A Meaningful Life? A Qualitative Narrative Analysis of Life Stories of Patients with Personality Disorders Before and After Intensive Psychotherapy

Abstract

Patients with personality disorder (PD) experience problems with identity and self-directedness, resulting in a lack of an autobiographical sense of self and of meaning in life. Here we report on a qualitative narrative analysis using a holistic content approach and theoretical thematic analysis to investigate meaning in life in 15 life stories of patients with PD before and after intensive psychotherapy. The seven theoretical themes were purpose, moral worth, self-worth, competence, comprehensibility, connectedness, and spiritual transcendence. The pretreatment life stories mostly concerned tragic lives and problems within the seven themes, but hardly any spiritual transcendence. Being a victim of moral injustice indicated the theme of moral worth. In the post-treatment life stories comprehensibility, self-acceptance and an awareness of existential vulnerability emerged. The presence and/or emergence of the specific meaning in life themes could result from attaining treatment goals that ameliorate personality dysfunction. Here the meaning in life themes of purpose, self-worth, competence, comprehensibility and connectedness are of interest as they also turn up as personality functions in the DSM-5 alternative model for Personality Disorders.