Queen of the Owls: Metaphor and Identity in Psychiatric Diagnosis

Abstract

Clinical social workers’ commitment to social justice makes them acutely concerned about discrimination and dis-empowerment, and thus they are sensitive to the impact of stigma on persons diagnosed with a mental disorder. At the same time, it is important to explore whether clinicians’ assumptions about psychiatric diagnoses as stigmatizing mesh with the views and experiences of those who actually receive and live with these diagnoses. To address this question, in-depth interviews were conducted with 30 individuals carrying a range of psychiatric diagnoses. Narrative and thematic analysis yielded several distinct narratives about living with a mental health label. For many participants, diagnosis brought validation; to be “named” was to be welcomed into one’s tribe. For others, diagnosis meant reduction and mistranslation. Findings raise questions about the assumption that diagnostic labels necessarily bring shame and/or loss of self-efficacy. Without minimizing the impact of stigma, clinicians need to remain open to discovering how each client finds meaning in the diagnostic experience. Based on participants’ use of deeply personal images, metaphor is proposed as a creative means for re-claiming identity. Implications for practice and further research are suggested.

KEYWORDS:

• mental illness
• labels
• stigma
• illness narratives
• diagnosis