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This doctoral thesis examines how existential isolation is experienced by individuals diagnosed with borderline personality disorder (BPD) in a UK context. BPD is a diagnostic construct within the medical model of human distress and individuals receiving this diagnosis are at significant risk of hospitalisation, self-harm, and suicide. From an existential-phenomenological perspective, BPD-associated distress can be interpreted as disclosing one’s embeddedness in, and response to, existential givens. Of these, existential isolation, the experience of a fundamental separateness between self and others/world, appears significant throughout the literature. However, to the author’s knowledge this is the first study to directly investigate existential isolation in BPD experience. In this interpretative phenomenological analysis, six people with a recent diagnosis of BPD explored their experience of existential isolation in semi-structured interviews. Three interrelated themes were developed in a hermeneutic approach to interview transcript analysis: existential isolation is an embodied, pervasive experience associated with meaninglessness and death; intrapersonal isolation inhibits experience of connectedness with others and world; and relational paradox contributes to existential isolation. These themes are contextualised in contemporary phenomenological research and theory. Existential isolation is interpreted as a characteristic of the phenomenal field associated with alienation from affectivity and subjectivity. Implications for training and clinical practice are discussed: these include the importance of developing client subjectivity through engagement with affect, finding a balance between empathy and separateness, and managing own discomfort around existential contingency.

This thesis develops a grounded theory of clients' experiences of therapists' nonverbal embodied communications (NVECs). Therapists' NVECs have received relatively little attention in the empirical and theoretical literature. Until now, NVECs have been discussed across various therapeutic models; however, the impact of therapists' NVECs on clients, from clients' perspectives, has been largely overlooked. In this proposed study, 10 former clients took part in semi-structured interviews and talked about the perceived impacts of their therapists' NVECs on them and the process of therapy. Transcripts were analysed using a grounded theory methodology from a critical realist framework. The resultant theory shows a connection between therapists' level of acceptance of their NVECs, which is comprised of different degrees of awareness, acknowledgement, and allowance, and clients' emotional engagement within therapy, which is manifested as feeling seen, wanting to help the therapist in helping them, opening up and emotional buy-in. The theory also shows the significance of a special therapist-client connection which is formed partly influenced by the above processes and partly by the modifying role of contextual factors involved. The study speaks to the current practice-based evidence on influential factors in therapy and the therapeutic relationship and endeavours to enhance our understanding of the impact of therapists' NVECs on clients and the therapeutic process. Understanding how clients perceive therapists' NVECs will contribute to a valuable and holistic perspective to practice, training and policy of counselling psychology (CoP) as well as other related professions. Further implications and indications for future research are discussed.

Focusing oriented therapy is based on humanistic and existential-phenomenological theory (Gendlin, 1996) and encourages clients to connect with their "felt sense" experiencing of the present moment by tuning into their bodies. In the literature review, I review relevant theories of embodiment and the theory and research behind focusing as a technique and as a therapy. I also illustrate how focusing relates to counselling psychology. While there is a substantial body of research highlighting the effectiveness of focusing as a therapeutic approach, clients' experiences of focusing oriented therapy have not been fully conceptualised. My research question was therefore "what are clients' experiences of focusing oriented therapy?" I interviewed six clients of focusing oriented therapy using an unstructured interview style, exploring their experiences of their therapy, aiming to identify the core essence of focusing oriented therapy from their perspectives. Colaizzi's (1978) descriptive phenomenological method was used to analyse the data and five main themes and several sub-themes were identified. The main themes were, 'a way to find true north,' 'voyage through murky waters,' 'the journey that begins with a single step,' 'temporal investigations,' and 'the self-driven revolution.' Throughout these themes, a number of new pieces of knowledge were identified. My co-researchers described focusing oriented therapy as being better and more beneficial than both mindfulness and CBT, leading to longer lasting and deeper changes than either other approach. Focusing allowed them to really tune in to their bodies which gave them access to imagery that helped them describe in great detail, and make sense of, what they were experiencing. Through this process, my co-researchers described how they learned how to support and be there for themselves, rather than needing to rely on others and each even incorporated focusing practice into their daily lives. Clinical implications of these and other findings are explored in relation to therapists' use of therapy and ways in which focusing could be incorporated into the practice of second and third wave CBT to enhance its practice. Areas of further research are identified, including exploring clients' experiences of their therapists being in therapy, embodiment and the link between focusing and CBT.

In this thesis, I develop a constructivist grounded theory of the process by which counselling psychologists (CoPs) make decisions about touching their clients. Clinician-client touch is widespread, yet controversial - because it may be experienced as harmful or beneficial. However, practitioners across disciplines report little-to-no training, and their accrediting bodies offer no explicit guidance, on touch in clinical practice. Consequently, they lack confidence and competence in this area, and are fearful of, and vulnerable to, accusations of bad practice. Despite the clinical criticality of CoPs' touch-decision-making, there is no existing research on it. Therefore, I recruited nine CoPs and, as a form of negative case analysis, a clinical psychologist and two clinicians who work with the body, and interviewed them about their touch-decision-making. My resultant theory constitutes a dual process model of decision-making centring on the core category "weighing the predicted balance of appropriateness", whereby clinicians use an embodied sense of "felt appropriateness" and a cognitive process of "considering the appropriateness" to assess the extent to which they anticipate a given "touch-related action" will be experienced as minimising harm and maximising therapeutic benefit. My overarching aim was to facilitate best practice in CoPs' touch-decision-making by evaluating, thence recommending changes to, relevant existing models, guidelines, and training. My recommendations centre on the development of a "CoP stance" towards touch and decision-making about touch - henceforth, "touch(-decision-making)" - and promoting talking about touch. Indications for future research include furthering the saturation and scope of my theory in relation to the impact of "gender-and-sexuality" on CoPs' touch-decision-making, because my theory indicates they may use touch differentially in response to socially-derived gender- and sexuality-based norms and assumptions.

Despite an emerging presence of diverse gender identities within the UK and increasing numbers of gender diverse youth seeking psychological support, little is known about their lived experiences. Non-binary youth (those who identify outside the commonly assumed gender binary) face particular challenges navigating a male-female society, yet research is missing their voices. This research responds to calls from communities and literature to centrally involve young people in research to develop affirmative practice. This dual-phase qualitative exploration of non-binary young people's experiences (16-25) incorporates participatory methods including collaborative research question development.

In this study, lived time within the therapeutic encounter was explored phenomenologically. Five Counselling psychologists and two Existential psychotherapists were interviewed and the resulting data was analysed using Interpretative Phenomenological Analysis. Three super-ordinate themes emerged: Tacit Temporality, the first theme, speaks of the inherently relational nature of lived time emerging as co-creational dance between client and therapist; when therapist is ‘in time’ with their client she seems to move beyond clock time. The second theme, Overt Temporality, refers to experiences when the presence of clock time has taken over therapeutic presence and therapist experience being ‘out of time’ with her client. Arising ‘Temporal-ing’, the third theme, signifies that therapist and client constantly create their experiences of lived time ‘through’ the other as a dynamic process of constant emerging ‘in-time’ and ‘beyond-time’. Implications for practice are discussed in terms of highlighting opportunities for deep attuned connection to the client’s lived experience of time and addressing challenges to the therapeutic alliance. The findings are discussed as well as limitations of the study and suggestions for future research.