ABSTRACT
Much of what passes as psychotherapy today is crippled by the absence of real cause-and-effect psychopathology. Symptoms are taken at face value, regardless of whether they are found in an Axis I versus an Axis II patient, and both are treated the same way by cognitive therapy, with motivational interviewing substituting for a real understanding of the patient’s resistance and how to therapeutically respond to it. Consequently, our mental health services are bogged down by borderline personality patients who, year after year, manipulate the system to achieve their own ends or even to get out of trouble.
