Among the featured topics:

• the role of the mother or primary caretaker in the development of the normal self
  
• the minimizing and denial of the role of the mother in the borderline personality disorder
  
• handicaps of the DSM-IV descriptive approach to diagnosis and the advantage of a psychodynamic approach
  
• the integrating influence of a concept of the self on an understanding of the personality disorders
  
• the differential diagnosis of those patients whose primary defense is focus on the object
  
• the diagnosis and treatment of intimacy problems in patients with personality disorders

A unique highlight is the inclusion of a comprehensive report of a six-year course of psychoanalytic psychotherapy of a patient with a closet narcissistic defense against neurosis. This rich case study makes accessible not only the overt clinical issues being negotiated, but also the all-important nuances of disclosure and treatment.

Readers across the field will benefit from Dr. Masterson's decision to pause and reflect on his 25 years of work in the personality disorders -- his decision to pause and project what the future may hold in this important area of investigation.

 

Recently on vacation I read two well written books. The first was a new Grisham novel. The other was Dr. Masterson's fine attempt at reviewing a quarter century of thought on Axis II mental health problems. He is a leader and a thoughtful theorist in a field that has had far more questions the answers. The understanding and treatment of personality disorders has eluded us since the time they were first viewed as a category of mental illness. Most clinicians continue to struggle with the treatment of the borderline patient even today. With new research and techniques appearing almost daily, this volume is timely. Techniques such as Linehans DBT, and recent discoveries of neurobiological findings, that advance the knowledge in this field, make this book even more important reading.

It offers perspective and an opportunity to look at the theories and techniques of the last twenty-five years. It questions what knowledge has held up with time and what data has not. Masterson evaluates the findings of himself and other major theorists in light of recent findings. How well has his own work in developmental theory of object relations held up with time? He looks at the work of Mahler; Kernberg, Kohut, and Klein among others. He thoughtfully examines his own theory of the mother's availability and the failure of development of the self in explaining the arrest of the ego and the self in borderline personality. Much of this is in the framework of psychodynamic theory of twenty-five years ago. He compares this knowledge with more recent theory and findings, which include biological events, and abandonment theory. He examines the usefulness of the DSM-IV in the diagnosis and treatment of the borderline patient.

Included in this excellent volume is diagnoses and treatment based on the failure of the personality to fully develop in healthy ways. He outlines the stages of normal development where failure occurs and why. He reviews what aspects of the individual's growth have not been supported properly in particular stages of development? What is the outcome for the individual and the resulting personality disorder? What defenses emerge?

He provides details of the disorders of the self and how they emerge. He explains the all-important issue of differential diagnosis of the borderline, narcissist, and schizoid. He presents comprehensive case studies that illustrate well the complicated history and treatment required in helping the patient reclaims mental health. He outlines in detail the painstaking work that lies ahead for the therapist in the treatment of the personality disordered individual. There is much more in this dynamic book.

I find this book to be a necessary piece of information for the student or professional who wants to possess a broad and historical perspective of personality disorders. This 276-page volume is full of historical and current treatment information needed in the comprehensive understanding of the personality disorders. It helps in understanding and integrating new theory and knowledge that is emerging. I recommend this book to every clinician who wishes to gain a perspective on the personality disorders. Dr. Masterson brings clarity and systematic understanding to this work. Available from Zeig, Tucker and Associates Phoenix, AZ, published in 2000, this writing is a welcome addition to the therapist's bookshelf.

Reviewed by:
Michael Baer.

"A brilliant account of an exceptionally effective treatment approach by a masterful theorist, clinician, and writer. Case examples and treatment directives are cogent and compelling. If you treat personality-disordered individuals in your practice, you must read this book." -- Len Sperry, MD, Ph.D., Author of Handbook of Diagnosis and Treatment of the DSM-IV Personality Disorders

"His approach is a powerful intervention for [personality] disorders, both in longer term treatment, with the aim of resolution of the underlying causes of the disorders, and also in shorter term treatment, where interruption of pathological defenses by his techniques leads to much better self-management by the patient. ... His approach is learnable and operational ... This book should be highly useful to all disciplines working with patients with personality disorders of all degrees of intensity of pathology, whether [they] are in an inpatient unit for crisis stabilization or in outpatient treatment settings of any variety." -- T. Stuart Harris, MD, Associate Clinical Professor of Psychiatry, University of Arkansas School of Medicine.

A demonstration video with James Masterson highlighting key moments from a complete course of therapy for closet narcissism.

James F. Masterson, M.D., pioneer of the developmental, object relations approach to the personality disorders, is Director of the Masterson Group and Masterson Institute in New York City. For more information, visit the Masterson Institute website.

Masterson PDF-Bookflyer