Editorial: self-illness ambiguity and narrative identity

Abstract

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 their illness ever since the dawn of modern (mental) health care. It is therefore exciting, both from a philosophical as well as clinical point of view, that the concept of self-illness ambiguity is increasingly gaining attention. The history of this concept can be traced back to the late 1980s and early 1990s, when qualitative research started to elucidate how complex the relation between ‘self’ and ‘illness’ is from the perspective of the diagnosed individual (see e.g. Estroff 1989; Estroff et al. 1991). Sociologist David Karp coined the term ‘illness ambiguity’ (e.g. Karp 1992, 1994) to explicate the confusion that often arose when psychiatric patients tried to clarify this relation. Psychiatrist John Sadler, drawing on some of this pioneering qualitative research, offered the first philosophical analysis of this phenomenon and coined the term ‘self-illness ambiguity’ to underscore that both sides of the relation are complex and may as such contribute to the ambiguity of the self-illness relation (Sadler 2003, 2007). Recent years have also witnessed a renewed interest in the ‘self’ in the context of psychiatry, not only because of theoretical considerations (e.g. Tekin 2019), but also because of developing trends in mental health care, such as recovery-oriented care, self-management and person-centered care (e.g. Glas 2019; Slors and Strijbos 2020). This in turn has led to a renewed interest in the phenomenon of self-illness ambiguity (e.g. Dings 2020; Dings and Glas 2020). However, there are still various questions about and domains of self-illness ambiguity that demand further consideration. This special issue seeks to facilitate and focus the debates surrounding these questions and to further philosophical and empirical investigations into key domains of self-illness ambiguity.