Interpersonal Diagnosis and Treatment of Personality Disorders (Diagnosis & Treatment of Mental Disorders S.) - Hardcover

"Building on Harry Stack Sullivan's thesis that interpersonal behavior rather than symptoms should provide the framework for a fruitful psychiatric diagnosis, Dr. Lorna Benjamin has developed a sophisticated system, the Structural Analysis of Social Behavior (SASB). The Interpersonal Circle on which the system is based has a longer history but Dr. Benjamin's impressive achievement is unequaled in terms of its scientific rigor, clinical penetration, and comprehensiveness. SASB has given rise to a growing body of research aimed at an improved description and classification of the personality disorders. Thus, Dr. Benjamin's system provides a powerful alternative to the DSM-III-R and the forthcoming DSM-IV. An added and singularly important virtue is its clear relevance for psychotherapy. The book will predictably have a powerful impact on psychiatric diagnosis and treatment in the coming years. It is a superb accomplishment, a true labor of love.--Hans H. Strupp, Ph.D., Vanderbilt University "Benjamin has written the right book at the right time. Whether one talks about Axis II driving Axis I, intrapersonal and interpersonal dynamics, or causal determinants, there is a consensus that a focus on patients' interpersonal behavior patterns is central to the therapeutic change process. As a result, there is a real need for clear guidelines that can be used by the practicing clinician, and that can provide the psychotherapy researcher with meaningful, testable hypotheses. Lorna Benjamin's incisive book fulfills such a need. Using extensive clinical experience and research backing, Benjamin has masterfully translated DSM categories of personality disorders into observable, conceptually meaningful dimensions. It is indeed refreshing to read a book such as hers that is both empirically sound and clinically sophisticated. What is also particularly impressive is that the treatment implications described by Benjamin have relevance for therapists of varying orientations. Although her contribution has its roots in interpersonal theory, it has the potential to enhance the clinical work of cognitive-behavioral and experiential therapists. This book will undoubtedly be widely read. Indeed, because of its clarity, insightfulness, and widespread relevance, this groundbreaking volume is destined to be a classic in the field."--Marvin R. Goldfried, Ph.D., State University of New York, Stony Brook "Lorna Benjamin's originality, depth, and clinical awareness shine. With folksy anecdotes and high scholarship, she leads readers through the rich intellectual history and psychodynamic observations from which her system for assessing social behavior has been developed. Even while her conclusions have already informed the DSM-IV personality disorders, this book clearly spells out the scientific mandate and the psychotherapeutic significance for them to become even more interpersonally anchored."--John G. Gunderson, M.D., McLean Hospital

Bringing intellectual rigor and discipline to the art of psychotherapy, Lorna Smith Benjamin has developed a unifying theory of personality disorders that has unprecedented clinical relevance. This groundbreaking volume presents an interpersonal approach that will enable therapists of all theoretical orientations to increase their effectiveness and reduce their frustration in working with this very difficult population.
The book opens with an introduction to the interpersonal approach and to the Structural Analysis of Social Behavior (SASB) developed by Dr. Benjamin. This dimensional model of interpersonal and intrapsychic interactions can be used to assess patients, their families, and their therapists to determine the specific ways in which they interact with and influence one another. In the sections that follow, each of the DSM personality disorders is sharply delineated in a finely tuned description that is greatly enhanced by Dr. Benjamin's interpersonal approach and clinical insights. Adding an extensive and clinically useful list of descriptive amendments to the DSM criteria, she provides a sophisticated differential diagnosis that greatly reduces the problem of overlap in symptoms that frequently occurs when using the DSM rules alone. Expected transference reactions, developmental histories, and probable underlying motivations are also explored in detail.
Throughout, the volume is rich with clinical material that specifically illustrates the interviewing method, the diagnostic process, and treatment interventions. Dr. Benjamin also presents hypotheses concerning the development of crucial interpersonal relationships which may explain the patient's current behavior. Such understanding provides perhaps the most valuable clues on how best to interact with and treat these patients.
A major breakthrough in the treatment of personality disorders, this important work will be an invaluable resource for all clinicians - behavioral, psychodynamic, and eclectic - working with this challenging population. It also offers researchers a method to dissect and study more objectively vitally important problems in psychosocial diagnosis and treatment. This volume will serve as an excellent text for psychiatric residencies and graduate courses in psychopathology, personality and personality disorders, psychotherapy, and assessment and diagnosis.