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The most important overall thesis of this chapter is that borderline patients need treatments that are disorder specific. In retrospect, much of the early literature emphasizing how difficult these patients are to treat now reads as a testament to how treatments that are not adjusted to accommodate the specific needs of these patients will often make them worse. Noncompliance, dropping out, psychotic transferences, regressions, escalating self-destructiveness, and escalating hospital usage should be seen as signs that treatment is not working rather than as signs of an untreatable patient.

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