How women diagnosed with Borderline Personality Disorder negotiate identity in relation to risk

This thesis examines how women with a diagnosis of borderline personality disorder (BPD) negotiate their identity in relation to risk, also referred to as their ‘risk identity’. This is defined as, ‘…the view people have of themselves and project to others in their talk and actions in relation to risk and risk taking’. The theoretical perspective which underpins the study is informed by ontological realism, epistemological discursive/linguistic social constructionism, and an ideological critical liberatory position primarily derived from the work of Foucault (1978; 1991a; 1991b; 1998; 2002; 2008a; 2008b; 2009). This perspective informed the decision to adopt email interviews as a method for generating appropriate texts for analysis. Eight women diagnosed with BPD were interviewed over a period of ten months. Adopting a critical emancipatory methodology which incorporated feminist principles of research, Lather’s (1991) adaptation of Van Maanen’s (1988 cited in Lather 1991) ‘four tales’ was employed to view and analyse the texts from four theoretical perspectives; a ‘Realist Tale’, a ‘Critical Tale’, a ‘Deconstructivist Tale’, and a ‘Reflexive Tale’. By ‘layering’ these tales, the findings revealed sets of tensions discernable within the context of interactions with staff, the nature of services, and the wider material and discursive resources at play which inform how risk identities are negotiated. Converging Western discourses of the subject, binary gender discourse, neoliberal discourse, ‘psy’ discourses, and discourses around motherhood were found to be key discursive resources through which risk identity is produced, resisted and projected. In addition these to broad discursive findings, the study also contributes to the existing empirical literature that focuses on the lived experience of those with a BPD diagnosis. A conclusion is drawn that women with a BPD diagnosis not only receive a label which discursively excludes them from being able to be viewed as a ‘good subject of psychiatry’ (and hence leads to them being viewed as dangerous and risky), but that their difficulties and need for relational approaches to manage risk and promote recovery run counter to the way that mental health services are structured in the current neoliberal era