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.

摘要

“如果我经历了 X，是因为疾病、药物还是‘只有我’？” (Karp 2009) [是我还是我的药物？与抗抑郁药一起生活。哈佛大学出版社]。这个问题被称为自我疾病模糊性（SIA）（Sadler 2007）[“个人自我的精神病学意义”。精神病学：人际和生物过程70（2）：113–129]。在她的论文《了解你自己：双相情感障碍和自我概念》中，Carls-Diamante (2022) [“了解你自己：双相情感障碍和自我概念”。哲学探索，1-17]提供了双相情感障碍与自我和自我概念相关的不同方式的分类。与她似乎采用的精神障碍本质主义模型相反，我对 SIA 提出了不同的看法，遵循将精神障碍视为意义建构障碍的积极方法。一个人理解世界和/或自己的方式可能会陷入一种僵化的模式，这种模式比自己更强大，并且与一个人想要的方式不一致。我认为，区分具体经历的经验性SIA（我是否反应过度/反应不足？ ）和存在性SIA的长期关注（尽管/同时具有某些脆弱性，如何按照对我重要的事情过我的生活）是有帮助的。 ？）。我的结论是，认识自己不是一个个体内部的问题，也不是一个反思的问题：它而是一种关系和物质的实践，试图按照对你来说重要的事情来生活。