Challenge of the Borderline Patient: Competency in Diagnosis and Treatment ((1988))

by Jerome Kroll

Book Overview

Borderline personality is one of the most confusing and controversial psychiatric disorders. Jerome Kroll cuts through that confusion with his clear, sensible discussion of the development of the borderline concept, of the diagnosis of personality disorder, and of competency-based treatment.

• Format: Hardcover
• Language: English
• ISBN: 039370047X
• ISBN13: 9780393700473
• Release Date: January 1988
• Publisher: W. W. Norton & Company
• Length: 256 Pages
• Weight: 1.30 lbs.
• Dimensions: 1.1" x 6.1" x 9.3"

Customer Reviews

Excellent Summary of Borderlines

Beginning with a discussion of the historical and socioeconomic factors of the concept of "borderline", Kroll moves on to present the core clinical features in an attempt (which succeeds) to organize the disparate features. In Chapter 3, he examines the controvery between borderline syndrome and the affective disorders, and moves on in Chapter 4 to present an overview of therapy. Chapter 5 focuses on the disturbances in cognitive style and emotional intensity and Chapter 6 takes up victimization and and intolerance of aloneness. In Chapter 7, he considers medication, and then in Chapter 8 discusses the effects of borderlines on the therapist and where the responsbility lies, e.g. the notorious countertransference brought about by borderlines.At times Kroll comes off as patronizing, but on the whole this just emphasizes how difficult therapy with borderlines can be. In fact Kroll mentions in several places that some are good with borderlines, and others aren't. There are some places where he shines, such as when, in discussing the stresses of dealing with chronic suicide threats, he says, "Therapy cannot proceed when the therapist is more anxious than the patient." It is also reassuring when he says, "While it is part of the patient's longstanding psychopathology to get others to become so anxious about him that they lose perpective of what is a proper response, it is part of my longstanding psychopathogy to move in too fast and take over." It's a dance ... and who's leading who? Therapy with a borderline is notoriously difficult, and Kroll doesn't dodge that issue.Kroll ends by saying, "The challenge for the psychotherapist is to be able to use his or her own personality in the therapeutic process in a manner that facilitates competence and growth in the patient." Kroll cleary believes competence and growth can be facilitated in the borderline patient, and does a good job of telling you how this can be brought about!