“Who am I without my disorder?”: An interpretative phenomenological analysis of recovery from combined bulimia nervosa and borderline personality disorder

Abstract

Abstract Background Co-occurring Bulimia Nervosa (BN) and Borderline Personality Disorder (BPD) affect a substantial population in the United Kingdom. This study explored how individuals experience recovery from these conditions, with a focus on interpreting how individuals with such experiences make sense of themselves. Methods Semi-structured interviews were conducted with twelve individuals with lived experience of recovery from BN and BPD. Data were analysed using Interpretative Phenomenological Analysis. Results Three superordinate themes were identified: (1) Ambivalence around recovery, reflecting conflicting messages from care systems; (2) Controlled chaos and support, capturing emotional volatility, relational instability, and the non-linear nature of recovery; and (3) Identity, stigma, and the search for self, highlighting developing self-compassion, agency, and identity shifts. Recovery was described as an evolving, relational process shaped by ambivalence and self-redefinition. Therapeutic trust and authentic connection facilitated recovery, while invalidating environments, trauma, and service limitations acted as barriers. Conclusions Recovery from co-occurring BN and BPD is a complex, relational process involving identity reconstruction and emotional integration. Findings suggest that recovery-oriented services should prioritise compassionate, trauma-informed, and relationally attuned care, with particular attention to reducing diagnostic stigma, fostering collaborative therapeutic relationships, and supporting the development of a meaningful sense of self beyond illness.