A Dissociation Model of Borderline Personality Disorder

by Russell Meares

Overview

A neurobiologically informed approach to a very difficult-to-treat disorder.

This book addresses one of the fundamental, understudied issues of borderline personality disorder (BPD): dissociation and a lack of sense of self. Exploring dissociation from developmental, neurobiological, and behavioral perspectives, Russell Meares presents an original theory of BPD, offering new insights into this debilitating disorder and hope for recovery.

BPD is not a new phenomenon, but much about it remains unclear and controversial. Meares’s three-stage treatment emphasizes the failure of synthesis among the elements of psychic life, the need for both personal and social development, integration of unconscious traumatic memory, affect regulation, hallucinosis, stimulus entrapment, paranoid states, and ultimately, restoration of the self. Mental health professionals working with patients suffering from symptoms of BPD will find an invaluable theoretical grounding for treating the difficult—and varied—symptoms of BPD.

Product Details

ISBN-13:	9780393705850
Publisher:	Norton, W. W. & Company, Inc.
Publication date:	10/22/2012
Series:	Norton Series on Interpersonal Neurobiology
Pages:	416
Product dimensions:	6.20(w) x 9.40(h) x 0.70(d)

About the Author

Russell Meares is a professor emeritus of psychiatry at Sydney University. He lives in Australia.

Table of Contents

1 Introduction: The Borderline Experience 1

2 From Hysteria to Borderline: A Brief History 14

3 Self Disturbance as the Core of Borderline Personality Disorder 34

4 "Le Moi est une co-ordination" 48

5 A Failure of Neural Co-ordination in BPD: A Study of P3a and P3b 63

6 A Neural Network for the Matrix of Self 85

7 Dissociation in Borderline Personality 112

8 Fusion and Disconnection: The Paradoxical Structure of Dissociative Experience 157

9 The Expectational Field, Reversals, and Other Aspects of Disintegrated Relatedness 179

10 The Polysymptomatic Nature of Borderline Personality 200

11 Emotional Dysregulation 212

12 Somatization and Stimulus Entrapment 236

13 A Malady of Representations: Dysautonomic Aspects of BPD 248

14 Paranoid Ideas and Delusion Formation 268

15 Is BPD a Particularly Right Hemispheric Disorder? 287

16 Toward Cohesion: Analogical Relatedness 301

Credits 319

References 321

Index 381

Editorial Reviews

"This highly readable, brilliant book is a true masterpiece in the contemporary study of psychopathology. Russell Meares's original and evidence-based account of the core of borderline personality disorder convincingly explicates its dissociative nature and its relationships with impulsivity, hindered mentalization, and traumatic memories. Meares offers clinicians a unique understanding of the borderline patient's affects and inner experience of self, thereby laying the foundation for highly effective therapeutic exchanges."

Giovanni Liotti

"From PTSD and borderline personality to distancing procedures and emotional responses to trauma, this is packed with insights any analyst can use."

Midwest Book Review

"[A] fascinating and easy-to-read book, by an author with broad clinical experience and scholarship, who has been working with patients with BPD for over 30 years and has conducted an amazing number of empirical studies in this field. . . . The history of dissociation . . . is presented in a fascinating way, intermingled with sketches of patients treated by the author. This blending of historical and clinical knowledge will make the book interesting for both researchers and clinicians. . . . I would recommend this volume to both psychiatrists and psychotherapists."

Journal of Psychiatric Practice

"This excellent book, the culmination of a distinguished career, is vital for anyone seeking to understand the extreme mental suffering of what we currently call BPD. Drawing from neuroscience, historical scholarship, psychological research, and clinical observation, Russell Meares offers an erudite, compassionate account of the 'painful incoherence' at the heart of this disorder. By synthesizing both left- and right-brain data into a useful narrative, which is also a pleasure to read, he demonstrates on a grand scale the integrative process that nourishes us all and agonizingly eludes individuals with borderline psychologies."

Nancy Williams

"Meares does an excellent job of integrating the relevant brain/neuroscience research . . . There are compelling hypotheses drawn . . . very thought-provoking. . . . I would recommend these two books to anyone who works with borderline patients. . . . [O]utstanding for the researcher/theoretician and is thought-provoking for the clinician as well."

The National Psychologist

"These two companion volumes together make a remarkable and original contribution to the theoretical and clinical literature on borderline personality disorder (BPD). . . . [T]his is the most comprehensive, evidence-based, and theoretically integrated model of BPD that I have read."

Journal of Analytical Psychology

"With this fascinating book, Professor Russell Meares has created a magnificent piece of work, based on the premise that Borderline Personality Disorder (BPD) is a 'failure of personal synthesis.' Understanding this integrative failure is essential in the treatment of patients suffering from this incapacitating biopsychosocial disorder. Starting with the pioneering studies of Hughlings Jackson, Pierre Janet, and William James, Meares thoroughly examines the theoretical, scientific, and clinical evidence for his model of BPD. The book's great value surpasses the domain of BPD proper and should attract a much wider readership than BPD specialists only."

Onno van der Hard

"This new book by Meares is a significant contribution to the BPD field, and reinforces the importance of narrative telling in the co-creation of self and other within psychotherapy."

Psychotherapy in Australia