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This book admirably fulfills its stated purpose, which is to serve as a resource book on borderline disorders, with specific reference to treatment. In a concise volume, Dr. Goldstein manages to give a clear, relatively jargon-free review of theory and clinical practice concerning borderline patients. But she goes beyond this, providing a wealth of clinical vignettes to illustrate each of the points she makes about borderline characteristics, therapeutic interventions, and resistances. Since work with such patients is often an ongoing exercise in self-doubt, this “hands-on” feature is most appealing.
It is somewhat remarkable how Goldstein has managed to combine the essentials of both theory and clinical work in such a short volume. This may be due to her mastery of the relevant material and her extensive practical experience, and to how objectively she presents the various authors' points of view. While she clearly favors a self psychological approach, she is able to describe each theorist's ideas without prejudice and without polemics.
While many authors including Masterson, the Blancks, Gunderson, and Adler are represented, the structure of the book becomes primarily a comparison between the diametrically opposed approaches of Kernberg and Kohut. There is an elaboration of the contrast between the conflict derived, classical formulations of the former, and the deficit-derived formulations of the latter. Despite the clear differences, Goldstein still attempts an amalgamation of the clinical styles. Her conclusion is that borderline behavior is both complex and variable. Thus, flexibility in working with such patients is both a necessity and an advantage. Within this framework, she explores the strengths and weaknesses of each model and its consequent techniques, as well as the varying levels of borderline pathology that might lend themselves to one technique more than another. She comes to the reasonable, perhaps inevitable, conclusion that there is no single, optim