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Tip: To review the bibliography…

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It is always useful to review an article’s bibliography and references to get a deeper understanding of the psychoanalytic concepts and theoretical framework in it.

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Stòne, M.H. (1993). Borderline Personality Disorder: By John G. Gunderson. Washington, DC: Amer. Psychiat. Assn. Press, 1984, 204 pp., $33.00.. J. Amer. Psychoanal. Assn., 41:247-249.

(1993). Journal of the American Psychoanalytic Association, 41:247-249

Borderline Personality Disorder: By John G. Gunderson. Washington, DC: Amer. Psychiat. Assn. Press, 1984, 204 pp., $33.00.

Review by:
Michael H. Stòne, M.D.

This well-written and richly referenced book on borderline personality disorder covers all important aspects of this disorder. Though the focus is on therapy, there are chapters and sections on the origin of the term, on diagnosis, and on multimodal and pharmacological treatment as well.

In relation to diagnosis and etiology, Gunderson mentions that his concept of borderline personality disorder (BPD) is narrower than that of Kernberg's borderline personality organization (BPO). Because BPD can occur in the absence of prominent symptoms, the disorder cannot, in the author's view, be considered simply as an epiphenomenon of depressive illness. I would endorse this opinion, given the multiplicity of causative factors that can lead to the same clinical picture. To what extent underlying affective illness plays a role in etiology will vary from one sample to another. The predictable interpersonal patterns in BPD lend the underlying psychodynamic coherence that, in Gunderson's view, gives validity to the diagnosis.

Kernberg situates "borderline" as a level of mental organization intermediate between neurotic and psychotic. Gunderson holds a magnifying glass to this intermediate level, noting that the BPD patients themselves function on three different levels in which (1) the important person(s) are available and supportive, (2) these figures are frustrating, and (3) they are absent.

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