Personality-Disordered Patients

Treatable and Untreatable

Michael H. Stone, M.D.

2006
277 Pages
Editorial Reviews

ISBN 978-1-58562-705-9
Item #62705

List Price: $59.00
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Description
Contents
Editorial Reviews
About the Authors

Determining the amenability of personality disorders to psychotherapy—a patient's capacity to benefit from verbal approaches to treatment—is important in helping clinicians determine the treatability of cases. Michael Stone here shares the factors he has observed over long years of practice that can help practitioners evaluate patients, stressing the amenability of the various disorders to amelioration. By focusing on which patients are likely to respond well to therapeutic intervention and which will prove most resistive, his book will help therapists determine with what kinds of patients they will most likely succeed and with which ones failure is almost a certainty.

Stone establishes the attributes that affect this amenability—such as the capacity for self-reflection, motivation, and life circumstances—as guidelines for evaluating patients, then describes borderline and other personality-disordered patients with varying levels of amenability, from high to low. This coverage progresses from patients belonging to the DSM anxious cluster, along with the depressive-masochistic character and the hysteric character, to patients who demonstrate an intermediate level of amenability to psychotherapy. He introduces the interrelationship between borderline personality disorder and dissociative disorders and discusses treatability among certain patients in Clusters A and C, as well as others with narcissistic, histrionic, depressive disorders. Final chapters address the most severe aberrations of personality and the limitations they impose on the efficacy of therapy. Personality-Disordered Patients is filled with practical, clinically focused information. This guideline structured book:

Covers all personality disorders-including ones not addressed in the latest DSM such as sadistic, depressive, hypomanic, and irritable-explosive
Identifies both attributes necessary for treatability and factors associated with low treatability
Pays particular attention to borderline disorders, which represent the most discussed conditions and are among the most challenging to psychotherapists
Reviews personality traits whose presence, if intense-even if unaccompanied by a definable personality disorder-creates severe problems for psychotherapy

Numerous case studies throughout the book provide examples that will help therapists determine which of their own patients are most likely to benefit from their efforts and thereby establish their own limits of effectiveness. By alerting practitioners to when therapy is likely to fail, these guidelines can help them avoid the professional disappointment of being unable to reach the most intractable patients.

CONTENTS
PREFACE
Chapter 1. AMENABILITY TO TREATMENT IN THE REALM OF PERSONALITY DISORDER
Chapter 2. PERSONALITY DISORDERS MOST AMENABLE TO PSYCHOTHERAPY: BORDERLINE PERSONALITY DISORDER
Chapter 3. PERSONALITY DISORDERS MOST AMENABLE TO PSYCHOTHERAPY: THE ANXIOUS CLUSTER AND RELATED DISORDERS
Chapter 4. PERSONALITY DISORDERS OF INTERMEDIATE AMENABILITY TO PSYCHOTHERAPY: BORDERLINE PERSONALITY DISORDER
Chapter 5. PERSONALITY DISORDERS OF INTERMEDIATE AMENABILITY TO PSYCHOTHERAPY: OTHER PERSONALITY DISORDERS
Chapter 6. PERSONALITY DISORDERS OF LOW AMENABILITY TO PSYCHOTHERAPY: BORDERLINE PERSONALITY DISORDER
Chapter 7. PERSONALITY DISORDERS OF LOW AMENABILITY TO PSYCHOTHERAPY: OTHER PERSONALITY DISORDERS
Chapter 8. PERSONALITY TRAITS AT THE EDGE OF TREATABILITY
Chapter 9. UNTREATABLE PERSONALITY DISORDERS
AFTERWORD
INDEX

Michael H. Stone, M.D., is Professor of Clinical Psychiatry at Columbia College of Physicians and Surgeons.

This is vintage Michael Stone, a sophisticated, substantive and consequential book, a logical and scholarly synthesis that provides a sequence of vivid, differentiated and incisive clinical portrayals. Impressive in scope, organization and balance, this eloquently written work comprises a persuasively argued scaffold of practice-oriented proposals that will be of everyday utility to experienced professionals, as well as to psychiatric residents and graduate students-in-training.—Theodore Millon, Ph.D., D.Sc., Dean and Scientific Director, Institute for Advanced Studies in Personology and Psychopathology, Coral Gables, Florida

Being a seasoned therapist of personality disorders requires the vocabulary of a dedicated linguist because these disorders are captured by the adjectives of our language, especially those spoken in superlatives or written in capital letters. In his latest book on personality disorders, Michael Stone once again proves he is master of both the vernacular of character and the clinical encounter with the character disordered. In richly textured prose he provides the reader with lively descriptions of the remarkable diversity of personality disorders among us, and drawing upon his vast professional experience he teaches us the extent to which we can engage and influence these people and their disorders as clinicians. It is one of the finest pieces among his extensive repertoire of variations on personality disorders.—Thomas H. McGlashan, M.D., Professor, Department of Psychiatry, Yale University School of Medicine and Yale Psychiatric Research at Congress Place, New Haven, Connecticut

Books by Dr. Stone are invariably scholarly and thought-provoking. This timely and much needed analysis of the treatability and untreatability of personality disorders is no exception. It is stimulating, meticulous, informative, and provocative. Personality Disordered Patients: Treatable and Untreatable is an essential read for anyone who treats these conditions.—John Livesley, M.D., Ph.D., F.R.S.C., Professor of Psychiatry, University of British Columbia, Vancouver, British Columbia

In this very well-written and clinically rich text, Personality-Disordered Patients: Treatable and Untreatable, Stone approaches the treatability of personality-disordered patients, from most amenable to untreatable, across 11-at times, interrelated-factors or dimensions. . . . The greatest strength of Personality-Disordered Patients: Treatable and Untreatable lies in its vast clinical richness and the fact that the information contained within will be useful to mental health professionals from all schools of thought. Clinical vignettes constitute probably more than half the text and beautifully and poignantly illustrate the technical points being made during each phase of the book, which is a pleasure to read.—PsycCRITIQUES, 6/21/2006

[Personality-Disordered Patients] is enjoyable, readable, and informative. We are invited in for a glimpse of Michael Stone's many therapeutic encounters and learn from his broad range of experience. His organizing the book along the lines of amenability to treatment is useful, and his tables of traits and characteristics can help clinicians evaluate prognosis and course, and can provide comfort to therapists who are having difficulty understanding what is going on their therapists with personality-disordered- patients.—The Journal of Nervous and Mental Disease, 6/21/2006

Personality-Disordered Patients is a terrific book for clinicians. It is well written with multiple clinical vignettes. I would highly recommend this book to all clinicians who work with challenging patients.—Journal of Clinical Psychiatry, 6/21/2006