What’s special about ‘not feeling like oneself’? A deflationary account of self(-illness) ambiguity

Abstract

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 selfambiguity). 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 selfambiguity. Finally, we link our deflationary account of self(-illness) ambiguity to pattern theories of self.

Obsessive-compulsive disorder and recalcitrant emotion: relocating the seat of irrationality

“…Here, the challenge becomes to explain the nature of such evaluative construals in a way that imputes enough irrationality to recalcitrant emotion. To highlight this challenge, Helm (2001) draws an analogy between recalcitrant emotions and 13 The self-ascription of thoughts, beliefs, or emotions linked to the disorder raises interesting questions with respect to the "self-illness ambiguity" phenomenon (see Sadler 2007;Dings and de Bruin 2022). One might think that it matters for questions about irrationality whether a person ascribes a particular thought, emotion, etc.…”

The Role of Self-Illness Ambiguity and Self-Medication Ambiguity in Clinical Decision-Making

“…The X is the ambiguating factor; the thing that makes it unclear whether it is themselves or X that is making them desire, feel or do Y. There are numerous potentially ambiguating factors, coming from all domains of everyday life (Dings and De Bruin 2022), but in the context of clinical decision-making for patients with psychiatric problems it is particularly self-illness and self-medication ambiguities that are relevant.…”

Examination of self patterns: framing an alternative phenomenological interview for use in mental health research and clinical practice

“… 3 Several studies have indicated the viability of the PTS as a basis for understanding mental disorders ( Dings and de Bruin, 2016 ; Fingelkurts and Fingelkurts, 2017 ; Baird, 2019 ; Fingelkurts et al, 2020 , 2021 ; Neustadter et al, 2021 ; Ciaunica et al, 2022 : Dings and de Bruin, 2022 ; Zawadzki, 2022 ; Giommi et al, 2023 ), or more broadly for self-understanding ( Newen, 2018 ; Lindahl and Britton, 2019 ; Motta, 2023 ). …”