The Fate of Borderline Patients

Successful Outcome and Psychiatric Practice

Michael H. Stone

May 4, 1990
ISBN 9780898623994
Price: $60.00
357 Pages
Size: 6⅛" x 9¼"

Providing a cost-effective treatment model that is respectful of patients' needs, their strengths, and their limitations, this book presents the first dynamic and coherent approach to group treatment for the chronically mentally ill. By structuring members' variable attendance, the flexibly bound model, which utilizes group dynamic principles to maximize therapeutic opportunities, respects the actual behavior of many chronically ill persons, making this treatment format available to a broad portion of this population. Illustrated with numerous case vignettes, the book outlines the elements of supportive treatment and therapeutic goals and then describes in detail specific strategies and interventions.


American Journal of Psychiatry

“The importance of the present volume lay in its potential to enhance the predictive powers of clinicians who work with borderline patients...provides reassurance, perspective, and hope. ”

Psychoanalytic Books

“Every mental health professional working with borderline patients will enjoy this book and learn from it. ”

Journal of Psychotherapy Practice and Research

“It is a pleasure to read and easy to assimilate. This clarity makes the book valuable to us all who work in the front lines of patient care....I suspect this book will take it place in the ranks of other landmark longitudinal studies. It will be held in high esteem and will be quoted often by the investigators who follow and the clinicians who refer to it.”

Hospital and Community Psychiatry

The Fate of Borderline Patients should be carefully studied by mental health clinicians and researchers. There are very few books to which psychotherapists return, year after year, to validate clinical impressions or to gain assistance with conceptualizing difficult problems, or simply to become nourished and refreshed....This unusual book by Michael Stone is replete with clinical wisdom and original thinking. Reading it is an opportunity to receive supervision from a master clinician who has devoted his professional life to the study and treatment of borderline patients.”

—Richard C. Friedman, M.D. Journal of the American Academy of Psychoanalysis

Table of Contents

1. Introduction to the Study.

2. The Borderline Patients: Definitions and Earlier Studies.

3. General Results and Outcome on Major Variables.

4. Suicide and Suicidal Behavior.

5. Parental Morbidity, Subsequent Morbidity, and Striking ``Borderline'' Characteristics in Borderline Patients.

6. Personality Subtypes among the Borderline Patients.

7. The Impact of Life Events: Early Loss, Incest, and Parental Brutality.

8. Gender Differences and Factors Affecting Women's Outcomes.

9. Substance Abuse and Its Effects on Outcome.

10. Other Factors Affecting Outcome.

11. Outcomes for the Borderline Patients: Correlations and Case Vignettes. 12. Disorders Presenting with Psychosis.

13. Outcome Patterns.

14. Effects of Therapist and Type of Therapy.

15. Counterintuitive Results.

16. Afterword.

About the Author

Michael H. Stone, M.D. is Professor of Clinical Psychiatry at Columbia College of Physicians and Surgeons, Research Director at Middleton Psychiatric Center, and Lecturer at New York State Psychiatric Institute. The author of The Borderline Syndromes and the editor of three books on borderline and schizophrenic conditions, Dr. Stone has written 120 articles and chapters on personality disorders, psychotherapy, the psychoses and familial transmission, and the history of psychiatry. His current research focuses on traumatic antecedents in the backgrounds of patients with borderline personality.


Clinicians, both novice and experienced, who treat clients with chronic mental illness.

Serves as a text for group therapy courses in psychiatry, psychology, nursing, and social work.