Abstract
Considering service user movements advocating for change in how individuals with
mental ill-health were thought about and supported, the concept of ‘personal recovery’ has
emerged in literature, policy and mental health services. This concept recognises that
recovery is more nuanced and broader than the remission of symptomology alone and that
one can live a meaningful life alongside a mental illness. This thesis sought to illuminate
experiences of recovery from the perspective of those with borderline personality disorder
(BPD), with the hope of gleaning what constitutes meaningful change and what supports or
hinders this journey. Part A of this portfolio presents a systematic review and reflexive
thematic synthesis of recovery and treatment experiences in BPD. The findings of this review
demonstrate that individuals experience change in several key areas involving how they relate
to themselves and others, which can be enhanced or negatively affected by several factors
across generic and specialist services. Links between areas of change and treatment
characteristics were made. Clinical implications and recommendations for clinical practice
are explicated, such as the importance of continual reflection upon the therapeutic
relationship, employing a goal-orientated skill-focused approach and seeing the person, not
the ‘diagnostic label’. Part B presents an empirical paper that employed reflexive thematic
analysis to explore the concept of recovery in BPD and associated barriers and facilitators on
a popular online social media forum. The findings propose that a prerequisite to the recovery
journey is holding oneself accountable and cultivating agency through successfully
implementing acquired coping skills. Individuals may then experience a change in how they
relate to others, in combatting shame through acceptance and compassion, in developing a
consistent, coherent sense of ‘self’ and in adaptively responding to emotions. The impact of
stigma, experiences of help and distance between one’s identity and the diagnosis on recovery
are outlined.