Drs. Gabbard and Horowitz Reply

To the Editor: We thank Dr. Schwaber for her thoughtful letter. We agree that locating the patient"s perspective is critically important in the psychotherapy of borderline personality disorder. Indeed, finding that perspective and validating its legitimacy is a cornerstone of both mentalization-based therapy and dialectical behavior therapy. In our article, we noted that transference interpretation of borderline personality disorder only works if the road has been paved with empathic validation of the patient"s point of view. Where we differ from Dr. Schwaber is that we think there needs to be an oscillation between finding the patient"s perspective and presenting an "outside" or alternative perspective to the patient, an essential component of mentalization-based therapy.