The question “What is the relationship between the self and mental disorder?” is especially important for mental health professionals interested in understanding and treating patients, as most mental disorders are intimately tied to self‐related concerns, such as loss of self‐esteem and self‐control, or diminished agency and autonomy. Philosophy, along with the cognitive and behavioral sciences, offers a wealth of conceptual and empirical resources to answer this question, as the concepts of the self and psychopathology have occupied a central place in (...) these fields since their inception. Interestingly, and unfortunately, however, scientific psychiatry, in its approach to mental disorder as primarily a cluster of signs and symptoms has been slow in acknowledging the advances in conceptualizing and investigating mental disorders in relation to the self. The article addresses this problem and offers solutions for better cross‐fertilization between empirical and philosophical inquiry into the self and psychiatric research on mental disorders. The first part evaluates what empirically informed philosophical inquiry and philosophically informed empirical inquiry offer to the examination of the relationship between the self and mental disorders. The second part argues that scientific psychiatry has missed opportunities to find effective treatments for mental disorders because of its insularity from debates in naturalistic philosophy and cognitive and behavioral sciences. Psychiatry has much to gain from the conceptual, scientific, and clinical resourcefulness of philosophy's collaboration with the cognitive and behavioral sciences. (shrink)

In a compelling and provocative paper, ‘Solving the Self-Illness Ambiguity: The Case for Construction Over Discovery,’ Sofia M.I. Jeppsson distinguishes two ways of addressing the self-illness ambiguty problem. The first is the Realist Solution, which postulates a pre-existing border between the self and the illness and frames the goal of treatment in psychiatry as helping the patient ‘discover’ this boundary. Addressing the shortcomings of the Realist Solution, both in terms of its feasibility and possible outcomes, Jeppsson proposes and defends the (...) Constructivist Solution, according to which the patient, through self-reflection and deliberation with others, including the clinicians, decides, which parts of her experiences they identify with themselves and which parts they attribute to their illness. This paper critically evaluates Jeppson’s arguments and addresses some of the shortcomings of Jeppsson’s positive argument, i.e. the Constructivist Solution. (shrink)

Some employ neurological theories of empathy to train medical students and to explain why care work is emotionally exhausting. I argue, however, that these theories develop conceptual and methodological confusion that creates a reductive and misdirected focus in patient-centered care. Neurological theories on empathy do not help us understand patient-centered care, nor do they help us understand why care work can be exhausting. By discussing examples of care work, I argue that empathic attentiveness to patients is a dialogical ethical response (...) to the whole person and takes place in daily care settings of working, helping, and responding to each other. (shrink)

Self-illness ambiguity is a difficulty to distinguish the ‘self’ or ‘who one is’ from one's mental disorder or diagnosis. Although self-illness ambiguity in a psychiatric context is often deemed to be a negative phenomenon, it may occasionally have a positive role too. This paper investigates whether and in what sense self-illness ambiguity could have a positive role in the process of recovery and self-development in some psychiatric contexts by focusing on a specific case of mental disorder – anorexia nervosa.

The article provides a conceptualization of self(-illness) ambiguity and investigates to what extent self(-illness) ambiguity is ‘special’. First, we draw on empirical findings to argue that self-ambiguity is a ubiquitous phenomenon. We suggest that these findings are best explained by a multidimensional account, according to which selves consist of various dimensions that mutually affect each other. On such an account, any change to any particular self-aspect may change other self-aspects and thereby alter the overall structural pattern of self-aspects, potentially leading (...) to self-ambiguity. Second, we propose that self-ambiguity comes in degrees and should be understood as a spectrum (as opposed to there being qualitative differences among instances of self-ambiguity). Third, we argue that complexity is the most useful dimension to organize cases of self-ambiguity, with mundane instances of self-ambiguity on the one end and self-illness ambiguity on the other end of the spectrum. Fourth, we address the promises and perils of narrativity with regard to self-ambiguity. Finally, we link our deflationary account of self(-illness) ambiguity to pattern theories of self. (shrink)

The article provides a conceptualization of self(-illness) ambiguity and investigates to what extent self(-illness) ambiguity is ‘special’. First, we draw on empirical findings to argue that self-ambiguity is a ubiquitous phenomenon. We suggest that these findings are best explained by a multidimensional account, according to which selves consist of various dimensions that mutually affect each other. On such an account, any change to any particular self-aspect may change other self-aspects and thereby alter the overall structural pattern of self-aspects, potentially leading (...) to self-ambiguity. Second, we propose that self-ambiguity comes in degrees and should be understood as a spectrum (as opposed to there being qualitative differences among instances of self-ambiguity). Third, we argue that complexity is the most useful dimension to organize cases of self-ambiguity, with mundane instances of self-ambiguity on the one end and self-illness ambiguity on the other end of the spectrum. Fourth, we address the promises and perils of narrativity with regard to self-ambiguity. Finally, we link our deflationary account of self(-illness) ambiguity to pattern theories of self. (shrink)

Although the concept of self-illness ambiguity is relatively new, the phenomenon is not. It seems likely that people have struggled with the oftentimes ambiguous relation between themselves and the...