A Real Affliction: BPD, Culture, and Stigma

What do people with BPD need? When Paula Tusiani-Eng co-founded a BPD non-profit after the tragic loss of her sister Pamela, she realized that we often need more community support. In this interview, Paula tells me about Pamela’s struggle with BPD in the 1990s and how Emotions Matter has built a community for others like her.

If you are having thoughts of suicide, call or text 988 to reach the 988 Suicide and Crisis Lifeline or go to SpeakingOfSuicide.com/resources for a list of additional resources:

Emotions Matter website

Bea Tusiani, Pamela Tusiani, and Paula Tusiani-Eng, Remnants of a Life on Paper: A Mother and Daughter’s Struggle with Borderline Personality Disorder

Evan A. Iliakis et al., “Treatment of Borderline Personality Disorder: Is Supply Adequate to Meet Public Health Needs?”

How can people with BPD find their voice? In this candid interview, the radiant and loving Melanie Goldman (@mindovermelanie) tells me her story of lived experience with BPD, from the shock of the diagnosis to the joys of advocacy and reclaiming her voice. She also shares wisdom from her training as a registered psychotherapist and her ultimate goal of treating others with BPD. 

Can we diagnose the narrator of Osamu Dazai’s novel, No Longer Human, with BPD or some other diagnosis? And does it make sense to try? In this bonus summer solo episode, I give my perspective as a Japanese literature scholar and a person with BPD.

Osamu Dazai, No Longer Human

Osamu Dazai, The Setting Sun

Roland Barthes, “The Death of the Author”

Shirley Dent, “Don’t ‘Diagnose’ Fictional Characters”

Jared D. Fife, “Stuff Psychologists Like—#1. Diagnosing Fictional Characters”

Edward Fowler, The Rhetoric of Confession

Cynthia Gralla, “Suicide Contagion and the Risks of Literature”

Cynthia Gralla, “Dream Girls Gotta Have Agency”

Merri Lisa Johnson, Girl in Need of a Tourniquet: Memoir of a Borderline Personality

Mieko Kawakami, Breasts and Eggs, Heaven, and All the Lovers in the Night

Craig M. Klugman and Carol Levine, “Diagnosing Shosha: Literature As a Lens to View Disease and History”

Herman Melville, “Bartleby the Scrivener”

Yukio Mishima, The Sea of Fertility tetralogy

Ottessa Moshfegh, My Year of Rest and Relaxation

J. D. Salinger, The Catcher in the Rye

Sophocles, Oedipus Rex

Carol Fisher Sorgenfrei, Unspeakable Acts: The Avant-Garde Theatre of Terayama Shūji and Postwar Japan

Narrative medicine at Columbia University

Can a stuffed animal help people to cope with BPD? In this episode, I interview American McGee, the celebrated video game designer and mastermind behind the mental health Plushie Dreadfuls line. We talk about his BPD Rabbit, metaphors and stereotypes, the connection between this bunny and the one in American McGee's Alice, the crowd design process, dark humor, and the controversy surrounding the mental health plushies.

Plushie Dreadfuls website

Lewis Carroll, Through the Looking-Glass

George Lakoff on conceptual metaphors

Ronald W. Pies on mental illness as a metaphor

Donald Winnicott’s concept of transitional objects

Who gets BPD, and are they likely to recover? In this second and final part of my interview with Dr. Sara Masland, she and I discuss the gender distribution for BPD, contemplate the prognosis for people with the disorder based on longitudinal studies (spoiler alert: it’s bright!), and consider what needs to change in medical culture over the next 5 to 10 years. Dr. Masland is a clinical scientist who researches BPD and stigma, a licensed clinical psychologist, an associate professor of psychological science at Pomona College, and an expert in Good Psychiatric Management, a generalist treatment for BPD. 

Resources for this episode:

“The BPD diagnosis is an entry point to understanding how you can get on a road to recovery”: Dr. Sara Masland

Jake Camp et al., “Gender- and Sexuality-Minorized Adolescents in DBT: A Reflexive Thematic Analysis of Minority-Specific Treatment Targets and Experience”

Sara R. Masland and Hannah E. A. Peeples, “People with BPD Need Compassion Yet Even Clinicians Stigmatise Them”

Sara R. Masland et al., “Destigmatizing Borderline Personality Disorder: A Call to Action for Psychological Science”

Sara R. Masland et al., “Longitudinal Course of Borderline Personality Disorder: What Every Clinician Needs to Know”

Craig Rodriguez-Seijas et al., “Is There a Bias in the Diagnosis of Borderline Personality Disorder Among Lesbian, Gay, and Bisexual Patients?” 

Why do we need a generalist approach to treating BPD? Because there are nearly 6000 treatment-seeking people with BPD to every certified, specialist clinician in the United States. In this episode, Dr. Sara Masland explains how she is helping to simultaneously reduce stigma and increase access to care by training others in Good Psychiatric Management. Dr. Masland is a clinical scientist, licensed clinical psychologist, and professor at Pomona College, whose research explores such topics as BPD, stigma, and epistemic trust.   

