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Book Reviews

Borderline Personality Disorder: A Clinical Guide, 2nd ed

Borderline Personality Disorder: A Clinical Guide, 2nd ed

by John G. Gunderson, MD, with Paul S. Links, MD, FRCPC. APPI, Arlington, VA, 2008, 350 pages, $60.00 (paper).

Interested in shifting from distressed to confident in managing patients with borderline personality disorder? This book will get you there—if your approach involves multiple modalities.

John Gunderson, who has guided this nation’s conceptualization of borderline personality disorder for the past 35 years, and Paul Links, an international authority on personality disorders and the management of the suicidal patient, have authored a comprehensive, sophisticated, and pragmatic guide. They successfully provide the background of DSM-IV‘s conceptualization, with modesty, especially considering Gunderson has been most influential in this field. Besides the diagnosis, the patient and family want an explanation; this book suggests 2 jargon-free explanations.

Though the patient may meet the DSM criteria for borderline personality disorder, differentiating and exploring all other diagnoses are essential since most patients with this disorder have an additional psychiatric diagnosis. Next, when focusing on the treatment plan, the authors stay close to the patient’s symptoms, not a theory-driven process. The chapters on medication are empirically driven, with many useful nuances; they are chapters that alone justify recommending that psychiatrists read this book.

The authors do not recommend solo flying. Usually, a range of services is needed. Especially recommended are group psychotherapy, family psychotherapy, and 3 forms of individual psychotherapy: cognitive-behavioral therapy, dialectical behavioral therapy, and psychodynamic therapies. However, the type of therapy most commonly used, supportive psychotherapy, is not described. (A. H. Appelbaum’s supportive psychotherapy does get a 3-sentence review, though, that points out that her approach, a successful one, is not representative of the usual supportive psychotherapy.)

Contributing to this book’s sophistication is that the authors have been very observant of clinicians working with these patients. Many of the insights and pearls (and almost every page has 1 or 2) come from observations of the clinicians working with these patients. Highlighting many points are 28 vignettes.

An Appendix provides many psychoeducational resources for patients, their families, and professionals.

Roger Peele, MD

RogerPeele@aol.com

Hind Benjelloun, MD

Author affiliations: George Washington University School of Medicine and Health Sciences (Dr Peele) and Georgetown University School of Medicine (Dr Benjelloun), Washington, DC. Potential conflicts of interest: None reported.

Volume: 71

Quick Links: Personality Disorders