Being ‘Framed’ as Delusional: A Sociological Inquiry Towards Epistemic Injustice in Clinical and Lay Ascription

Abstract Although we have gained considerable insight through first-person accounts into the experience of credibility deflation that can accompany the attribution of delusion, its workings may remain somewhat undertheorised in relevant fields such as philosophical psychiatry. Such experience is often linked to negative perceptions or stereotypes, given the association of delusion with formally diagnosed mental health disorders, yet we have a limited explanatory account for the logics and dynamics of testimonial injustice in action. This paper goes back to the sociological work of Bateson (2000 [1955]) and Goffman (1974) on framing theory in order to move us forwards towards new interdisciplinary understandings of how it operates to the detriment of those attributed with delusion. We extend our insights into a reimagined conceptualisation of frame trap, which describes how the frame is reinforced with resistance to it. As this holds the potential to cause considerable and sustained distress through habitualised action, we consider its relevance to those lay-attributed with delusion in the familial context. Contrasting clinical with lay attribution in our analytic discussion allows us to redefine both the epistemic and deontic underpinnings of the framing of delusion, potentially informing better practices of communication through enhanced theoretical understandings.