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Psychotherapy of the Quiet Borderline Patient: The As-If Personality Revisited

Psychotherapy of the Quiet Borderline Patient: The As-If Personality Revisited

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Rating: 5 stars
Summary: Altered perspective of the borderline.
Review: Frustration, anger, and manipulations are often evident when attempting to work with borderline clients. My empathy increased ten-fold as I read and applied the principles of this book. Highly recommended for all mental health professional

Rating: 5 stars
Summary: The Problem of Elusive Identity
Review: In their introduction to this orderly, accessible, and informative book, the authors define as-if pathology as "essentially imitative, a way of life built on a series of transient identifications in which the individual acts as if he or she were sensitive, empathic, conservative, religious, or even rebellious - all dependent on what others want the individual to be."

The "quiet borderline patient" is, according to the authors, an overlooked personality, having ceded psychoanalytic terrain (in the literature as well as the consulting room) to the demanding histrionics and chaos of the "noisy borderline." Completely different etiology!

Because as-if etiology includes the "appearance of normalcy, precocious ego development,and the absence of identity," (which are also chapters headings), there is no psychosis. According the the authors, a clinician who is unaware of the 'as-if' pathology may have a feeling that something is not quite right with the patient, but be continuously unable to identify it - or to treat it. To add to the elusiveness (of the pathology as well as its diagnosis), the authors write that it's a given that all persons, to greater or lesser extent, experience transient identifications - ideally, on the way to a solid, developed identity. So one of the difficulties that clinicians have in identifying this pathology is that patients often seem pretty "normal." It takes a perceptive - and educated - clinician to competently diagnose and treat these patients. This book would seem to make a sizable contribution to that education. Many examples are provided, in a fluid and readable format.

The authors rely on literature, their clinical experience,and what is obviously a great deal of their focused attention in order to describe intervention strategies and techniques. The final chapter, "As-if Trends in Culture and Therapy," strives to place this pathology in societal context.

There is an extensive bibliography and a good index. I'm not in the field, rather an enthusiastic reader - but I wouldn't hesitate to recommend this book to anyone with an interest in the subject.

Rating: 5 stars
Summary: The Problem of Elusive Identity
Review: In their introduction to this orderly, accessible, and informative book, the authors define as-if pathology as "essentially imitative, a way of life built on a series of transient identifications in which the individual acts as if he or she were sensitive, empathic, conservative, religious, or even rebellious - all dependent on what others want the individual to be."

The "quiet borderline patient" is, according to the authors, an overlooked personality, having ceded psychoanalytic terrain (in the literature as well as the consulting room) to the demanding histrionics and chaos of the "noisy borderline." Completely different etiology!

Because as-if etiology includes the "appearance of normalcy, precocious ego development,and the absence of identity," (which are also chapters headings), there is no psychosis. According the the authors, a clinician who is unaware of the 'as-if' pathology may have a feeling that something is not quite right with the patient, but be continuously unable to identify it - or to treat it. To add to the elusiveness (of the pathology as well as its diagnosis), the authors write that it's a given that all persons, to greater or lesser extent, experience transient identifications - ideally, on the way to a solid, developed identity. So one of the difficulties that clinicians have in identifying this pathology is that patients often seem pretty "normal." It takes a perceptive - and educated - clinician to competently diagnose and treat these patients. This book would seem to make a sizable contribution to that education. Many examples are provided, in a fluid and readable format.

The authors rely on literature, their clinical experience,and what is obviously a great deal of their focused attention in order to describe intervention strategies and techniques. The final chapter, "As-if Trends in Culture and Therapy," strives to place this pathology in societal context.

There is an extensive bibliography and a good index. I'm not in the field, rather an enthusiastic reader - but I wouldn't hesitate to recommend this book to anyone with an interest in the subject.


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