Borderline Patients:
Extending the Limits of Treatability

Harold W. Koenigsberg, MD
Otto F. Kernberg, MD
Michael H. Stone, MD
Ann H. Appelbaum, MD
Frank E. Yeomans, MD
Diana Diamond, PhD
Published by
Basic Books.
New York (2000)

Borderline conditions are a growing presence in the treatment room, yet they are uncommonly resistant to treatment. The authors, all Senior Fellows at the Personality Disorders Institute of the New York Presbyterian Hospital, Westchester Division, and all also engaged in private practice, have already articulated the modality they call Transference-Focused Psychotherapy. Now, in an unusually textured elaboration, they confront the complications that limit treatability—co-existing psychopathologies, early trauma/dissociation, problems endemic to therapeutic situation like attachment disturbances and erotic transferences—and bring new rounds of clinical ammunition to meet those challenges.

"Borderline patients present the most difficult challenge to contemporary dynamic psychotherapists. Dr. Koenigsberg, Dr. Kernberg and their colleagues offer a comprehensive summary of their current approach to these patients, by far the most well studied and most influential therapy in use today. This is must reading for every dynamic therapist who sees borderline patients, and that means every dynamic therapist."

--Robert Michels, MD; Walsh McDermott University Professor of Medicine; University Professor of Medicine, Cornell University Medical College

"Kernberg's transference-focused psychotherapy for borderline patients has become the most theoretically-based, persistently developed and operationally defined psychoanalytic therapy to date. The collective wisdom of the authors represented in this book will help clinicians learn how to select and prepare patients for this therapy and how it interfaces with other modalities."

--John G. Gunderson, MD; Director, Outpatient Personality Disorders Clinic, McLean Hospital; Professor in Psychiatry, Harvard Medical School

"This book does exactly what it says it intends to do—extend the limits of treatability—by building on the Transference-Focused Pshychotherapy that Otto Kernberg developed some twenty-five years ago. Therapists will now know what to do when patients don't respond. They will also know how to use the method in combination with such other modalities as dream analysis and pharmacotherapy. This is an update on an already-effective method for meeting the challenge of treating borderline patients. We are lucky to be living in this century with such a guide at hand."

--Lester Luborsky, PhD, Center for Psychotherapy Research, University of Pennsylvania

"A lucid exposition of the complex issues involved in Transference-Focused Psychotherapy of patients with borderline personality disorders, this is filled with rich clinical vignettes. It offers especially thoughtful discussions of etiologic factors in the genesis of borderline personality disorder, its misdiagnosis, complications of sadomasochism and psychopathy, and TFP's complementarity with other treatment modalities for borderline patients."

--Larry Siever, MD, Professor of Psychiatry, Mount Sinai School of Medicine