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The cover of Clarkin, Yeoman, and Kernberg's new book, Psychotherapy for Borderline Personality, shows a face largely obscured by a hand turned toward the reader. When I picked up the book, I assumed this to be the face of a woman with a borderline personality, wanting both to see and to not be seen. It is an intriguing cover; the expression in only half an eye and eyebrow is both suggestive and limited. It is hard to tell whether this is the countenance of fear or aggression, and whether the gesture of the outstretched hand is to protect or attack. Even before opening the book, the challenges of treating borderline patients are evoked.
This is the third book on the treatment of patients with borderline personality organization completed by members of the Psychotherapy Research Program at the New York Presbyterian Hospital—Cornell Medical Center. The first in the series is Psychodynamic Psychotherapy of Borderline Patients, published by Kernberg et al. in 1989, in which the integrative ego psychology/object relations conceptualization of borderline psychopathology and treatment, termed “expressive psychotherapy,” was presented.1 In 1992, Yeomans, Selzer, and Clarkin published Treating the Borderline Patient: A Contract-Based Approach, which outlined a contract-based psychotherapy.2
Psychotherapy for Borderline Personality, published in 1999, picks up where the 1992 book left off. The authors introduce “Transference Focused Psychotherapy” or “TFP,” and offer an extensive, step-by-step articulation of the psychoanalytically based psychotherapy. Via analysis of the transference, the main task of TFP is to bring into awareness unconscious conflict regarding primitive object relations, so as to facilitate resolution. The authors assert that