Treatment of Borderline Personality Disorder: A Guide to Evidence-Based Practice

by Joel Paris

Acclaimed for its wisdom and no-nonsense style, this authoritative guide has now been revised and expanded with 50% new content reflecting a decade of advances in the field. Distinguished psychiatrist Joel Paris distills current knowledge about borderline personality disorder (BPD) and reviews what works in diagnosis and treatment. Rather than advocating a particular therapy, Paris guides therapists to flexibly interweave a range of evidence-based strategies, within a stepped-care framework. The book presents "dos and don'ts" for engaging patients with BPD, building emotion regulation and impulse control skills, working with family members, and managing suicidality and other crises. It is illustrated throughout with rich clinical vignettes.
 
New to This Edition
*Up-to-date findings on treatment effectiveness and outcomes.
*Chapter on dimensional models of BPD, plus detailed discussion of DSM-5 diagnosis.
*Chapter on stepped care, including new findings on the benefits of brief treatment.
*Chapter on family psychoeducation and other ways to combat stigma.
*New and expanded discussions of cutting-edge topics--BPD in adolescents, childhood risk factors, and neurobiology.

Genres: Psychology, Psychiatry

316 pages, Paperback

Published January 21, 2020

About the author

Dr Paris is Professor, Department of Psychiatry, McGill University, and Research Associate, Department of Psychiatry, Jewish General Hospital. He obtained his psychiatric training at McGill. His research interests include: developmental factors in personality disorders (especially borderline personality), culture and personality.
Current projects: risk factors for borderline personality disorder in children the biological correlates of borderline personality disorder.

Reviews

[Gabriella · Rating 4 out of 5]

Really interesting read. I learned of several different symptoms or issues connected to BPD that I wasn't aware of before, despite quite extensive research. The only thing that really bothered me about this book were the copious mentions of suicide attempts and overdoses. I felt like Paris was heavily implying that every Borderline case would present with constant and consistent attempts and overdoses, but my perspective has not shown that to be the case. Suicidal ideation is always apparent in my opinion, but I don't believe overdoses and attempts are as common as he suggests; at the very least, the attempts might be much more passive. Otherwise, it's a smart and modern look at BPD, and offers valuable insight in how to treat it. Useful for both practitioners and patients.

[Don · Rating 5 out of 5]

Just extraordinary — a book I’d recommend to all mental health clinicians. The focus here is on BDP, and Paris does a nice job explaining the disorder, not just going through the DSM-5 criteria but also explaining why some criteria are more important than others and why the disorder is best understood as consisting of four broader trait deficiencies. This leads to an inside-baseball talk about the advantages of a dimensional classification system for mental health, which is then followed by a fascinating distillation of the research around the nurture-nature debate and what this research means for BPD as well as other disorders.

I found the treatment sections to be the most helpful. Paris understands that BPD can be a life-threatening illness, but he also exudes a great deal of hope. Most people with BPD, he emphasizes, experience a gradual reduction of symptoms over time, and he notes that this reduction can be sped up with good therapy. He says some things that those familiar with BPD treatment already know — e.g., having a clear structure is essential — but also things that I don’t think I’ve ever read before. For example, he makes the point that we don’t have research showing that long-term care for most BPD individuals is more efficacious than short-term care, as most studies of DBT and the like don’t go past 12 months. Paris has found that an intermittent approach often works best for these patients, as it prevents them from becoming too dependent on the therapist and encourages their own self-healing capacities.

All and all, just an eye-opening and uplifting read.

[Eila Jameson-Avey · Rating 1 out of 5]

I was not impressed with the limited viewpoint and research that Paris undertook in the writing of this book. Also, I feel many of the terms and diagnoses are already out of date.

[Steven R. Kraaijeveld · Rating 4 out of 5]

This book gives a great overview of both borderline personality disorder and the latest treatment methods that are being employed to battle it. It is easy to read, to the point, and case descriptions are interspersed throughout the text which makes it more humane.

My only criticism would be that the philosophy behind the different treatment approaches is expounded somewhat superficially. This is an explicit choice on the author's part as he chose to pay more attention to the empirical studies that support the approaches, but I still find the theory aspect not entirely satisfactory.

That being said, the purpose of the book is to provide a broad overview of BPD and a point of departure for further research, which is precisely what it does.

[Ele-Reet · Rating 4 out of 5]

Author at first discusses problems involving DSM criteria and misdiagnoses which can be made. Then he discusses the problem that there's no evidence that any medicine is effective enough in BPD, but many psychiatrist prescribe 4-5 different drugs to BPD patients, with little use but many unpleasent side effects. He also discusses different therapies that have been found to be most effective in patients in BPD, but instead of them still these are used freaquently, which create more problems. And he ends with his ideas about how to cope wth suicidiality in BPD patients.

[Noella · Rating 4 out of 5]

Paris' book really helped me write a well-researched paper on the treatment of BPD.

[Bruce Campbell · Rating 4 out of 5]

Good introduction to the topic.