Michael Stone is eminent in the field of ‘borderline’ and has made major contributions to the psychoanalytic and psychiatric literature on the subject of personality disorder. In the preface to his new book, he promises that the book's focus is ‘on the amenability of the various disorders to amelioration by any method of therapy whatsoever’ (p. vii). Stone thus implies that the book is about all personality disorder subcategories and indeed he delivers a good helping of ‘other’ personality disorder subcategories, not just borderline. However, his promise to consider a wide spectrum of approaches is not fulfilled and there is scant mention of methods other than his own - modified psychoanalytic. In the body of his book, Stone provides case material, largely from his own clinical work, with which to demonstrate the patient factors likely to be associated with prognosis - good or bad.

Stone's first chapter usefully unpacks the concept of personality into a range of constituents, although with some surprising emphases. For example, aspects of ‘spirituality’ figure prominently in his adept dissection of the concept. Indeed, they form the majority of items on a checklist for assessing suitability for therapy, which Stone helpfully appends, although this is not a ‘how to’ book. Most of the usual suspects appear in the line-up as personality constituents that might be relevant to prognosis: motivation, perseverance, life circumstances, object relations, cultural factors and others. The case illustrations attest to the author's depth of experience in his field.

The chapters that follow illustrate with vignettes why, in the author's view, such treatments were successful or not. This approach, however, is problematic for two reasons. First, it is almost as if Stone assumes that amenability to his treatment is amenability to any treatment, since most of the evidence he sifts derives from his own work. Second, in the absence of a detailed consideration of other factors, such as therapist factors or therapy type, Stone indirectly invites the reader to consider that success or failure of any method of treatment reflects patient factors. Although highly influential, such factors form only part of the story of therapeutic outcome. Although Stone does not neglect other aspects completely, he provides relatively little space for their consideration.

Stone does acknowledge (for example, p. 52) where there is good evidence for (at least symptomatic) change in patients with personality disorder, citing some of the small number of relevant randomised controlled trials. However, it is tempting to be lulled by the richness of Stone's illustrative case material into valuing personal anecdote, albeit from a highly creditable source, above that of higher levels of evidence. He makes little attempt to interrogate such data in order to extrapolate, identifying those patients who are amenable to such treatments.

For specialists interested primarily in borderline personality disorder and in psychoanalytic methods, the book is reassuring and informative, even though not much of the recent literature is examined in detail. Those from a generalist background, who embrace wide treatment horizons and personality disorder comorbidity, while likely to be impressed by the author's depth of understanding, could feel disappointed by the restricted breadth of his focus. However, Stone's rich case material does, to an extent, complement the academic personality disorder literature on what works for whom. As such it could help the clinician who struggles to understand its relevance to everyday clinical practice.