Perspective
Mood Disorders
Major Depressive Disorder
Dysthymic Disorder
Bipolar Disorders
Borderline or Bipolar?
Picturing Borderline Personality in the Brain
Genetics
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
Eating Disorders
7. Behaviors II: Self-Harming Behaviors and Dissociation
Cutting and Other Forms of Self-Mutilation
Why Do Individuals Self-Harm?
Suicidal Behavior
Dissociation
Dissociative "Disorders"
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
III. Treatment
9. Treating the Disease
What Do Medications Treat in Persons with Borderline Personality Disorder?
Antidepressant Medications
Mood-Stabilizing Medications
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
Gender Differences
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
Safety Issues
Recognizing and Addressing Abusive Behaviors
Borderline Personality Disorder in the Workplace
Getting Support
Epilogue
Appendix A: Resources and Further Reading
Appendix B: Theory and Development of the BorderlineConcept: A Primer for Students and Therapists
References
Index
