Internal Research WiP: Dr Doug McConnell

Self-illness ambiguity in addiction

Patients who are diagnosed with a mental disorder often find it difficult to make sense of themselves in relation to their mental disorder. Specifically, they have problems with distinguishing their ‘self’, or ‘who they are’, from their mental disorder or diagnosis (Sadler 2007;  Dings & Glas 2020; Dings 2020). This phenomenon is also called ‘self-illness ambiguity’, and it is expressed in statements such as “Is it me or my mental disorder?” and “I don’t know who I am anymore”. We will discuss how self-illness ambiguity presents in the context of addiction and use a narrative account of addicted agency to add some detail to the concept of self-illness ambiguity. Addicted people may be unsure as to the authenticity of their values (Do I value drug-use that highly or is it my addiction causing me to value them that highly?) and/or addicted people may be unsure as to the authenticity of their self-narratives (Is my established addiction self-narrative really mine or has my addiction determined the content of my narrative so it is not really a self-narrative after all?). Furthermore, people can experience self-ambiguity between their evaluative stance and their self-narrative (Am I what I value or what is described by my established self-narrative?). This means that if one wholeheartedly values recovery but sees one’s narrative as determined by illness, then SIA can rear its head again if one doubts whether the evaluative stance or the self-narrative best represents who one really is.

This internal talk is for Oxford Uehiro Centre members and associates.

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