I was initially going to leave this one off Goodreads, because it's on a somewhat personal topic. But it is so terrible I feel it would be a dereliction of duty to let it pass. I honestly gave up on this book early and hate-read the rest, so I guess you could say I still enjoyed it. That said, if you or a loved one are suffering from BPD and you are genuinely looking to learn more to help contextualise/cope, please do not buy this particular book.
Because this book was awful. It was astoundingly awful in almost every single conceivable way. The Spelling and Grammar editing wasn't awful, actually, but that's about all that wasn't utter trash. Shelving in 'Political Fiction' because honestly my Science shelf is too good for this trash and although the 'quantitative' science is accurate when reporting raw figures, the interpretation of the science is seemingly politically motivated fiction.
I am incredibly thankful I have an educational background in this topic, so it was very easy for me to spot the problems. I picked this up not because I thought it would be particularly new content to me, but because sometimes it can be nice to have everything put together coherently rather than having to do that myself.
Lets start with the core, and work out way outwards.
This book is largely made up of disparate anecdotes of patients that the author has either treated, or otherwise come across. In that sense it reads more like a series of case histories than a coherent attempt to discuss a common disorder, and at its worse it comes off as a series of freak shows. Rather than being from a place of compassion, empathy, or understanding this book feels like it was written as if BPD was a spectator sport. See what freak of nature Jerold heroically treated next! See how he calmly smiles and shakes his head as the harpies (his words, not mine) thrust themselves upon him! See how he wisely tells a black woman she is overreacting to systemic racism because she has BPD. In each case study mentioned the focus is on 'look how crazy this lady is', and compassion, empathy or even an attempt to understand the sociobiological causes of the behaviour are nowhere to be seen. Rather than using case studies to support a scientific understanding, build empathy, and show success in treatment, case studies are a never ending competition to one-up earlier chapters in a context of 'that's crazy!' Nowhere is this more clear than in a chapter where the author tries to diagnose famous people with BPD, especially actresses he finds beautiful or attractive. Every Hollywood actress has BPD apparently.
Most of the cut-and-dry science in this book is accurate, but the cut-and-dry science makes up only a very small portion of the book, the rest of which is filled with baseless speculation, Freudian psychoanalysis, just-so stories, and random anecdotes. My edition boasted being completely revised and updated, and while that was true of many of the minor, obvious statistical facts - EG, we get an recent estimated prevalence rate rather than one from the last century - all the actual interpretation, synthesis, and understanding was way back in the 80's and completely lacking any understanding of modern cognitive psychology, personality theory, or behavioural biology. For example, the claim that people suffering from BPD are incapable of empathy is straight out of 1950's research that has since been overturned. I don't want to go into the nitty-gritty scientific details here, but it seems the revision was limited to easily google-able factoids that could be looked up in an afternoon.
In fact, my favourite chapter is the chapter on medication for BPD. There was no medication when the 1st edition was published, so this is an all-new chapter -- and it's clear the author doesn't understand any of it. This chapter in particular reads like an undergraduate summary of some lecture slides, for all the insight and detail it shows. At least there is little to misrepresent.
If it wasn't already clear, this book is utterly filled with misogynistic, ageist, asides that have little to do with anything. Insinuating Snow White is a whore because she lived in a house with a bunch of men says more about how you view the world, Jerold, than it says about either Snow White or BPD. Calling a patient a whore because she had a marriage affair during a psychotic breakdown seems a little, to put it mildly, 'unhelpful.' A lot of this book feels like the author ranting and railing about whatever it is he doesn't like, and it would be hilariously out-of-touch if it wasn't so dangerous. Perhaps keep the sexist jokes out of a book meant to help patients with a mental illness that skews female? In fact, every time a female is mentioned - be it a patient, actress, or doctor - her looks are carefully deconstructed in the following sentences. Jerold, I really don't care how shapely you thought the BPD patient that was hitting on you legs' were. I really don't, and honestly, neither should you. Nor do I care about your apparent fetish-fantasy for having a famous actress come to you for treatment and fall in love with you. You can stop describing it. Please. While you are at it, please stop referring to female patients as 'harpies' and 'harridan.'
He finishes with a warning for new students of clinical psychology: They should stay away from BPD patients, who might lure them into sexual affairs. I mean, or they could do their jobs like professionals, but what do I know. Then again, Kreisman displays this particular lens of the world and causality time and time again. In one of his anecdotes, he laments on a woman who 'provoked' her husband into hitting her. He is constantly building up women with BPD as some kind of supernatural sexual other bent causing chaos for the good, family men around her.
In the opening, the author rails about how 'Political correctness' makes things harder to read, and has taken the 'bold stand' to preserve clarity by using he/him and she/her rather than they/them 'to preserve clarity' - and then goes on to treat them as interchangeable, swapping pronouns mid-paragraph, sometimes mid-sentence. A consistent they/them would have been a much better choice 'to preserve clarity.'
And here is where the major components of political fiction come in: In his analysis Kreisman pins the increasing numbers of of BPD diagnoses, not on better/more widely available MH services but on... the moral degeneracy of society since the 1950s, and the breakdown of the nuclear family into 'faux-families' (his term) and sexual deviancy (which, Kreisman explicitly states, includes homosexuality). In such a world full of moral decay, young women lack a firm guiding hand and thus develop BPD - this is Kreisman hypothesis. This is not the place to go into why that particular brand of social analysis is little more than right-wing fetishism of the 50s and conspiracy-grade nonsense, but I at least wanted to point it out.