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Keywords:

  • borderline personality disorder;
  • grounded theory;
  • lived experience;
  • psychiatric services;
  • therapeutic nihilism;
  • unstructured interviews

This study adopted a lived experience approach utilizing a broad research question to ask ‘How do people with borderline personality disorder (BPD) experience their contact with mental health services?’. Unstructured interviews were conducted with seven participants from one mental health trust. A grounded theory methodology was adopted to develop a theory of how people with BPD conceptualized their contact with psychiatric services and what strategies they adopted to negotiate their way through them. The study found that people with BPD valued their contact with psychiatric services despite negative experiences and encountering negative staff attitudes. It also found that relationships with others were vital in containing their distressing emotions despite their difficulty in trusting others. Overcoming these paradoxes was achieved by consistent long-term involvement with experienced staff, containing relationships, encouraging the participants to contribute to their care through the structure of the care programme approach and improving staff understanding of their behaviour by key informants.