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In this latest monograph of his important oeuvre on borderline and narcissistic personality disorders, Kernberg has organised the material in a new more comprehensive way. The unifying theme throughout is his focus on aggression and its clinical manifestations of rage and chronic hatred. In addition to expanding his theoretical ideas and clinical findings, he has also added a separate section on perversions.
In the first two sections of the book, Kernberg undertakes a thorough review of the development of the aggressive drive and its vicissitudes at different developmental levels. The current work's developmental orientation and focus on aggression comprise its raison d'être and distinguish it from earlier works. Because the different chapters represent adaptations of previously-published articles Kernberg has written since Severe Personality Disorders: Psychotherapeutic Strategies, published in 1984 (New Haven & London: Yale Univ. Press), there is occasionally a disjointed quality about the way they are arranged. An example is the separation of the presentation on infantile personalities under Clinical Applications from other types of borderline personality disorders discussed under Developmental Aspects.
In his Preface, Kernberg describes the present work as the 'continuing exploration of the etiology, nature, and treatment of personality disorders' (p. vii). Regarding aetiology, most students of Kernberg are familiar with his view that affects are the building blocks of drives, and that 'good' and 'bad' affective memories organise drives into a motivational system. This formulation, based on infant research by Emde, Stern, and others, is the theoretical base for Kernberg's positing a connection between the pathology of mother–infant relationships in infants at high risk, and the development of inordinate aggression in the psychopathology of patients with borderline personality organisation.
In the ensuing discussion of the psychopathology of hatred, Kernber