In this compact volume, Dr. Masterson invites the reader to look back and review his early formulations regarding the psychodynamic treatment of borderline personality disorder and related psychopathologies and presents his current thoughts on the status of his model. Indeed, the primary focus of the book is a revisitation of his 1972 model, originally presented in Treatment of the Borderline Adolescent: A Developmental Approach(1). Dr. Masterson places considerable emphasis on both integrating the model advanced in his previous monograph with contemporary developments in psychodynamic models of severe personality pathology (e.g., Kernberg, Kohut) and on differentiating it from the same models. Dr. Masterson also touches on other more recent developments in our understanding of severe personality disorders, including Linehan’s behavioral approach, in terms of treatment.

The developmental emphasis in Dr. Masterson’s rich thinking about borderline psychopathology is unmistakable and much appreciated. His model as well as those of Kernberg and Kohut has always maintained a prominent developmental thrust, and the relevance of this vantage point becomes only clearer with the accumulation of empirical data on both the effects of trauma and the development of neurobiologically based affect systems.

Perhaps the greatest strength of this volume is in the exceptionally rich case history material and the explicit focus on the diagnostic approach and therapeutic process in a number of interesting cases. This material is contained in parts 2 and 3 of the volume and takes up approximately 200 pages. Part 2 addresses diagnostic issues from the standpoint of Dr. Masterson’s model, and part 3 is concerned chiefly with psychotherapeutic process and case material. Such abundant clinical material will serve as a useful guide to those seeking to see just what it is that Dr. Masterson takes as his focus in work with severe personality pathology.