Couple relationships and Borderline Personality Disorder: examining the interpersonal experience of caregiving partners and people diagnosed with BPD

Borderline Personality Disorder (BPD) is a mental condition characterised by emotional lability and turbulent
interpersonal connections [1]. People diagnosed with BPD have more relationships characterised by a major change or
termination compared to healthy individuals and those with other mental health conditions [2, 3] and BPD features are associated
with received and perpetrated abuse within the couple [4]. For many individuals diagnosed with BPD-more than a third of
whom are in long-term romantic relationships [5]- spouses and romantic partners are the main providers of care [6]. Recent
studies highlighted the reciprocal relationship between the quality of interpersonal relationships and the severity of BPD features
[7]. Further, carers of people with BPD experience a higher carer burden than carers of people affected by other mental illnesses
[8, 9] which, in turn, negatively impacts relationship quality and stability.
The changing perception of relational dynamics that is typical of the disorder, along with its interdependence with BPD
features and the role of the partner-caregiver, gives rise to a complex interpersonal context that is yet to be investigated
qualitatively. The available interventions for BPD couples are limited and largely informed by theoretical models rather than
grounded on couples' experience [10]. Gaining insight into the experience of both caregiving partners, and people diagnosed
with BPD in a romantic relationship will provide the experiential ground necessary to model relationship-centred interventions
based on the couple's needs, improving clinical outcomes and general wellbeing. Researching this area is particularly relevant
considering that psychotherapy is the first-line treatment for BPD [11] and that this disorder has a prevalence of 1.6% in the
general population [11].
The core clinical domains of BPD are a reinforcing and maintaining factor of disordered affect [12]. Specifically,
difficulties regulating...