ABSTRACT‘If I experience X, is it because of the illness, the medication, or is it ‘just me’?’ (Karp 2009) [Is it me or my Meds? Living with Antidepressants. Harvard University Press]. This issue is known as self-illness ambiguity (SIA) (Sadler 2007) ["The Psychiatric Significance of the Personal Self." Psychiatry: Interpersonal and Biological Processes 70 (2): 113–129]. In her paper Know Thyself: Bipolar Disorder and Self-concept, Carls-Diamante (2022) [“Know Thyself: Bipolar Disorder and Self-Concept.” Philosophical Explorations, 1–17] offers a taxonomy of different (...) ways in which Bipolar Disorder can be related to one’s self and self-concept. In contrast to the essentialist model of mental disorders she seems to adopt, I propose a different outlook on SIA, following an enactive approach to psychiatric disorders as disorders of sense-making. One’s way of making sense of the world and/or oneself can become stuck in a rigid pattern that is stronger than oneself and at odds with how one would want to be. I argue that it is helpful to distinguish between the experiential SIA of specific experiences (Am I over/underreacting?) and the long term concerns of existential SIA (How to live my life in accordance with what matters to me despite/while having certain vulnerabilities?). I conclude that knowing oneself is not an intra-individual matter, nor primarily a matter of reflection: it is rather a relational and material practice of trying to live your life in accordance with what matters to you. (shrink)

Adult persons normally are taken as prima facie authorities regarding their own avowed interests, so that an accusation of self-deception with respect to such interests troubles our default presumptions. Furthermore, the difficulty, in practice, of knowing when such accusations are warranted presents a peculiar obstacle to moral justification, inasmuch as knowing how the interests of various persons really are likely to be affected by some act or norm is an accepted preliminary to moral justification across a wide range of theoretical (...) approaches and is, in some cases—such as in contractualist accounts—decisive. I argue that a careful examination of the pragmatics of coherent allegations of self-deception shows them to rely on a form of ‘proleptic’ argument, and that the truth- or validity-conditions for such utterances lie in the transformative appropriation of the one so accused. (shrink)