A Qualitative Analysis of Couples’ Experiences of Living with Borderline Personality Disorder in Marital Life
Keywords:
Borderline personality disorder, marital life, couples, psychological coexistence, thematic analysis, qualitative researchAbstract
This study aimed to explore couples’ lived experiences of living with borderline personality disorder in marital life. This qualitative study was conducted using thematic analysis. The study population consisted of couples living in Tehran in which at least one spouse had a clinical diagnosis of borderline personality disorder or prominent borderline-related clinical features. Participants were selected through purposive sampling, and recruitment continued until theoretical saturation was achieved. The final sample included 18 participants, representing 9 couples. Data were collected through individual semi-structured interviews. After obtaining informed consent, interviews were audio-recorded, transcribed verbatim, and analyzed using NVivo software. The analytic process included familiarization with the data, initial coding, category development, theme review, and final naming of the main themes. Data analysis resulted in four main categories: emotional instability and relational unpredictability, fear of abandonment and exhausting reassurance seeking, caregiving fatigue and erosion of the spouse’s identity, and relational reconstruction through boundaries, validation, and professional help. The findings indicated that marital life in the context of borderline personality disorder is often characterized by oscillation between intense closeness and sudden withdrawal, recurrent misinterpretations, emotional outbursts, control over the partner’s social relations, constant caregiving vigilance, social shame, and efforts to establish safer patterns of communication. Couples’ experiences of living with borderline personality disorder should not be understood merely as exposure to an individual disorder; rather, it is a relational, emotional, and interactional experience that affects the entire structure of marital life. The results suggest that couple-oriented interventions, psychoeducation, emotion regulation skills, healthy boundary setting, and improved disorder literacy may play an important role in reducing marital exhaustion and improving relationship quality.
Downloads
References
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). American Psychiatric Association Publishing.
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. doi:10.1191/1478088706qp063oa
Chapman, J., Jamil, R. T., & Fleisher, C. (2024). Borderline personality disorder. In StatPearls. StatPearls Publishing.
Crowell, S. E., Beauchaine, T. P., & Linehan, M. M. (2009). A biosocial developmental model of borderline personality: Elaborating and extending Linehan’s theory. Psychological Bulletin, 135(3), 495–510. doi:10.1037/a0015616
Fruzzetti, A. E., & Iverson, K. M. (2006). Intervening with couples and families to treat emotion dysregulation and psychopathology. In D. K. Snyder, J. Simpson, & J. N. Hughes (Eds.), Emotion regulation in couples and families: Pathways to dysfunction and health (pp. 249–267). American Psychological Association.
Greer, H., & Cohen, J. N. (2018). Partners of individuals with borderline personality disorder: A systematic review of the literature examining their experiences and the supports available to them. Harvard Review of Psychiatry, 26(4), 185–200. doi:10.1097/HRP.0000000000000164
Guest, G., Bunce, A., & Johnson, L. (2006). How many interviews are enough? An experiment with data saturation and variability. Field Methods, 18(1), 59–82. doi:10.1177/1525822X05279903
Gunderson, J. G., Herpertz, S. C., Skodol, A. E., Torgersen, S., & Zanarini, M. C. (2018). Borderline personality disorder. Nature Reviews Disease Primers, 4, 18029. doi:10.1038/nrdp.2018.29
Hennink, M., & Kaiser, B. N. (2022). Sample sizes for saturation in qualitative research: A systematic review of empirical tests. Social Science & Medicine, 292, 114523. doi:10.1016/j.socscimed.2021.114523
Hoffman, P. D., Fruzzetti, A. E., Buteau, E., Neiditch, E. R., Penney, D., Bruce, M. L., Hellman, F., & Struening, E. (2005). Family Connections: A program for relatives of persons with borderline personality disorder. Family Process, 44(2), 217–225. doi:10.1111/j.1545-5300.2005.00055.x
Kay, M. L., Poggenpoel, M., Myburgh, C. P., & Downing, C. (2018). Experiences of family members who have a relative diagnosed with borderline personality disorder. Curationis, 41(1), a1892. doi:10.4102/curationis.v41i1.1892
Leichsenring, F., Fonagy, P., Heim, N., Kernberg, O. F., Leweke, F., Luyten, P., Salzer, S., Spitzer, C., & Steinert, C. (2024). Borderline personality disorder: A comprehensive review of diagnosis and clinical presentation, etiology, treatment, and current controversies. World Psychiatry, 23(1), 4–25. doi:10.1002/wps.21156
Lieb, K., Zanarini, M. C., Schmahl, C., Linehan, M. M., & Bohus, M. (2004). Borderline personality disorder. The Lancet, 364(9432), 453–461. doi:10.1016/S0140-6736(04)16770-6
Lincoln, Y. S., & Guba, E. G. (1985). Naturalistic inquiry. Sage.
Downloads
Published
Submitted
Revised
Accepted
Issue
Section
License
Copyright (c) 2026 Reyhaneh Fazeli-Moghadam (Corresponding author)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
