Self-concept through the diagnostic looking glass: Narratives and mental disorder

This paper explores how the diagnosis of mental disorder may affect the diagnosed subject's self-concept by supplying an account that emphasizes the influence of autobiographical and social narratives on self-understanding. It focuses primarily on the diagnoses made according to the criteria provided by the Diagnostic Statistical Manual of Mental Disorders (DSM), and suggests that the DSM diagnosis may function as a source of narrative that affects the subject's self-concept. Engaging in this analysis by appealing to autobiographies and memoirs written by people diagnosed with mental disorder, the paper concludes that a DSM diagnosis is a double-edged sword for self-concept. On the one hand, it sets the subject's experience in an established classificatory system which can facilitate self-understanding by providing insight into the subject's condition and guiding her personal growth, as well as treatment and recovery. In this sense, the DSM diagnosis may have positive repercussions on self-development. On the other hand, however, given the DSM's symptom-based approach and its adoption of the Biomedical Disease model, a diagnosis may force the subject to make sense of her condition divorced from other elements in her life that may be affecting her mental-health. It may lead her to frame her experience only as an irreversible imbalance. This form of self-understanding may set limits on the subject's hopes of recovery and may create impediments to her flourishing.