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Title: Psychodynamic psychotherapists' lived experience of working with patients with borderline personality disorder : an interpretative phenomenological analysis
Author: Marozsan, Isabel T.
ISNI:       0000 0004 2738 7110
Awarding Body: University of Roehampton
Current Institution: University of Roehampton
Date of Award: 2012
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This thesis presents an in-depth exploration of psychotherapists’ lived experience of working with borderline personality (BPD) disorder in psychodynamic psychotherapy, using interpretative phenomenological analysis (IPA). The existing research literature suggests that working with borderline patients is very difficult, as they can evoke negative counter transference experiences in therapists and thus make the working alliance difficult to maintain. The stigmatising and negative attitude towards BPD, which is found amongst mental health professionals, can cause many therapists to avoid working with this patient population, leaving many patients without the necessary help for treatment. Some literature also suggests that psychodynamic therapy may not be helpful for the treatment of BPD in its traditional form, because of the neutrality of the model and borderline patients’ ‘reduced capacity to mentalise’. Instead, empathy and the therapeutic relationship have been reported to be significant factors. This qualitative study aimed to provide a rich and detailed examination of the experiences, which psychodynamic psychotherapists and counselling psychologists might have in their work with BPD patients. Five psychodynamic psychotherapists were interviewed twice in one unstructured and one semi-structured interview, and IPA was used to analyse the data. The five master-themes (Negative countertransference feelings; “Sitting in the dark together”; Hindrance in therapeutic work; Therapist omnipotence; Labelling as problematic) found in this study suggested that borderline patients could benefit from a modified version of psychodynamic 1 Note that the ‘psychodynamic’ and ‘psychoanalytic’ terms will be interchangeably used in this study. 2 The researcher, as a trainee-counselling psychologist, is in favour of using the word ‘client’. However, psychodynamic practitioners talk about their ‘patients’ rather than ‘clients’, and as this study focuses on psychodynamic therapists’ experiences, the researcher will use these two terms interchangeably. Thus, the word ‘patient’ here is applied in the psychodynamic and not in the medical sense. 9 psychotherapy with a focus on empathy and a bond between therapist and patient. Furthermore, the therapists’ awareness of negative countertransference feelings and emergent obstacles in the therapeutic work, as well as their understanding of BPD as a label and its effects on their borderline patients were crucial. Finally, the therapists’ experienced ‘omnipotent’ feelings, which may have emerged in response to their negative countertransference feelings. While these findings support many of the previous publications and accounts reported in the literature, they also shed new light on therapists’ experiences, which might have implications for the approach that psychotherapists and counselling psychologists take towards working with borderline individuals within the psychodynamic modality.
Supervisor: Farnfield, Stephen ; Moon, Lyndsey Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: Borderline personality disorder ; psychodynamic psychotherapy