Broken Structures: Severe Personality Disorders and Their Treatment

This most simple question of all in the field of domestic violence is never asked. Regardless of where men acquire their narcissistic attitudes, or justify their dominance, where and how they learn to treat women with such disrespect and contempt is a high value question to be asked. Most would never expect women to treat them similarly, and in fact, most women would never dream of treating them similarly because they have been conditioned to respect males. So, where do men learn to mistreat women? As children, it does not happen automatically. Either it must be learned in their family home, or it must be taught through religion, schools, or the miltiary with reinforcement through media. Women do not teach men to mistreat women. Seeking the source of its progression, it may be possible to treat and cure the patient, unless, of course, the status quo is preferred to meet some malcontent in men's desire for what they erroneously view as ego enhancement. The master/servant mentality that often precedes male dominance may be one source, though they rarely learn that at home unless by example, or a misreading of principles at work. Interestingly men sometimes but more rarely are abusive to children or the elderly. Does that mean culture prefers the burden of wife abuse? Or, are men hardwired for pediphilia, trusting and feeling generous toward children, but competitive toward adults? Just where do males learn to torture and mistreat women so disdainfully? Answer this question, and society may find a solution to numerous kinds of domestic violence.

With an introduction by the doyen of the field, Otto Kernmberg, the book sails off to a good start. Akhtar is a prolific scholar of personality disorders. This tome is typically lucid and borrows from a deep theoretical background coupled with a rich clinical experience. Yet, it is largely confined to the vantage point of Object Relations theory and, therefore, lacks coverage of recent advances in treatment modailties as diverse as Cognitive-Behavioral Therapies, Gestalt, NLP, and others. Sam Vaknin, author of "Malignant Self Love - Narcissism Revisited".

This is an excellent review of personality disorders. It is a beautifully written and readable text which explains theory of personality development (especially object relations theory), personality disorder, and psychotherapuetic techniques for treating personality disorders. It is a fascinating text for clinicians, philosophers, or anyone interested in personality development and pathology.