Cognitive-Behavioral Treatment of Borderline Personality Disorder

Marsha Linehan wrote this volume as the clinical manual for dialectical behavior therapy, the treatment she built for chronically suicidal clients meeting criteria for borderline personality disorder. It sets out the theory before the technique. Linehan reads the disorder as pervasive emotion dysregulation, the product of a biological vulnerability meeting an environment that repeatedly treats a person's private experience as wrong. From that reading follows the method: therapy holds acceptance and change in constant tension, validating the client's suffering while pressing steadily for new behavior.

The book maps how a full DBT programme fits together. It covers the treatment stages and their targets, the hierarchy that decides what a session addresses first, the commitment and structuring work that keeps difficult clients in treatment, and the therapist's own stance toward crisis, suicide risk, and the pull to give up. A companion skills manual carries the exercises; this volume carries the reasoning behind them.