This is a review of the revised edition. It is my understanding that this edition is substantially updated.
This book is an overview of Borderline Personality Disorder. The biggest problem that I have with the book is that the book does not really know who it is written for. There are three distinct audiences for Borderline Books. The first audience is medical practitioners, the second Borderlines themselves and the third loved ones of Borderlines. There is also a fourth audience that is everyone that doesn't fit those three categories. To some degree, this book is written for that audience. That is an OK thing, but I don't think that the book really communicates the reality of this illness to those who have not experienced it first hand.
My own experience is replete with people with this illness. I now know that because of some experiences in my early childhood, I formed a personality that was attracted to and almost ideally suited for people who suffer from Borderline Personality Disorder. I am also attracted to similar personality types to my own which often have at least one Borderline in their life as well. As a result, it appears to be the case that there are a freakishly large number of individuals in my past history who suffered either from BPD or from behavioural patterns closely associated with it.
My own experience of Borderlines is that while all Borderlines have a lot in common there can be sharp differences in how those Borderlines whose rage is mostly sent inward act, as opposed to those where their rage is directed outward. This book tends to focus on cases where the rage is primarily directed inward, although there is often a mother figure in the background of the case studies who is plausibly borderline and whose rage is directed outward.
It is also a lot more optimistic than I would be about the Borderline's prognosis. My experience is that Bordelines tend to get worse and that this continues into old age. Their destructiveness tends to be more and more directed outward and if they are in therapy they get more and more adroit at manipulating and lying to their therapists. Borderlines are adept at constructing an external image of what others want them to be and they do this to therapists as well and because they do this all day long they become extremely good at it. My experience has led me to be deeply pessimistic about treatment for Borderlines.
As I have mentioned, I have known many probable Borderline's in my life, and my life has been fundamentally shaped by their behaviour. I have in general been advised not to publicly discuss this for career reasons, but I think that it is critically important that this disease becomes as well known as other mental health issues such as depression, PTSD or alcoholism. There is a real taboo around this illness and in effect a conspiracy of silence. Other than medical professionals, I have had to explain what this illness is to everyone, I have ever talked about it with. It appears to be much more common than many other illnesses such as schizophrenia, however there is no awareness of it. Because the illness is often associated with spectacular abuse there is a stigma around labeling people with this illness, although it is clear than many borderlines are not abusive.
However, one person I was in a relationship with, was such a severe case and so mentally ill, destructive and abusive that there was initial disbelief that anyone would engage in her behaviour and this only changed when she was first identified as fitting the Borderline pattern. Her behaviour was often practically sociopathic in nature. She has not been diagnosed with this illness and I do not believe that she ever will allow herself to be put in a situation where she will be. But, quite frankly, it is the only conceivable explanation for her bizarre behaviour and my recovery has been successfully based on this hypothesis.
The chapter on how loved ones should deal with people with Borderline Personality Disorder is I think naive. It emphasizes a strategy of Support, Empathy and Truth. I have a tendency to behave in that way anyway, which is part of what attracts Borderlines to me and that can be successful. In the case of the profoundly damaging relationship, attempts to abide by that strategy would result in much more dramatic and rapid mood swings. She also was intrinsically threatened by truth and I do not think that there was any way to reach her. I deeply believed that I could love her to health and I am concerned that this chapter might lead people with a similar problem to me, to believe that this is possible.
I struggle to understand this illness, because its affect on my life has been so fundamental and as a consequence my life has become defined by the effects of a mental illness that I do not have but have suffered from at second hand. I think that society as a whole does not understand this illness. Most people have not heard of it and those who have, including in my experience therapists, struggle to understand it.
This book, I think, also struggles to understand the illness. The initial chapters that talk about abandonment issues, the splitting, the intense rapid mood swings and manipulativeness are reasonably good. But Borderlines can take all sorts of shapes. This book helped me understand some of the other people that I have known that probably have this illness, but it did not help me that much in understanding the Borderline that fundamentally harmed me. Admittedly, that Borderline was an extreme case and she has been labelled by various different therapists as abusive, manipulative, controlling, demonic, despicable, sociopathic, a torturer, a brainwasher and, on more occasions than I can count, as evil. Because of the brainwashing, I had to hear these things and that has been a difficult journey for me. Of course, being a borderline, there was another side to her that was as sweet and kind and, what appeared to be, loving as anyone that I have ever met. In short, she was of the subset of sufferers of Borderline Personality Disorder that are extreme abusive monsters. I read this book to understand her better, it helped, but not as much as I would have wanted.
The book ignores behaviour that can be extremely toxic or criminal and this does occur in some cases. In the end. that that degree of cruelty and remorselessness could be combined with someone who in other ways was a good person remains a complete mystery to me and this book did not help in understanding that mystery despite its promising title.