I Hate You—Don't Leave Me by Jerold J. Kreisman Summary

I Hate You—Don't Leave Me by Jerold J. Kreisman is a comprehensive guide to understanding Borderline Personality Disorder (BPD). First published in 1989 and now in its third edition, the book explores the emotional instability, fear of abandonment, and identity struggles that characterize BPD. Kreisman combines clinical expertise with accessible language to help readers recognize BPD patterns and offers practical strategies for communicating with and supporting individuals who have the disorder.

Jerold J. Kreisman, M.D., is a renowned psychiatrist and leading international expert on Borderline Personality Disorder. He serves as Associate Clinical Professor at St. Louis University and has been designated a Distinguished Life Fellow of the American Psychiatric Association. His bestselling books on BPD have been translated into multiple languages and sold over 300,000 copies worldwide. Kreisman has lectured internationally and appeared on major media platforms including The Oprah Winfrey Show.

I Hate You—Don't Leave Me is essential reading for family members, partners, therapists, and friends of individuals with Borderline Personality Disorder. Mental health professionals seeking deeper clinical understanding of BPD will find valuable insights, while those personally affected by BPD can gain self-awareness and validation. The book serves anyone struggling to understand the intense emotional patterns and relationship challenges associated with BPD, offering both theoretical knowledge and practical communication tools.

I Hate You—Don't Leave Me remains a foundational text on Borderline Personality Disorder, with the third edition updated in 2021 to reflect current research and treatment advances. The book has sold over 300,000 copies and continues to be recommended by mental health professionals worldwide. While some readers note certain aspects feel dated, the core insights into BPD emotional patterns and relationship dynamics remain relevant and valuable for understanding this complex disorder in contemporary contexts.

According to Jerold J. Kreisman in I Hate You—Don't Leave Me, Borderline Personality Disorder is characterized by a weak sense of identity, intense fear of abandonment, and rapid mood swings. Individuals with BPD experience emotional instability so severe that Kreisman describes it as "emotional hemophilia"—lacking the ability to moderate intense feelings. The disorder involves difficulty tolerating solitude, leading to relentless loneliness that can only be relieved by others' physical presence, often resulting in turbulent relationships.

The "emotional hemophilia" metaphor in I Hate You—Don't Leave Me illustrates how individuals with BPD lack emotional regulation mechanisms. Kreisman explains that just as hemophiliacs lack blood clotting factors, people with BPD lack the psychological "clotting mechanism" to moderate emotional responses. When feelings are triggered, they experience uncontrolled emotional bleeding—intense reactions without natural boundaries. This vivid comparison helps readers understand why BPD individuals may have disproportionate responses to seemingly minor events or perceived rejections.

Jerold J. Kreisman describes fear of abandonment as the central dynamic in Borderline Personality Disorder throughout I Hate You—Don't Leave Me. This terror of being left alone creates the paradoxical "I hate you—don't leave me" pattern where individuals push people away while desperately needing connection. The book explains that when alone, those with BPD lose their sense of continuity, confidence, and even reality, making solitude psychologically unbearable. This insight helps loved ones understand seemingly contradictory behaviors.

I Hate You—Don't Leave Me provides practical communication strategies for managing the intense emotions and conflicts that arise with Borderline Personality Disorder. The third edition specifically includes advice for setting boundaries, expressing needs effectively, and responding to emotional crises without enabling destructive patterns. Kreisman emphasizes understanding the underlying fear and pain driving BPD behaviors rather than taking attacks personally, helping families develop compassion while maintaining healthy limits in their relationships.

I Hate You—Don't Leave Me explains that individuals with Borderline Personality Disorder experience profound metaphysical loneliness that cannot be conquered through typical means. Kreisman cites theologian Paul Tillich's insight that "loneliness can be conquered only by those who can bear solitude," noting that borderlines find solitude intolerable. This drives them to seek constant companionship in singles bars or crowded places, often with disappointing or violent results, as they desperately try to fill an internal void that external presence can only temporarily relieve.

I Hate You—Don't Leave Me serves as Kreisman's foundational introduction to Borderline Personality Disorder, while his follow-up Sometimes I Act Crazy focuses more on living with BPD from the patient's perspective with practical coping techniques. His later book Talking to a Loved One with Borderline Personality Disorder specifically addresses communication skills for family members. Together, these books form a comprehensive trilogy—I Hate You—Don't Leave Me provides understanding, Sometimes I Act Crazy offers self-management tools, and Talking to a Loved One delivers relationship strategies.

I Hate You—Don't Leave Me identifies core Borderline Personality Disorder symptoms including unstable sense of identity, fear of abandonment, rapid mood swings, and difficulty tolerating aloneness. Kreisman describes how continuity and connectedness cease when borderlines are alone, with confidence and reality perception slipping away like "sand falling through fingers". The book details impulsive behaviors, intense and unstable relationships, inappropriate anger, and chronic feelings of emptiness that characterize the disorder, helping readers recognize patterns in themselves or loved ones.

I Hate You—Don't Leave Me has maintained its status as the definitive guide to Borderline Personality Disorder for over 35 years because it combines rigorous clinical knowledge with accessible, compassionate explanations. Published when BPD had only recently entered official psychiatric classification in 1980, Kreisman's book filled a critical gap in public understanding. Its innovative use of metaphors like "emotional hemophilia" and the paradoxical title itself capture the disorder's essence in memorable ways. The third edition's updates ensure continued relevance while preserving the original's groundbreaking insights.