Book reviews

Conclusion

The Narcissistic and Borderline Disorder is an unusually thought provoking and useful book because it encourages the reader to compare and evaluate the work of several major theorists who have attempted to conceptualize narcissistic and borderline pathology. In spite of my disagreement with some specific formulations, I think that for the most part Masterson's choice of separation-individuation theory as an organizing framework for describing these disorders is quite effective in providing a logically consistent developmental context in which clinical phenomena can be studied and understood. Regardless of one's theoretical orientation, this book, is notable for its large measure of clinical wisdom, especially Masterson's observations about: (1) “The Tallionic Impulse,” in which he discusses how borderline patients attempt to injure the object by attacking the self; (2) “The False Self,” in which he outlines how the patient's compliance with the therapist's unspoken expectations may become a major resistance to treatment; (3) the hopelessness helplessness, and despair that narcissistic and borderline patients predictably experience as they begin to separate and thereby confront the existential loneliness of forging an autonomous identity; and (4) the confusion and discouragement that therapists experience when faced with the patient's despair at the very moment when the patient has initiated some constructive change.