The book is divided into three sections: the first on etiology, the second on case histories that illustrate variations in course and outcome, and the third on treatment. The integrated model the authors propose in their first chapter shows the interaction of genetic and environmental influences that may combine to create a disorganized pattern of attachment. Impulsivity and instability of mood may show up as temperament traits stemming in good measure from the genetic side. On the environmental side are maltreatment by parents (such as chronic verbal, physical, or sexual abuse) with its attendant stress and stress from other sources (such as early loss of key caretakers). All aspects of the mental triad—thought, feeling, and behavior—are adversely affected, leading to the special types of cognitive dysfunction, emotional dysregulation, and turbulent behavior that we place together under the heading of borderline personality disorder. The authors explain how the abnormally strong emotional reactions in borderline patients return "more slowly to baseline" (p. 31) and how their common complaint of "emptiness" is akin to an awareness that "something is missing." This may reflect a feeling of disconnectedness from others and from the pain they anticipate from interaction with others: a bad feeling, in other words, that is protecting the patient from still worse feelings of being overwhelmed by closeness with others.