CW: Suicide, self-harm

I’m Alexandra, a philosophy PhD candidate at the University of Toronto. I am the co-founder and former co-chair of the department’s Mental Health & Disability Caucus (MH&D), an initiative that promotes mental health and disability visibility in academia. Currently, I co-organize the Mental Health & Disability Network, an expansion of MH&D that connects philosophy graduate students internationally. And last year – nearly 4 years into my PhD, at nearly 30 years old – I was diagnosed with Borderline Personality Disorder. In this blog, I will talk about my experiences and how it has shaped me as a PhD student to date.

Understanding BPD

What is Borderline Personality Disorder (BPD)? Essentially, it’s an emotional dysregulation disorder: generally speaking, people with BPD experience intense and unstable emotions that they have a difficult time managing. According to CAMH, common signs and symptoms of BPD may include:

• intense but short-lived bouts of anger, depression or anxiety
• emptiness associated with loneliness and neediness
• paranoid thoughts and dissociative states in which the mind or psyche “shuts off” painful thoughts or feelings
• self-image that can change depending on whom the person is with
• impulsive and harmful behaviours such as problematic use of substances, overeating, gambling or high-risk sexual behaviours
• non-suicidal self-injury such as cutting, burning with a cigarette or overdose that can bring relief from intense emotional pain (onset usually in early adolescence); up to 75 per cent of people with BPD self-injure one or more times
• suicide (about 10 per cent of people with BPD take their own lives)
• intense fear of being alone or of being abandoned, agitation with even brief separation from family, friends or therapist (because of difficulty to feel emotionally connected to someone who is not there)
• impulsive and emotionally volatile behaviours that may lead to the very abandonment and alienation that the person fears
• volatile and stormy interpersonal relationships with attitudes to others that can shift from idealization to anger and dislike (a result of black and white thinking that perceives people as all good or all bad).

This diagnosis, given to me just last summer, has answered a lot of questions (“Is that why I take criticism as a sign of deep, personal failure?”). I’m thankful for it. Still, the choice to “go public” has been difficult. BPD is heavily stigmatized, and so-called “Cluster B” personality disorders (of which, BPD is one) are even more so. And yet, these kinds of diagnoses are not so rare: close to 10% of the population is thought to have a personality disorder. In academia, where an undeniable mental health crisis persists, one wonders about the potential abundance of these kinds of disorders, too (which are often comorbid – that is, co-occurring – with mood disorders like depression or bipolar disorder).

The difficulty is that these kinds of disorders are just not well understood. But they aren’t understood because they aren’t seen. I’m a passionate advocate for mental health and disability visibility in academia, and stigma is decreased when visibility is increased – or so I believe. That’s why I share here how my BPD is more than just a fact about me; rather, it makes me the particular kind of philosopher I am.

For me, the PhD with BPD looks like this

The week starts as usual: with my morning medications. I sip decaf coffee, I’m sure to eat something so that the pills metabolize properly. I start counting the glasses of water I have left to drink. If I don’t fulfil each of these small preconditions for the day, my disorder looms large. Caring for myself has become like caring for a delicate plant. A look at the calendar tells me there are practice job talks to attend, final exams and final papers to grade, and my usual three hours of therapy to fit in between. 

The first meeting of the week is with a student of mine. I feel all of their building frustration, their intense anxiety, and it’s not long before my nervous system is overwhelmed. I practice “grounding” while working through their essay with them, an attempt to self-regulate. While they speak, I imagine my feet are rooted to the floor. I am solid, I am stable. They’d never know it, but I’m near panic. When we disconnect, I’m as frustrated and anxious as they were. In this case, that means that I spend the day ruminating about everything I should have said. I feel like I’ve failed my student.  I clean my apartment methodically, an attempt to distract myself from the growing grief. By the end of the day, I’m wondering if there’s even a place in academia for someone like me. I fall into bed after midnight, knowing I have two hours of group therapy to save my energy for. As I wait for sleep, I’m hopeless.

I go to group DBT – Dialectical Behaviour Therapy – for 2 hours in the middle of my Tuesday. I break my day up into two unequal chunks, planning for the long come-down after therapy. I drink an extra glass of water. In therapy, we learn mindfulness. We learn new skills in emotion regulation and distress tolerance. We learn that, for any emotion we feel, we must pause to judge: is this emotion appropriate? If so, is this intensity appropriate? After therapy, I write ‘R.E.S.T.’ (Relax, Evaluate, Set an intention, Take action) on every mirror in my apartment so that I can’t forget. Then, I receive an email: the student from yesterday! They express appreciation for our “helpful” meeting, and I mean it when I tell them I’m absolutely thrilled! For the rest of the day, I’m sky-high! The mood carries into my grading, and I’m burning through essays with an almost-manic energy. I message my friends that I appreciate them, I’m bold and vulnerable. After all, I’m helpful! I’m something. I listen to music while I clean my apartment, maybe I dance with my cat. I jump into bed well after midnight.

Wednesday it’s individual therapy first thing in the morning (to “get it out of the way”). You’d think that by now, I’d have invested in some tissues. Instead, it’s always a roll of toilet paper that I bring to my online sessions. Here, I’m provided a safe space to feel the big emotions I’ve learned to over-regulate throughout the day. I feel and talk and process. I’m unsurprised to discover that I feel ashamed of yesterday’s exuberance: I forgot to use my DBT skills. For me, shame quickly turns into self-hatred if I’m not careful. In therapy, I process the shame in a healthier way, imagining an ocean big enough to hold all of my rage. I do this and I cry; I wish I wasn’t the way I am. Then, my day starts.

Thursday is a blur – I’m emotionally exhausted. Friday, the Mental Health & Disability Caucus meets. We talk about our challenging months and the unique struggles we share. We talk about therapy, medication changes, the labyrinth of disclosure. Each of us has been told at least once in our short careers that we shouldn’t disclose (this from both junior and senior faculty). But this amounts to being complicit in an ableist system: by not speaking we encourage our colleagues and students to think of their own disabilities as something to be hidden. I know that internalized shame, and I can’t agree that its continuation is the solution to academia’s mental health crisis. We end the session with words of gratitude and appreciation, each of us already thinking about the job talk or grad forum we have to attend next. The weekend slips by, and Monday it begins again.

The choice to embrace emotion

Philosophically, my disorder has raised some interesting questions. As a philosopher of the emotions (my research focuses on love, especially romantic love), I’ve questioned whether I have any business doing the kind of work that I do. I know my emotional experience is atypical, so how can I possibly write about the emotions faithfully? 

Ultimately, I’ve accepted this challenge and decided to tackle it head-on, embracing my unusual emotional experience as an insight into the nature of emotions and their reasons. This is the same attitude I take toward my dissertation, in which I argue other philosophers ought to pay more attention to the way love feels. In it, I’m trying to understand the way love operates in a world that I’m not quite in sync with, ultimately arguing that the way things feel is of more theoretical importance than perhaps most philosophers can recognize.

And so there is a need for people like me in philosophy; those with disabilities still have insight that is invaluable to philosophical progress. Our experience may be atypical, but this is exactly what makes our perspectives so essential: it’s exactly this that gives us insight into the phenomena we study. I don’t think this is just a story I tell myself so that I can feel I belong. Rather, I think it’s the start of something new for philosophy and academia as a whole – or so I hope.

Alexandra Gustafson is a Social Sciences and Humanities Research Council (SSHRC) Canada Graduate Scholar and a PhD candidate in philosophy at the University of Toronto. Her research focuses primarily on the phenomenology of love, especially romantic love.