Cover -- Half-title -- Title -- Copyright -- Dedication -- Contents -- Contributors -- Preface -- 1 Treatability in severe personality disorders: how far do the science and art of psychotherapy carry us? -- Factors that influence amenability to psychotherapy -- Estimates of treatability -- Follow-up studies in the domain of the severe personality disorders -- Borderline personality disorder (BPD) -- Schizotypal personality -- Antisocial and psychopathic personalities -- Concluding remarks on the efficacy of treatment -- REFERENCES -- 2 The treatment of choice: what method fits whom? -- Treatment choices facing the clinician -- Patient heterogeneity -- Diagnostic variability -- Patient characteristics other than diagnosis -- Which treatment model? -- Match between therapist and patient in transference-focused psychotherapy (TFP) -- Research on patient-therapist match -- Patient A -- Patient B -- Summary and comparison -- REFERENCES -- 3 Countertransference: recent developments and technical implications for the treatment of patients with severe personality disorders -- The contemporary concept of countertransference -- Classification of countertransference with particular implications for the treatment of severe personality disorders -- Analysis and management of countertransference -- Particular countertransference complications -- Contemporary controversies regarding countertransference -- REFERENCES -- 4 Beyond management to cure: enhancing the positive dimensions of personality -- Introduction -- The practical necessity to reduce disability -- What does reduce disability and enhance well-being? -- The wishes of the suffering for spiritual meaning -- Stages in the path to well-being -- Voyages to well-being -- Obstacles to well-being in patients with severe personality disorders -- REFERENCES.

5 Personality disorders from the perspective of child and adolescent psychiatry -- Developmental aspects of personality disorders -- Heredity -- Prenatal issues -- Attachment -- Temperament -- Maltreatment -- Diagnosis of personality disorders in children and adolescents -- Childhood psychopathology and its relation with personality disorders -- Prevention and treatment -- Prevention -- Treatment -- Summary -- REFERENCES -- 6 Disruptions in the course of psychotherapy and psychoanalysis -- Definition -- Dynamics -- Unconscious guilt -- Anxious retreat from "higher" level conflicts -- Sadomasochistic need to destroy a helpful situation -- Retreat due to separation anxiety -- Shift in psychic organization -- Empathic failures of the therapist -- Manifestations -- Case 1 -- Case 2 -- Case 3 -- Case 4 -- Treatment -- Holding and containing -- Assuring safety and setting limits -- Naming and taming -- Oscillating in accordance with the patient's level of transferences -- Acknowledging one's own role in precipitating a disruption -- A developmental postscript -- Case 5 -- Conclusion -- REFERENCES -- 7 Managing suicidal crises in patients with severe personality disorders -- Suicidal crises and suicide prevention -- The setting of treatment for managing crises -- Suicidal crises and chronic suicidality -- An approach to the management of crises in severe personality disorders -- REFERENCES -- 8 Borderline personality disorder, day hospitals, and mentalization -- Epidemiology -- Severity -- Severity and context of treatment -- Some common features of day hospital treatments -- Milieu -- Affect focus -- Individual and group psychotherapy -- Research and day hospital treatment -- Mentalization -- Mentalizing as the key to successful treatment.

Mentalization: the common theme in psychotherapeutic approaches to borderline personality disorder and the key element of the treatment milieu -- Conclusions -- REFERENCES -- 9 Pharmacotherapy of severe personality disorders: a critical review -- Conceptual issues -- Treating the disorder itself -- Treating symptoms or symptom clusters -- Treating associated Axis I disorders -- Treating trait vulnerabilities -- The pharmacological treatment algorithms of Soloff and APA borderline guidelines -- Methodological problems -- Studies on the efficacy of drugs in personality-disordered patients -- Antipsychotics -- Classical antipsychotics -- Atypical antipsychotics -- Antidepressants -- Classical antidepressants -- MAO inhibitors -- Modern antidepressants -- Selective serotonin reuptake inhibitors (SSRIs) -- Mood stabilizers -- Lithium -- Carbamazepine -- Divalproex -- Topiramate -- Lamotrigine -- Conclusion -- Benzodiazepines -- Remaining groups -- Opiate antagonists -- Omega-3 fatty acid -- Discussion -- Towards a revised approach of pharmacotherapeutic interventions in patients with personality disorders. -- Cognitive perceptual symptoms -- Psychotic-like symptoms -- Dissociation -- Impulsive-behavioral dyscontrol -- Affective dysregulation -- REFERENCES -- 10 Severe cases: management of the refractory borderline patient -- The refractory borderline patient -- Characteristics of the refractory borderline patient -- Environmental factors -- No alliance, no therapy -- A rehabilitation perspective -- Rehabilitation -- Assertive community treatment -- Intensive outpatient programs for refractory BPD -- Engaging the refractory patient -- Split treatment -- The "neutral psychotherapist" -- Integrating hospitalization admissions -- Indications to hospitalize -- Facilitating hospital discharge -- Systems support and systems interventions -- Team support.

Conclusion -- REFERENCES -- 11 Dangerous cases: when treatment is not an option -- The nature of the beast -- Case A -- Case B -- Diagnostic issues -- Countertransference phenomenon -- Therapeutic nihilism -- Illusory treatment alliance -- Fear of assault or harm -- Denial and deception -- Case C -- Helplessness and guilt -- Devaluation and the loss of professional identity -- Case D -- Hatred and the wish to destroy -- Assumption of psychological complexity -- Fascination and sexual attraction -- When treatment is undertaken -- Case E -- Conclusions -- REFERENCES -- NOTES -- 12 Stalking of therapists -- Introduction -- Stalking of therapists -- Studies of the stalking of therapists -- Pattern of stalking of health professionals -- Stalking and the therapeutic encounter -- Can you predict which patient will stalk their therapist? -- Avoiding and surviving stalking -- Early recognition -- Informing -- Keeping records -- Legal remedies -- Looking after yourself -- Conclusions -- REFERENCES -- 13 Common elements of effective treatments -- Contemporary perspectives on the treatment of personality disorder -- Common or generic factors -- Generic factors in the treatment of personality disorder -- Building and maintaining a collaborative relationship -- Maintaining a consistent treatment process -- Establishing a validating treatment process -- Building motivation -- General treatment strategies and the organization of treatment -- Generic aspects of specific interventions -- Phases of change and intervention strategies -- Structured approach to treatment -- Therapeutic stance -- Treatment contract -- Consistency -- Conceptual commonalities -- Cognitive structure as an integrating concept -- Schemata and personality -- Clinical implications -- Conceptualization of crises and symptoms -- Changing maladaptive schemata and interpersonal patterns.

Conclusions -- REFERENCES -- Index.