3 - (SYM 24) We're Still Working on This Together: How Intimate Partners of People with Borderline Personality Disorder Respond to Suicidal and Self-injurious Thoughts and Behaviors

 People with borderline personality disorder (BPD) experience considerable conflict and instability in intimate relationships. Not only is intimate relationship dysfunction distressing in its own right, but it can also precede self-injurious thoughts and behaviors (SITBs). Nonetheless, people with BPD often turn to intimate partners when disclosing SITBs and seeking comfort. Therefore, intimate partners of people with BPD may be in a key position to engage in behaviors that either reduce subsequent SITBS or exacerbate them. Despite this, it remains unclear how intimate partners respond to these SITBs and how much they believe they can influence future SITBs. Therefore, the present study investigated intimate partners’ experiences of responding to people with BPD'S SITBs, and their perceptions of how their responses impacted people with BPD’s distress and SITBs. Descriptive-Interpretive Qualitative Research was used to analyze 15 semi-structured interviews with intimate partners. Five themes were developed to describe intimate partners’ responses to SITBs: (1) Staying Steady: intimate partners suppressed their emotional reactions to SITBS and avoided sensitive topics; (2) Soothing: intimate partners provided verbal and physical affection and comfort; (3) Protection Mode: intimate partners rushed to help and tried to convince people with BPD not to harm themselves; (4) Problem Solving: intimate partners assessed how SITBs arose and tried to find solutions; (5) Opting Out: intimate partners stepped away to manage their own emotions or encouraged people with BPD to handle SITBs on their own. Additionally, three themes were developed to describe how intimate partners believed their responses impacted people with BPD: (1) Making a Positive Impact: intimate partners felt helpful and skilled at responding to SITBs; (2) Feeling Lost: intimate partners did not know how to fix things and felt uncertain about their impact on people with BPD’s mood and SITBs; (3) Relinquishing Responsibility: intimate partners challenged the assumption that they could stop SITBs, whether out of hopelessness or a sense of acceptance. Ultimately, intimate partners were highly engaged in helping people with BPD manage SITBs, despite often feeling distressed and unsure about the impact of their actions. These findings emphasize the need for interventions grounded in the lived experience of intimate partners, which help them respond effectively to SITBs while addressing their often-overlooked burden and distress.