Borderline Patients at the Border of Treatability: At the Intersection of Borderline, Narcissistic, and Antisocial Personalities

The author discusses the difficulties involved in treating patients with borderline personality disorder and concomitant Cluster B—narcissistic, histrionic, and/or antisocial—personality traits or disorders. He presents eight vignettes of patients with borderline personality disorder combined with various types of Cluster B personality traits or disorders and describes the course of their treatment. The author posits that such patients fall on a continuum ranging from difficult to treat but still treatable, to those with strong narcissistic or even psychopathic traits whose illness fails to improve no matter what treatment methods are applied (i.e., they have “untreatable” illness).

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