"I am ashamed that I exist. I feel like apologizing for existing": The phenomenology of shame in patients with borderline personality disorder: A qualitative study.

Shame is an essential affect in many patients with borderline personality disorder (BPD) and can be associated with most of the BPD diagnostic criteria. Severe shame is a highly aversive emotion with concomitant beliefs about the self as deeply inferior, insignificant, disgusting, and unloved. Shame and how it is manifested in the subjective experience and behavior in people diagnosed with BPD is remarkably under-researched, and our knowledge of the phenomenology of shame in BPD needs to be improved. Severe shame is often less accessible and available to conscious awareness, making it difficult to access via questionnaires and self-report measures. Therefore, this study is based on semi-structured interviews with 21 women Structural clinical interview for DSM-5 disorders' diagnosed with BPD. All interviews were analyzed using the interpretive phenomenological approach. Based on the analysis, the participants' descriptions of how severe shame manifests itself in their subjective experience and behavior are classified into 10 themes: the self is deeply flawed and unlovable; self-hatred/self-contempt; eye contact is awkward and shameful; shameful over being mentally ill; shameful identity diffusion; hiding behind façade/social roles; pleasing others/performing to avoid shame; self-destructive behavior to mitigate shame; sex associated with shame; and shame during the therapy session. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

How Does It Feel to Have a Disturbed Identity? The Phenomenology of Identity Diffusion in Patients With Borderline Personality Disorder: A Qualitative Study.

Identity diffusion is one of the defining characteristics of borderline personality disorder (BPD). Given its central importance in the formal diagnostic criteria for personality disorders, identity diffusion is remarkably under-researched. In particular, our knowledge of the phenomenology of identity diffusion needs to be improved. This study is based on semistructured interviews with 16 younger women SCID-5-diagnosed with BPD. All interviews were analyzed using the interpretative phenomenological analysis approach. On the basis of this analysis, the patients' descriptions of how identity diffusion manifests itself in their subjective experience are classified into nine categories: disintegrated self-image; using various façades to stabilize the self; painful feelings of the self as broken; feeling that the self does not fit in; inner emptiness; "I don't know what I want"; great need for attention from others to stabilize identity; feeling unable to handle interpersonal relationships; and using sex to distract the self and regulate painful self-states.