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During the past few decades much has been written about the etiology and treatment of borderline patients. The two books reviewed here deal with dimensions of borderline pathology. Michael Stone reports the results of a study, Eda Goldstein presents a comparison of a few models of treatment.
Stone is a professor of clinical psychiatry at Columbia College of Physicians and Surgeons. His present book describes the results of a long-term research project that was conducted at New York State Psychiatric Institute over a 14-year period. His major finding is that borderline patients tend to get better if they live long enough. On long-term follow up, approximately two thirds of borderline patients who had once been severely impaired were functioning normally or with minimal symptoms. In analyzing the follow-up data, Stone established clear correlations between causal variables and patient outcome. For example, borderline patients who had been victims of parental physical or sexual abuse usually did less well than their nonvictimized counterparts did. Female borderline patients with concomitant major affective disorder and alcohol abuse had a five-year survival rate of slightly more than 50%—unless they managed to curb their alcoholism Contrary to common psychiatric opinion in the past, patients with antisocial personality who do not manifest conscious guilt feeling do, under certain circumstances, commit suicide.
There is a high suicide proneness during the early 20s. Most borderline patients, however, begin to improve as they enter their