Books of Interest
I HATE YOU, DON'T LEAVE ME Book Review
Mar 21, 2006, 09:25
Understanding the Borderline Personality
By: Jerold J. Kreisman, M.D., & Hal Straus
Publisher: Avon Books, N.Y., NY
Publication Date: October 2002
ISBN: 0380713055
According to authors Jerold J. Kreisman and Hal Straus, Borderline Personality Disorder (BPD) is an ailment that is hard to define. The signs of BPD are often accompanied by other symptoms and this makes it difficult to diagnose and treat. However, in I Hate You, Don't Leave Me, the authors supply information and guidance to help patients, families and therapists deal with this illness.
In the first section of the book, Kreisman and Straus, outline the signs and symptoms of BPD and the possible origins of the illness.
Signs and Symptoms:
According to the authors, people with Borderline Personality Disorder may have weird mood changes that cause them to think they are losing their mind. The behavior is dramatic and emotional, and the person may show tremendous instability in interpersonal relationships and have a negative self-image. BPD may cause extreme mood shifts between deep depression and a manic state where they become very excited. The authors explain that other symptoms may include; identity confusion, a tendency toward self-destruction, eating disorders, drug abuse, an irrational fear of abandonment and an inability to be alone, rapid mood swings, impulsive self-destructiveness and violent outbursts, and oversensitivity to real or imagined rejection.
Underlying Causes:
Although victims of BPD are as different as any other segment of society, the authors describe some of the common factors such as family relationships, biological factors and societal influences in the development of the disorder. Kreisman and Straus point out that "BPD tends to span generations in families and is usually passed down from mothers to daughters. Familial factors that are thought to be linked to the development of BPD include disturbed parent-child relationships, violence and abuse." The authors also maintain that the current culture promotes an increase in BPD because of its "fragmented structure, changing gender roles, increased divorce rates and greater geographical mobility."
In the last three chapters, the authors explore several different therapy options for clients with BPD, including group therapy, family therapy and drug therapy:
Group therapy:
The goal of group therapy is to give clients insight into their actions as well as the inner conflicts that trigger their behaviors. This type of therapy also helps patients to identify the triggers that signal the onset of certain actions. Group members talk about their problems and listen to the messages of others. Other people in the group often mirror the patient's behavior and may reinforce the desired behaviors.
Family therapy:
Sometimes both the patient and their family participate in family therapy; at other times, there may be a separate group for families of patients. Family therapy offers everyone involved the tools needed to reinforce what the patients learned during individual therapy and helps to prevent them from slipping into old behaviors. The therapist's goal is to change any of the social dynamics that contribute to a specific disorder because it is assumed that disorders can only be fully understood in terms of the individual's family environment. Some types of family therapy focus on coping and communication skills. For those intimately involved with a person suffering from BPD, they often feel guilty, helpless and like they personally failed. Family therapy teaches all participants the steps they should take to assist a person with this disorder.
Pharmacotherapy:
Pharmacotherapy (drug therapy) is still widely used in the treatment of mental illness, but there is a growing debate about its effectiveness and safety. Patients with BPD are usually maintained with some type of drug therapy to control their behavior.
This book offers both an informative and practical in application. It does an excellent job of explaining BPD, and the authors provide real-life examples to describe the behavior and the experiences of people with this ailment.
I Hate You, Don't Leave Me: Understanding the Borderline Personality, is a good resource for professionals and families, because it provides therapists with concrete ideas to incorporate both instruction and hope into their practice by providing patients and their families suggestions in simple, non-condescending language. It is by far, the best book on the market on BPD.
About the Authors:
Hal Straus is a noted health writer. Dr. Jerold J. Kreisman is a psychiatrist, who heads a BPD unit in a St. Louis hospital.
