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Habitar a fronteira: Vivências de psiquiatras com pacientes borderline
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A Perturbação Borderline da Personalidade é reconhecida como uma das condições mais relacionalmente exigentes na prática psiquiátrica. Apesar de literatura extensa sobre atitudes profissionais e estigma, a experiência vivida de psiquiatras nestes encontros permanece pouco
explorada. Este estudo explorou as experiências vividas de psiquiatras no encontro clínico com pacientes com Perturbação Borderline da Personalidade ao aceder às dimensões relacionais, emocionais e de atribuição de sentido que caracterizam estes encontros. Foi utilizada Análise Interpretativa Fenomenológica (IPA) com sete psiquiatras com formação predominantemente biomédica, com cédula ativa da Ordem dos Médicos e com prática em Portugal. As entrevistas semiestruturadas foram analisadas idiograficamente (Anexo G), seguindo procedimentos estabelecidos para IPA. Emergiram quatro temas superordenados: (1) Navegação em Terreno Relacional Instável, caracterizado por hipervigilância, ambivalência e sentimentos de rejeição; (2) Impacto Emocional Corporalizado no Profissional, incluindo frustração, desgaste, preocupação constante e irritação; (3) Trabalho Emocional e Estratégias Defensivas, revelando empatia como exercício deliberado, humor ácido e vigilância discursiva; (4) Tensão entre Humanidade e Papel Profissional, articulando vulnerabilidade humana com expectativas profissionais. Os resultados
revelam encontros profundamente humanos e relacionalmente complexos, desafiando narrativas simplistas sobre estigma. As implicações incluem necessidade de validação de emoções difíceis,
formação em competências relacionais, atenção ao trabalho emocional invisível e criação de condições institucionais para cuidados relacionalmente informados
Borderline Personality Disorder is recognised as one of the most relationally demanding conditions in psychiatric practice. Despite extensive literature on professional attitudes and stigma, the lived experience of psychiatrists in these encounters remains inderexplored. This study explored the lived experiences of psychiatrists in clinical encounters with patients with Borderline Personality Disorder, accessing the relational, emotional, and meaning-making dimensions that characterise these encounters. Interpretative Phenomenological Analysis (IPA) was used with six psychiatrists with predominantly biomedical training, practising in Portugal. Semi-structured interviews were analysed idiographically, following established IPA procedures. Four superordinate themes emerged: (1) Navigating Unstable Relational Terrain, characterised by hypervigilance, ambivalence, and feelings of rejection; (2) Embodied Emotional Impact on the Professional, including frustration, relational erosion, constant worry, and irritation; (3) Emotional Labour and Defensive Strategies, revealing empathy as deliberate exercise, acid humour, and discursive vigilance; (4) Tension between Humanity and Professional Role, articulating human vulnerability with professional expectations. Results reveal profoundly human and relationally complex encounters, challenging simplistic narratives about stigma. Implications include the need to validate difficult emotions, training in relational competencies, attention to invisible emotional labour, and creation of institutional conditions for relationally informed care.
Borderline Personality Disorder is recognised as one of the most relationally demanding conditions in psychiatric practice. Despite extensive literature on professional attitudes and stigma, the lived experience of psychiatrists in these encounters remains inderexplored. This study explored the lived experiences of psychiatrists in clinical encounters with patients with Borderline Personality Disorder, accessing the relational, emotional, and meaning-making dimensions that characterise these encounters. Interpretative Phenomenological Analysis (IPA) was used with six psychiatrists with predominantly biomedical training, practising in Portugal. Semi-structured interviews were analysed idiographically, following established IPA procedures. Four superordinate themes emerged: (1) Navigating Unstable Relational Terrain, characterised by hypervigilance, ambivalence, and feelings of rejection; (2) Embodied Emotional Impact on the Professional, including frustration, relational erosion, constant worry, and irritation; (3) Emotional Labour and Defensive Strategies, revealing empathy as deliberate exercise, acid humour, and discursive vigilance; (4) Tension between Humanity and Professional Role, articulating human vulnerability with professional expectations. Results reveal profoundly human and relationally complex encounters, challenging simplistic narratives about stigma. Implications include the need to validate difficult emotions, training in relational competencies, attention to invisible emotional labour, and creation of institutional conditions for relationally informed care.
Descrição
Dissertação de Mestrado apresentada no Ispa – Instituto Universitário para obtenção de grau de Mestre na especialidade de Psicologia Clínica
Palavras-chave
Perturbação borderline da personalidade Experiência vivida Psiquiatras Análise interpretativa fenomenológica Trabalho emocional Borderline personality disorder Lived experience Psychiatrists Interpretative phenomenological analysis Emotional labour.