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This book constitutes an excellent primer for those who are interested in working with borderline personality disorder (BPD) patients. It does not require much in the way of psychoanalytic erudition and there is little in it about depth psychodynamics using either ego psychology, self psychology, or object-relations theory. The book basically consists of two books. One part constitutes a report on four interesting cases which were treated at length at Chestnut Lodge by intensive psychotherapy. The other part consists of theoretical discussion of such cases, utilizes mainly Bowlby's attachment theory, and generally reviews the treatment of BPD patients.
The book opens with what I would call a “politically correct” review of some of the psychiatric literature on the topic, what they call a “multidimensional and integrated etiological model of BPD that incorporates developmental theory, attachment research, and research on maltreated children with genetic and biological investigations, neuropsychological findings, family studies, and long term outcome studies of adult BPD patients” (p. x). Surely in this approach the authors have covered all the bases. Their literature review is thorough enough on these topics to warm the heart of any modern general psychiatrist but contains little about such psychoanalytic approaches as Kernberg's numerous contributions to the topic as well as that of other well known psychoanalytic authors. After the second section presenting the four cases the third section of the book applies the authors' developmental model to a general discussion of the treatment of borderline patients and is valuable especially for those who have little experience with them.