This book is about understanding and managing patients with severe personality disorders. It covers biological, psychoanalytic and cognitive-behavioural approaches and provides a pragmatic guide to best practice, based on the published evidence, where this is available. As well as discussing issues of severity, treatability and the range of appropriate management options, the content explores the common elements of effective interventions and covers early prediction, countertransference, disruptions of the therapeutic alliance, suicidal crises and what to do when dealing with dangerous, refractory and stalking patients. The chapters are authored by an international cast of distinguished investigators and innovators from the field. This is a holistic, practical guide to the treatment of patients with the range of these disorders and it should be read by all the members of the mental health team dealing with this challenging clinical group.

1. Treatability in severe personality disorders: how far do the science and art of psychotherapy carry us? Michael Stone; 2. The treatment of choice: what method fits whom? John Clarkin; 3. Countertransference: recent developments and technical implications for the treatment of patients with severe personality disorders Otto Kernberg; 4. Beyond management to cure: enhancing the positive dimensions of personality Robert Cloninger; 5. Personality disorders from the perspective of child and adolescent psychiatry Arnold Allertz and Guus van Voorst; 6. Disruptions in the course of psychotherapy and psychoanalysis Salman Akhtar; 7. Managing suicidal crises in patients with severe personality disorders Joel Paris; 8. Borderline personality disorder, day hospitals, and mentalization Anthony Bateman and Peter Fonagy; 9. Pharmacotherapy of severe personality disorders: a critical review Thomas Rinne and Theo Ingenhoven; 10. Severe cases: management of the refractory borderline patient Bert van Luyn; 11. Dangerous cases: when treatment is not an option Reid Meloy and James Reavis; 12. Stalking of therapists Paul Mullen and Rosemary Purcell; 13. Common elements of effective treatments John Livesley.