Fagan, Stephanie and Hodge, Suzanne (2017) A compassionate and relational understanding of adults with a diagnosis of borderline personality disorder. PhD thesis, Lancaster University.
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Abstract
Adults with a diagnosis of Borderline Personality Disorder (BPD) often experience stigma due to the reductionist narrative that accompanies its conceptualisation. The aim of this research was to challenge the reductionist narrative by exploring a relational understanding of BPD and integrating the construct of compassion. In Chapter 1, qualitative research that explored the relationships between adults with a diagnosis of BPD and mental health professionals was synthesised. Twenty-four themes that described relational dynamics emerged. These dynamics were reconceptualised by applying psychological theory to develop 12 3rd order interpretation themes. During this process, compassionate terminology based upon psychological theory was integrated into the understanding. In addition, four cycles of relational dynamics were identified between adults with a diagnosis of BPD and mental health professionals based upon these 3rd order interpretations. In Chapter 2, a qualitative research study was conducted which explored experiences of compassion in adults with a diagnosis of Borderline Personality Disorder (BPD) to further the development of the construct of compassion in relation to BPD. Interpretative Phenomenological Analysis was used to develop themes from the narratives of six adults with a diagnosis of BPD. Five themes emerged: Emotional Connection to Suffering, Empathic Understanding, Prioritisation of Needs, A Model of Genuine Compassion and Developing Self-acceptance and a Sense of Worthiness. The themes were integrated into a recovery model that highlighted the process of recovery through therapeutic relationships that model genuine compassion. In addition, barriers to compassion and factors which facilitate compassion emerged from the analysis which have implications for clinical practice. In Chapter 3, a critical appraisal was conducted which outlined the rationale for the research and compared findings from the previous two chapters to consider how a compassionate and relational understanding can be integrated into the BPD narrative to challenge stigma and inform positive therapeutic relationships.