I wrote in my first blog post about the interplay between identity and mental disorder as described in a Social Science and Medicine paper relating to the expression of identity in women with atypical sexual development.
I am interested in identity as it relates to the nature and experience of mental disorder and personal recovery experiences.
Vertical and Horizontal identities
Solomon (@andrew_solomon) (Solomon, A. (2013). Far from the Tree. Vintage Chatto & Windus) presents a series of narratives describing the experiences of children and parents where the child’s identity does not develop as the parent’s anticipated – either through physical or mental disorder or other factors. He describes two forms of identity:
- Vertical identities – inherited from our parents
- Horizontal identities – adopted ourselves through peer group interactions.
Personal recovery and identity
I’ve been thinking about the nature of identity in relation to my own research on personal recovery in mental disorder. Leamy, Bird and colleagues published a review of the available literature relating to personal recovery in mental health (Leamy, M., Bird, V., Le Boutillier, C., Williams, J., & Slade, M. (2011). Conceptual framework for personal recovery in mental health: systematic review and narrative synthesis. The British Journal of Psychiatry, 199(6), 445–452. doi:10.1192/bjp.bp.110.083733).
They identified five significant themes within the recovery literature:
Hope is widely recognised as being essential for personal recovery – in the absence of hope there can be no motivation for personal change and therefore no recovery. If we consider the remaining four elements I believe that they can be collapsed down into one factor – Identity with constituent parts:
A formulation of personal identity and personality
- Heritable components (race etc)
- Social network positioning
- Experience of power relations
- Narrative coherence
By social network position I mean our position within networks of family members and friends, as well as possibly our adopted role in society, for example employment.
Experience of power relations refers to our past efforts of autonomous expression. For example – if expression of some element of the self is met by resistance from society we may well make efforts to not express that part further.
Narrative coherence relates to our longitudinal sense of self. This is an example of one of two competing theories of identity that build on the work of Locke (Locke, J. (1997). An essay concerning human understanding. Penguin Books).
Building on this formulation what is personality? I would argue that personality represents the interpersonal manifestation of personal identity. This raises an interesting question in relation to the concept of personality disorder – what exactly is disordered? I’ve written about this previously.
- Psychological identity theory
A person is the same person (identity) when direct sequential memory links between two discrete points in time can be drawn. There must be a sufficient amount of memory connection.
- Narrative identity theory
- A person’s identity consists of a unifying narrative of purpose and experience.
Varying strengths of the narrative claim and the merits of psychological identity have been widely discussed (Beck, S. (2013). The misunderstandings of the self-understanding view. Philosophy.
Lumsden, D. (2013). Whole life narratives and the self. Philosophy, Psychiatry & Psychology 20(1), 1–10. Schechtman, M. (2005). Personal Identity and the Past. Philosophy, Psychiatry, & Psychology, 12(1), 9–22. doi:10.1353/ppp.2005.0032)
From my personal experience I find a great deal of merit in the narrative understanding of identity. I think this also has resonance in the experience of those who experience distress and trauma, as argued by Phillips (Phillips, J. (2013). On narrative: Psychopathology informing philosophy. Philosophy, Psychiatry & Psychology 20(1), 11–23). In contrast I find the psychological formulation of identity through memory somewhat disjointed and difficult to apply to my own experience.
I think there is substantial overlap here with a recent paper offering a review on the progress of work in relation to eudaemonia (Ryff, C. D. (2014). Psychological Well-Being Revisited: Advances in the Science and Practice of Eudaimonia. Psychotherapy and Psychosomatics, 83(1), 10–28. doi:10.1159/000353263).
Ryff presents six aspects of the self in relation to eudaemonia:
- Purpose in life
- Environmental mastery
- Positive relationships
- Personal growth
This overlap is interesting – my own experience and interest in personal identity has grown from my clinical experience in psychiatry and personal reading. Aspects of Ryff’s research have obviously been applied in the psychological sciences and I think there is some interesting work here in relation to outcome measures that I intend to explore further.