Trigger warning: This episode mentions suicide.

Resources for this episode:

If you are having thoughts of suicide, call or text 988 to reach the 988 Suicide and Crisis Lifeline or go to SpeakingOfSuicide.com/resources for a list of additional resources.

Alyson E. Blanchard et al., “Testing the Hot-Crazy Matrix: Borderline Personality Traits in Attractive Women and Wealthy Low Attractive Men Are Relatively Favoured by the Opposite Sex”

Lois W. Choi-Kain et al., “What Works in the Treatment of Borderline Personality Disorder”

Emotions Matter, “Supporting Students with BPD: A Guide for Educational Professionals, Parents, and Students”

Ellen F. Finch et al., “A Meta-Analysis of Treatment as Usual for Borderline Personality Disorder”

John Gunderson et al., “Good psychiatric management: A Review”

Evan A. Iliakis et al., “Treatment of Borderline Personality Disorder: Is Supply Adequate to Meet Public Health Needs?”

Susanna Kaysen, Girl, Interrupted

Sara R. Masland and Hannah E. A. Peeples, “People with BPD Need Compassion Yet Even Clinicians Stigmatise Them”

Sara R. Masland et al., “Destigmatizing Borderline Personality Disorder: A Call to Action for Psychological Science”

Sara R. Masland et al., “Longitudinal Course of Borderline Personality Disorder: What Every Clinician Needs to Know”

Why create a children's book about BPD? This is the second half of my interview with Jessie Shepherd, who is a writer, licensed clinical mental health counselor, licensed professional counselor, and director of Blue Clover Therapy. We talk more about her book for children and adults, Millie the Cat Has Borderline Personality Disorder, and muse on the power of children's literature to combat stigma and stir sympathies. 

Episode notes:

Jessie Shepherd, Millie the Cat Has Borderline Personality Disorder

The first part of my interview with Jessie

Charlie Mackesy, The Boy, the Mole, the Fox, and the Horse

Susan Stewart, On Longing: Narratives of the Miniature, the Gigantic, the Souvenir, the Collection 

What are some of the gifts of BPD? Find out from an adorable cat named Millie. Here, I interview Jessie Shepherd—a licensed clinical mental health counselor, licensed professional counselor, and director of Blue Clover Therapy—about her book for children and adults, Millie the Cat Has Borderline Personality Disorder.

Jessie Shepherd, Millie the Cat Has Borderline Personality Disorder

What kind of impact can a small organization make on BPD—in its province and globally? In this episode, I find out by interviewing Baylie McKnight, a co-founder of the BPD Society of British Columbia who has lived experience with the disorder, a master’s degree in social work, and a private practice. She tells me about the extraordinary efforts that the BPD Society of BC has made to expand treatment access and support in BC and around the world through online DBT courses, peer support groups, and other programs.

Trigger warning: The diagnostic criteria for BPD mention about suicide.

Please follow the podcast here or on Instagram so you don’t miss an episode: https://www.instagram.com/a.real.affliction.bpd/

Resources for this episode:

If you are having thoughts of suicide, call or text 988 to reach the 988 Suicide and Crisis Lifeline or go to SpeakingOfSuicide.com/resources for a list of additional resources.

Website for the BPD Society of BC: https://www.bpdbc.ca/

You can find the criteria for BPD in the DSM-5 here: https://www.bpdfoundation.org.au/diagnostic-criteria.php

Why do we need a revolution in the way borderline personality disorder is perceived by the medical field and wider culture? In this first episode of A Real Affliction, host Dr. Cynthia Gralla introduces the interview podcast and her upcoming guests, shares some of her experiences from her decades-long fight with BPD, and explains what needs to change if we are to better support people with this wildly misunderstood disorder.

Trigger warning: This episode talks about suicide.

Resources for this episode:

If you are having thoughts of suicide, call or text 988 to reach the 988 Suicide and Crisis Lifeline or go to SpeakingOfSuicide.com/resources for a list of additional resources. 

You can find the criteria for BPD in the DSM-5 here

Ron B. Aviram et al., “Borderline Personality Disorder, Stigma, and Treatment Implications”

Caroline Walker Bynum, Holy Feast and Holy Fast: The Religious Significance of Food to Medieval Women

Anne Boyer, The Undying

Rebecca Byerly’s NYT article about a marathon runner with BPD

Georges Didi-Huberman, Invention of Hysteria: Charcot and the Photographic Iconography of the Salpêtrière

Sara Rose Masland and Hannah E. A. Peeples, “People with BPD Need Compassion Yet Even Clinicians Stigmatise Them”

Sara Masland et al., “Destigmatizing Borderline Personality Disorder: A Call to Action for Psychological Science”

Marie Ociskova et al., “F*ck Your Care If You Label Me! Borderline Personality Disorder, Stigma, and Self-stigma”

Christina Vanvuren, “The History of Hysteria: Sexism in Diagnosis”

Simone Weil, “Human Personality”