‘Is it me or my illness?’: self-illness ambiguity as a useful conceptual lens for psychiatry

The complex relation between a person and their mental disorder is a recurring theme in (reflections on) psychiatric practice. As there is no uncontested concept of 'self', nor of 'mental disorder', the 'self-illness' relation is riddled with ambiguity. In this feature article, we summarise recent philosophical work on the phenomenon of 'self-illness ambiguity', to provide conceptual tools for psychiatric reflections on the self-illness relation. Specifically, we argue that the concept of self-illness ambiguity may contribute to patients' self-understanding and shed light on how paradigms of care and research should be revised in order to help clinicians support that self-understanding. We also suggest that the concept of self-illness ambiguity may improve the understanding of particular mental disorders, and may offer conceptual tools to address various ethical matters (including stigma and responsibility).