(PS12-B28) Understanding Couples’ Experiences of the Impact of BPD Symptoms on Communication and Relationship Functioning: A Thematic Analysis

Borderline personality disorder (BPD) is characterized by emotion dysregulation, unstable relationships, and destructive behaviors such as self-harm and suicide attempts. Individuals with BPD’s relationships are particularly disrupted and characterized by heightened conflict, repeated break ups, and violence. Contemporary models of BPD suggest that transactions between people with BPD and their significant others may inadvertently contribute to the maintenance of BPD by eliciting emotion dysregulation, which may reinforce destructive behaviors. In addition, intimate partners of those with BPD struggle with their own mental health, compounding unhealthy communication patterns within the relationship. Therefore, researchers and clinicians have begun to recommend and develop dyadic treatments for people with BPD and their intimate partners. While preliminary evidence suggests that such treatments are successful, it remains unclear how these dyads experience problems in their relationships, how they communicate about them, and what they would wish to change through treatment. Consequently, the key treatment targets for both dyadic and individual interventions for BPD lack refinement. The present study therefore employs a qualitative thematic analysis to elucidate couples’ lived experiences, understanding, and communication of the impact of BPD symptoms on their relationship, as well as couples’ treatment goals. The analysis consisted of 20 couples, each comprised of one individual with BPD and their intimate partner. Each couple was enrolled in either a case series or uncontrolled trial testing Sage (Fitzpatrick et al., 2022), a dyadic intervention for couples wherein one member had BPD, designed to improve BPD, relationship conflict, and partner mental health. In session one of Sage, each participant was asked to write a letter to their partner describing the impact of BPD symptoms on their relationship, emotions, and communication. In addition, they were asked to describe their hopes for the treatment. Couples read these letters to each other in the second session of Sage. To address this study’s questions, these letters were transcribed and coded for both verbal and non-verbal content. The thematic analysis of these letters is ongoing and final results will be presented at the convention. These results will describe: 1) the overarching themes regarding the impact of BPD on the relationship (e.g., partner accommodation); 2) treatment goals present in the letters; and 3) participants’ verbal and non-verbal reactions to hearing their partner’s letter. Better understanding couples’ lived experiences of BPD and treatment priorities is integral to bolstering existing and future interventions by identifying key treatment targets for this population. This presentation is also aligned with this year’s convention theme, centering lived experience of those with BPD and their partners, with the intention of drawing on such wisdom to develop interventions that promote wellness, connection, and joy.