November 29th, 2023. 3:30 pm.
Venue: Carlos Santamaria Zentroa, room 3.
Abstract:
Recent discussions in philosophy of psychiatry, especially the ones centering on self-illness ambiguity (Dings & Glas 2020), underscore different roles that acquiring a psychiatric diagnosis may play with respect to identity. In some cases, a newly acquired diagnostic label may be interpreted in explanatory terms, as a way to better understand “what is wrong” with oneself and to make sense of dystonic feelings and behavior. This is often the case, for instance, with depressive disorders: through the diagnostic process, the person makes sense of psychological and emotional changes that are experienced as unpleasant, such as the loss of motivation towards everyday interests and activities. In these contexts, people often seek a diagnosis exactly because they feel like they are not being “their usual self” or that “something isn’t right” (Kokanovic et al., 2013). In other cases, receiving a psychiatric diagnosis seems to play a revelatory role, as it allows one to improve self-understanding and to clarify one’s relation to others and the world. For example, autism diagnoses – especially when assigned in adulthood – are often experienced as affording deeper understanding of one’s own identity. In still other cases, diagnosis appears to play a transformative role and to bring about the creation of a new identity. This process seems to be more constitutive because it modifies one’s relationship with oneself in significant ways. Again, first-person accounts of autistic people diagnosed in adulthood support this point: “I viewed myself as a misfit, a retarded genius, a freak […] the spectrum gave me a new identity” (Botha et al. 2020).
In this talk I set out to propose a finer-grained account of the complex relationship between diagnostic status and identity. I start out by discussing diagnosis as a process. In doing that, I build on work that has been conducted in philosophy of information (Floridi 2014) to reframe the diagnostic process as one in which the person seeks to acquire a body of information about oneself. I set out to describe the diagnostic process as an epistemic enterprise, delving deeper on its explanatory, revelatory, and transformative components. Then I move on to describe diagnosis as a status and I argue that – once the diagnostic process is completed – a new set of questions opens up. Most of these questions concern (again) how to deal with the newly acquired body of information, e.g. who has the right to access it, whether and how one should disclose it, and so on. I conclude by showing that acquiring a psychiatric diagnosis exhibits a dual nature that may lead to positive or negative outcomes. On the one hand, it affords access to intervention and care and may open up new paths of affiliation to existing communities. On the other hand, it makes a person more vulnerable to stigma due to socio-material circumstances of discrimination.
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