Recovery stories: An anthropological exploration of moral agency in stories of mental health recovery

Abstract

Moral agency has been loosely defined as the freedom to aspire to a "good life" that makes possible intimate relationships with others. This article uses ethnographic research to further the discussion of the role of moral agency in mental health recovery. This article attends to the ebb and flow of moral agency in the life stories of three people diagnosed with a serious psychiatric disability at different stages in their individual recoveries to illustrate particular aspects of moral agency relevant for recovery. From these, a more complex notion of moral agency emerges as the freedom not only to aspire to a "good life," but also to achieve a "good" life through having both the intention to aspire and access to resources that help bring one's life plans to fruition. Each storyteller describes an initial Aristotelian peripeteia, or "breach" of life plan, followed by an erosion of moral agency and sense of connection to others. The stories then diverge: some have the resources needed to preserve moral agency, and others attempt to replenish moral agency that has been eroded. In these stories, the resources for preserving and nourishing moral agency include the ability to cultivate the social bases of self-respect, autobiographical power, and peopled opportunities. These stories cumulatively suggest that without such resources one's attempts to preserve or nourish the moral agency needed for recovery after the peripeteia, which is often perpetuated by the onset and experience of serious mental illness, may fall short.

Beyond the “Crazy House”: Mental/Moral Breakdowns and Moral Agency in First‐Episode Psychosis

“…The societal response to people deemed to be psychotic in the United States, as I have shown here and discussed further elsewhere, does little to support people in the much‐needed process of moral repair in the aftermath of a moral breakdown (Myers , , , , ; Myers & Ziv, ). A careful examination of Ariana's first‐person experiences, however, reveals the multiple moral experiments in which she engaged.…”

“…This article deepens our understanding of the importance of moral experimentation in the mental health recovery process for a young person experiencing a first episode of psychosis. Elsewhere, I have argued that mental health recovery in the United States is driven by one's ability to replenish one's own sense of moral agency in the aftermath of the medical, legal, and social response to psychosis (Myers ; Myers ; Myers & Ziv, ). Specifically, moral agency is the ability to act in a way that makes possible intimate connections with others.…”

Extraordinary Conditions: Global Psychiatric Care and the Anthropology of Moral Experience

“…Taking Mattingly's () work as a central orientation to our exploration of extraordinary conditions, we have asked all of the authors in this issue to carefully examine the ways our interlocutors craft themselves as moral actors. This process of recovery of one's ability to be seen as a moral agent may be essential to surviving the consequences of often‐damaging, institutionally driven representations of psychiatric patients (Myers ). Thus, these articles collectively contribute to psychological anthropology's project of foregrounding subjectivity, personhood, and individual agency in intersubjective social worlds (Parish ; Zigon ; Zigon and Throop ), while also situating moral persons explicitly in broader social‐structural surrounds.…”

“…First, Neely Myers offers a rich examination of the experience of one young Mexican‐American woman in North Texas, Ariana, as she experiences an initial hospitalization and community reentry following a mental breakdown that has been diagnosed as a “first episode of psychosis.” Myers’ piece examines the “moral breakdown” that accompanies the mental breakdown, and then the ways that Ariana attempts to use moral experiments to engage in moral repair over the next five months. Drawing on Goffman's classic work on moral selves and “total institutions” (Goffman , ), as well as her own work on “moral agency” (Myers , ), Myers shows how a psychiatric hospitalization disorients and demoralizes Ariana, ultimately having a corrosive effect on her moral subjectivity. However, she then focuses on the ways Ariana seeks out a return to moral personhood, even during her initial hospitalization in a “total institution,” thereby highlighting potential healing processes that could be incorporated into current mental health care, but that are not currently promoted in clinical literature or practice.…”

Substance‐Induced Psychosis: Clinical‐Racial Subjectivities and Capital in Diagnostic Apartheid

“…At stake in this racialized diagnostic divide is whether people who are psychiatrically diagnosed are left with the ability to exercise moral agency. Although the term “moral agency” has a long history in Western philosophical debates, from Immanuel Kant to Jeremy Bentham to John Rawls, and has more recent purchase in anthropological theories of the culturally contextual nature of morality (Mattingly ; Robins ), here I use “moral agency” in a more specific way that is articulated in Neely Myer's ethnographic analysis of the trajectories of people diagnosed with schizophrenia (Myers , ). She finds that a central dilemma of the diagnosed is their erosion of self‐in‐relation‐to‐others.…”