Social Processing Alterations in Individuals with Borderline Personality Disorder: A Therapist–Patient Interaction Perspective

Introduction: Borderline personality disorder is characterized by emotional instability, impulsivity, and difficulties in interpersonal relationships, which may significantly influence therapist–patient interaction. Understanding how alterations in social processing emerge within the therapeutic context is essential for improving clinical intervention strategies. Methodology: This study employed a qualitative exploratory design based on semi-structured interviews conducted with psychotherapists experienced in treating patients diagnosed with borderline personality disorder. The collected information was analyzed through thematic analysis to identify recurring patterns in the clinical experiences reported by the participants. Results: The findings revealed that difficulties in interpreting social cues, heightened sensitivity to interpersonal rejection, and challenges in building the therapeutic alliance represent central elements in the relational dynamics of these patients. In addition, negative interpretations of gestures, comments, or therapeutic interventions may generate tensions within the therapist–patient relationship. Conclusions: The results highlight the importance of implementing clinical strategies focused on emotional validation, regulation of affective responses, and strengthening of the therapeutic alliance in order to promote a more stable and effective psychotherapeutic process.