Hermeneutical Injustice in the Attribution of Psychotic Symptoms with Religious Content

Abstract: In this paper, I argue that a special kind of hermeneutical injustice occurs when someone is not permitted to interpret their experiences in a meaning-making way. I suggest that this occurs in certain cases where the possibility that the patient has a genuine religious experience is excluded by a medical diagnosis. In such cases, it is not that an experience is incomprehensible because of the absence of a valid interpretation. Instead, one perspective is not only dominant but exclusive, so the ensuing power imbalance is absolute. I begin by introducing the notion of hermeneutical injustice and subsequent refinements that have been instrumental in applying it to psychiatry. Then I show how even though voice-hearers are liable to be victims of such injustices, the literature has neglected the specific harm done to someone whose interpretation of their own experience is obliterated because of the dominance of exclusive medical views. To illustrate this, I point to a case that evinces the harms perpetrated toward patients diagnosed with psychotic symptoms with religious content and argue that depriving persons of meaning-making interpretations of their own experiences constitutes a profound and willful form of hermeneutical injustice. I then gesture toward studies on the religious reframing of anomalous experiences through contact with a normalizing framework. Finally, I pry from a successful case a general directive toward the virtue of hermeneutical justice through the attitudes of respect to first-person authority and the hermeneutical flexibility it embodies.