Self-invalidation in borderline personality disorder: A content analysis of patients’ verbalizations

• Published in: Psychotherapy research Vol. 32; no. 7; pp. 922 - 935
• Main Authors: Koivisto, Maaria, Melartin, Tarja, Lindeman, Sari
• Format: Journal Article
• Language: English
• Published: England Routledge 03.10.2022; Taylor & Francis Ltd
• Subjects: Borderline personality disorder; Content analysis; Coping; Emotional responses; Emotions; Evidence based research; Evidence-based medicine; Guilt; Interpersonal problems; Personality disorders; Psychoeducational treatment; Psychological well being; Psychopathology; qualitative research; Recurrent; Resentment; Self esteem; self-invalidation; self-stigma; Selfcriticism; Shame; Stigma; Suicide; self-stigma; qualitative research; content analysis; self-invalidation; Borderline personality disorder
• ISSN: 1050-3307; 1468-4381
• DOI: 10.1080/10503307.2022.2025627

The ability to trust one’s own perceptions is crucial for psychological well-being and growth. The relevance of its opposite, self-invalidation (SI), to the psychopathology of borderline personality disorder (BPD) is emphasized in many contemporary theories of evidence-based treatments for BPD. Empirical research on this topic remains scarce, however. This study aimed to describe manifestations of SI in individuals with BPD during a 40-session psychoeducational intervention based mainly on schema therapy. Transcripts of videotaped group sessions were analyzed inductively using qualitative content analysis. SI emerged as a recurrent, ubiquitous phenomenon. The content analysis yielded three core categories of SI: (1) a self-critical and harsh attitude towards the self (subcategories reflected punitive internalizations that could engender fear-based inertia, self-erasing, submissive coping behavior, and temporal fluctuation in SI), (2) a deficient sense of normalcy, and self-doubt, and (3) self-stigma. We also found an association of SI with various dimensions of BPD, including difficulty in the identification of emotions, secondary emotional reactions such as guilt, shame, anger, and resentment, self-related and interpersonal problems, and suicidal urges. SI is a detrimental cognitive-emotional process relevant to BPD that merits treatment. Efforts to reduce self-stigma, a pernicious aspect of SI, are imperative.