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The Fate of Borderline Patients should be carefully studied by mental health clinicians and researchers. There are very few books to which psychotherapists return, year after year, to validate clinical impressions or to gain assistance with conceptualizing difficult problems, or simply to become nourished and refreshed. Having already composed one that definitively discussed the borderline syndromes, Michael H. Stone now provides us with another class—a follow-up study of 502 selected patients hospitalized at The New York State Psychiatric Institute between 1963 and 1976.
The book consists of his methods, findings, and inferences, but in addition, his reflections on clinical and existential matters. Invariably compassionate in response to suffering, Stone writes with Swiftian irony about injustice, incompetence, and especially the moral frailties of patients and therapists alike. As I read this book I found myself wondering what other medical or psychiatric text it resembles. It has the narrative elegance of Oliver Sachs, combined with the descriptive precision of Kraepelin but ultimately stands alone in its style.
It is difficult, perhaps impossible, to accurately imagine the amount of work that went into collecting the data reported here. One way for the practitioner who may have little experience with carrying out systematic research to do so would be to picture himself retrieving office records of all patients treated in a single year, long ago. Then imagine attempting to interview each one, including those who may have abruptly terminated treatment during negative transference reactions, and others who may have been victims of damaging countertransference errors. Fancy attempting to interview the relatives of patients who suicided. Dr. Stone did all this and much more.
Stone did not even begin his project with the Herculean task of contacting the more than 500 patients who constitute the database of his book. The entire sample had been admitted to the New York Sta