The study of identity based on the presence of disease has traditionally focused on landmark events, such as diagnosis or the introduction of treatment options. These events have been shown to significantly alter so-called “illness identities.” The project was undertaken in Atlanta, GA, which has a relatively high rate of HIV infection and a large number of HIV-related services and support mechanisms. This study contextualizes illness identities within a larger socio-political and economic paradigm, recognizing that individuals use multiple identities to inform their interactions and decisions, specifically those regarding the beginning and continuation of antiretroviral (ARV) treatment. In addition, structural barriers which limit one’s access to ARV treatment are considered within a context of social and economic marginalization and inequitable power relationships within a post-industrial Western society.

People diagnosed with Borderline Personality Disorder (BPD) have been subjected to stigma and told that their difficulties are untreatable. Although recovery is now understood to be possible for this client group, much controversy exists around whether BPD is, in fact, an illness. The implications of this belief have not yet been explored from the perspective of the client. Furthermore, little research has attempted to deconstruct what constitutes the therapeutic alliance for people diagnosed with BPD and their clinicians from a Personal Construct Psychology (PCP) perspective. The present research study therefore aimed to explore what impacts on the recovery of people diagnosed with BPD. This included investigating the impact of the construct of illness and the therapeutic relationship. The research employed a correlational and non-randomised design, using a cross-sectional approach. The Repertory Grid technique was used among a sample of 20 clients diagnosed with BPD and their clinicians. Relevant questionnaires were also administered to ascertain BPD symptomatology and the perceived quality of the therapeutic relationship. Among findings, a statistically significant correlation is presented for the association between a poor therapeutic relationship and increased BPD symptoms. Evidence (in the form of a borderline significant correlation) is also revealed to suggest that clients diagnosed with BPD construe fewer benefits from psychological therapy when they consider the well-ill construct to be more important (i.e. superordinate). The results provide new information with regard to the treatment of people diagnosed with BPD.

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The aim of the thesis is to explore socially shared ideas about mental illness in everyday contexts. Drawing on social representation theory, organizations for users of mental health services and self-help groups are regarded as communities where social knowledge is constructed that makes intersubjective understanding of illness experiences possible. In order to investigate such knowledge as a resource in joint construction of meaning, a theoretical model is introduced where a distinction is made between a discursive level of situated ‘representational work’ and an underlying level of sociocultural resources. A focus group study was carried out with 27 participants who label their health problems as anxiety, depression or bipolar disorder, and were members of service user organizations. The focus group conversations were analysed with regard to thematic, interactional and discursive features to answer the questions: 1) how is mental illness represented, 2) how is the mentally ill person represented, and 3) how are others’ views on mental illness represented. The results show how mental illness is represented as a complex phenomenon that is contextualised to a number of frames of reference. Further, the analysis identified different types of resources that are utilized in representational work: local knowledge of the communities, medical concepts, different explanatory models, narrative structures, metaphors and conceptual dichotomies. It also revealed dialogical properties of the representational work that have rhetorical functions for self-presentation as a team performance. The discussion suggests that widely shared resources are put to use in group- and situation-specific representational projects, and that representations that are produced in group discourse can be characterised as ‘polemical social representations’ that respond to a double stigma of mental illness in everyday life where mental illness is regarded as a sign of ‘weakness’ as well as ‘otherness’.