Week 3 of our Mental Health Awareness Month posts come from Jodie Russell, a 3rd year PhD researcher at University of Edinburgh whose research explores the intersection of mind and medicine. In this guest post, she explains how our concept of the self can influence mental health.

I was awoken yesterday morning by a rather sheepish-looking boyfriend, hesitating to tell me, just before leaving for work, he’d finally caught Mr Mouse. I got up to examine the scene, and sure enough there he was, our furry neighbour, under an old take-away tub in my office, of all places. Neither of us wanted to touch him, as cute as he was, so it was on me to find someone to humanely evict him from our flat.

After a nervous shower – that scene from ratatouille in the kitchen playing out in my mind – I sat down to call pest control. From waking up and seeing the mouse to actually getting hold of a professional it took me a total of half an hour to get someone on the phone, shower included. Then it struck me: I’ve been meaning to call the doctor for several months now. It’s nothing serious, I just need to re-up my prescription for the contraceptive pill, but I have only one packet left. The clock is ticking. Why has it taken me so long?

It wasn’t until I was sitting in a talk between the incredible philosophers Miranda Fricker and Havi Carel (for which Mr Mouse was actually present, just so you know) that the nature of the anxiety became apparent. Together, these philosophers were bringing their expertise on phenomenology and testimonial injustice to talk about taking seriously the lived experience of people with medical conditions. This is a topic I’ve been writing and thinking about for my PhD in relation to mental disorders; the epistemic tools we have make an important difference, I’m arguing, not only for how we understand ourselves – and others – but in a material sense what we can do.

Who I Think Myself To Be

In essence, the kind of person I think myself to be shapes what I perceive as possible actions I see as possible for someone like me. The way I think of myself also closes certain possibilities of action for me and even prohibits actions. Being a fierce protector of nature means I can’t poison Mr Mouse, but being a person concerned for her hygiene I could certainly remove him from his (my) home.

This applies to how others think of you too; in epistemic injustice our capacity to give validated testimony can be compromised by the conceptual tools we have to understand and communicate our experience but it can also be adversely affected by how other people perceive us. This becomes pertinent when talking about interactions with the medical establishment.

In more recent years there has been evidence that the kind of treatment one receives, or whether one receives treatment at all, can be influenced by factors such as gender and race. Such experience can be seen in the case of Black actor David Harewood, for example, who was hospitalised after a psychotic episode. These types experiences of medical negligence – and harm – can be as a result of testimonial injustice where the first-person accounts of particular individuals with health issues are given less credibility based on the kind of person they are perceived to be.

Was I experiencing some testimonial injustice from my doctor? Not at all. But I became aware in that academic talk that my anxiety to make the call was due to a fear that my needs may not be perceived as credible. After all, I’m asking for more contraception, not a life-saving drug, and with the recent news on Roe vs Wade it was acute to me that not everyone, even very important people, see this medication as part of safeguarding people from people becoming pregnant, with the health and social consequences this comes with.

I was afraid about what my request for medication says about the person that I am. Will the doctor think I’m some kind of extremist anti-natalist, making a political point? Or that I’m some sinful, sexually liberated hussy, flagrantly subverting the traditional family dynamic? I exaggerate somewhat – and I will now be changing my twitter bio to “sexually liberated, anti-natalist hussy” – but the kind of medication I am asking for comes pregnant with (pardon the pun) meaning. I fear what the medical establishment may read into that.

Use Your Experience

The aim of this piece is not, however, how I’m going work up the courage to call the doctor but, rather, how conceptualisations of the self interact with mental illness. Whether you conceptualise yourself as having symptoms of a mental disorder or not will influence whether you see the medical establishment as possibilities for treatment; if we don’t give our experiences credibility then we may not feel treatment is appropriate or we may see it as out of reach, for example, if we believe resources are scarce and others are in greater need. The problem of credibility is made trickier when treatment is gate kept by individuals that also must give credence to your testimony. We can see already how epistemic injustices can arise, both on our own part and on the part of medical institutions.

Our experiences and expressions of who we are as people, as well as what kinds of people we are projected to be by others, and the demands on our behaviour that this might come along with, comes impregnated with meaning. A lot of that meaning may be out of our control; society at large might, we hope, change their mind on whether the contraceptive pill counts as essential, life-saving medicine.

My point, however, is to ask you, the reader, to, at the very least, give yourself credibility. Don’t allow yourself to take your experiences of your mental anguish less seriously than the experiences of others. Be aware of the perception of yourself and others that might make you feel like these are less valid. Taking yourself as a credible witness to your own experiences of mental illness – which, in fact you are, – is the first step to open up those opportunities to transform that experience for the better.

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