Abstract
Overview of Portfolio
This portfolio comprises two linked doctoral thesis papers examining how individuals labelled as having Borderline Personality Disorder or Emotionally Unstable Personality Disorder (BPD/EUPD), make sense of decisions about talking about sexual experiences within psychological therapy. Sexuality is closely connected to identity, relationships, trauma, shame, and emotional regulation. However, within both clinical practice and research, sexual experiences are often framed primarily through lenses of trauma, risk, or pathology, while aspects such as pleasure, intimacy, and relational meaning receive less attention. For individuals labelled as having BPD/EUPD, discussing sexual experiences may feel particularly risky due to the stigma associated with the diagnosis and stereotypes that portray individuals as ‘manipulative’, ‘attention-seeking’, or ‘sexually excessive’. This portfolio therefore explores the relational and contextual conditions that shape whether sexual experiences become speakable within therapy, with the aim of informing psychologically safe and clinically meaningful conversations about sexuality in therapeutic practice.
Part A presents a Q-methodological study designed to identify shared viewpoints shaping decisions to disclose or withhold sexual experiences in therapy among individuals labelled as having BPD/EUPD. Fifteen participants completed an online Q-sort examining influences such as trust, therapist competence, shame, and relational safety. Two distinct but related viewpoints were identified, both emphasising trust and therapist competence as central conditions for disclosure while differing in how relational risk and readiness were prioritised.
Part B builds on these findings by using Interpretative Phenomenological Analysis (IPA) to explore the lived experiences underlying these disclosure decisions. Through in-depth interviews with seven participants, the study examined how anticipated stigma, therapist identity, relational safety, and concerns about confidentiality shaped participants’ decisions about whether to speak about sexual experiences in therapy.
Together, the studies provide complementary perspectives on sexual disclosure in therapy and highlight how relational safety, therapist competence, and stigma shape whether sexual experiences are spoken about or remain unaddressed within psychological care.