Hear Us! Seven Women Diagnosed With Borderline Personality Disorder Describe What They Need From Their Therapy Relationships

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The purpose of my dissertation project was to explore the interpersonal therapy experiences of seven female participants diagnosed with borderline personality disorder (BPD) using a phenomenological approach with participants’ narratives as the primary data source. Data was gathered from individual interviews, administration of the core conflictual relationship theme-relationship anecdotes paradigm interview (CCRT-RAP; Luborsky, 1990), and relational space mapping (Josselson, 1996). The analysis involved a back-and-forth process whereby I moved between the developmental information, identified interpersonal patterns, described therapy experiences, and my own reflections. Immersion with the material was ongoing and allowed themes to be modified and elaborated. Results are described in a manner intended to illustrate the benefits of a phenomenological approach that relied heavily on participants’ voices and allowed for continual reflection on the material and deepening of meaning. As a group, the seven participants desired therapists who demonstrated caring and kindness and who joined them in their experiences through a deep form of listening and validation. These conditions were necessary but not adequate for the development of a healing alliance. Participants also desired clinicians who maintained a collaborative approach, balancing strength with flexibility, and who were willing to address conflicts and tensions head-on. Therapist neutrality, withholding, and inactivity were experienced as aversive and participants expressed a desire for explicit evidence of clinician humanity. The value of the qualitative approach for accessing the complex and vacillating therapy relationship needs of this patient group is discussed.

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