Severe cases: management of the refractory borderline patient

TL;DRAbstract

Borderline personality disorder (BPD) is a severe but not hopeless condition. Gradual improvement over time can be expected (Paris, 2003), and active psychotherapeutic treatment may be effective (Bateman and Fonagy, 2004; Giesen-Bloo et al., 2006; Linehan, 1993; Perry et al., 1999). However, not all patients respond well: some do not improve at all while others become very self-destructive, drop out of therapy, or worsen. This chapter will focus on treatment strategies and the management of severe, refractory patients.

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