A Real Affliction: BPD, Culture, and Stigma

“He was provoking all these symptoms he had wanted to cure”: Nina Shope, author of Asylum

How have power dynamics between doctors and patients changed over the past century and a half? In my second and final interview with Nina Shope, author of the award-winning historical novel Asylum, we talk about the complicated relationship between neurologist Jean-Martin Charcot and his most famous patient as he treated her for hysteria and documented her in photographs during the 1870s. Nina reflects on the photograph of Augustine that she chose to include in her novel, how she avoided flattening historical figures or reducing Augustine to past trauma, and the mythological roots in both the history of female madness and Charcot’s photography.
Nina Shope, Asylum
Nina Shope, “Changeling.” Conjunctions, Vol. 81 (“Numina: The Enchantment Issue), Fall 2023
Roland Barthes, Camera Lucida
Maud Casey, The City of Incurable Women
Georges Didi-Huberman, Invention of Hysteria: Charcot and the Photographic Iconography of the Salpêtrière
Euripides, The Bacchae
Saidiya Hartman, Wayward Lives, Beautiful Experiments
Susan Sontag, On Photography
Selby Wynn Schwartz, After Sappho
Emily Wells, A Matter of Appearance

“I was fascinated with showing the things behind hysteria that were being erased”: Nina Shope on Asylum

What did BPD look like in the 19th century? It looked like hysteria, a phenomenon that puzzled doctors and fascinated the public. In this episode, I interview Nina Shope, author of the award-winning historical novel Asylum, which explores the power dynamics between Jean-Martin Charcot, the father of neurology as we know it today, and his most famous patient. In the shadows of this dynamic, we find symptoms and conceptualizations of female illness familiar to those of us who experience or study BPD today.
Nina Shope, Asylum
Christopher Bollas, Hysteria
Georges Didi-Huberman, Invention of Hysteria: Charcot and the Photographic Iconography of the Salpêtrière
Sarah Shun-lien, Madeleine Is Sleeping
Elaine Showalter, The Female Malady

"Insurance companies are breaking the law": Paula Tusiani-Eng of Emotions Matter

How can we access expensive care? In the US, being diagnosed with BPD is often the first step in an odyssey through a complex and unjust health care system. In the second part of my interview with Paula Tusiani-Eng, co-founder of Emotions Matter, she discusses how to get life-saving coverage from your insurer, the wonderful success of her organization's peer support groups, the wild creativity that many of us with BPD have, and why we need an intersectional approach to treating and supporting 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:
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
Frank Yeomans, Paula Tusiani-Eng, and Kellyanne Navarre, “California Approves Law Granting Pretrial Diversion for BPD”

What I wish I’d known about getting a PhD with BPD

In this solo bonus episode, I talk about what I learned while getting my MA and PhD at Berkeley and offer tips for anyone who wants to pursue a higher education degree while managing their BPD. It can be done!

“How do I meet other people with BPD?”: Paula Tusiani-Eng of Emotions Matter

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?”

“I Love Us”: Melanie Goldman on living with and treating BPD

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. 

Is No Longer Human about BPD—and should we even ask that question?

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

“These are like emotional, psychological Trojan horses": American McGee's BPD Rabbit

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

“Folks with BPD are some of the brightest lights in my life”: Dr. Sara Masland

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?” 

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

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”