A qualitative exploration of recovery from combined Bulimia Nervosa and Borderline Personality Disorder

Turner, Gemma and Klein, Maike and Seal, Karen (2025) A qualitative exploration of recovery from combined Bulimia Nervosa and Borderline Personality Disorder. PhD thesis, Lancaster University.

Text (2025TurnerPhD)
GT_2022_Thesis_Submission_to_Library_September_2025.pdf - Published Version
Restricted to Repository staff only until 8 September 2027.
Available under License Creative Commons Attribution-NonCommercial-NoDerivs.
Download (22MB)

Abstract

This thesis comprises of three chapters in relation to the experiences of recovery from combined Bulimia Nervosa (BN) and Borderline Personality Disorder (BPD). The first chapter presents a systematic review and meta-ethnography of 17 peer-reviewed papers, relating to health and social care professionals’ experiences of supporting individuals with combined BN and BPD. The review illuminated professionals’ feelings of ambivalence and burnout, compounded by service limitations and diagnostic stigma. The review also considers how current treatment guidelines are interpreted and applied in practice, often leading to fragmented or exclusionary care. Implications for supervision, specialist training, and service design are discussed. Chapter two employed Interpretative Phenomenological Analysis (IPA) to explore the lived experiences of recovery from combined BN and BPD, among twelve adult service users in the UK. Findings highlight the fluidity of recovery and therefore underscore the importance of relational, identity-focused, and trauma-informed approaches in long-term care. The third chapter presents a critical appraisal of the two preceding chapters, examining methodological choices, epistemological positioning and reflexivity. It situates the findings and clinical implications of the thesis in the wider, sociocultural context. Conclusively, this thesis contributes novel insights into the experiences of combined BN and BPD, and advocates for integrated and trauma-informed approaches that recognise the relational and emotional dimensions within both conditions.