1. The Liberatory Deconstruction of the Bipolar Impaired Self Facing another day

2. An exploration of the psycho-emotional dimensions of disability is long overdue…

3. Reeve, D. (2002) Negotiating psycho-emotional dimensions of disability and their influence on identity construction. Disability & Society. 17, 493-508. (Reeve, 2002) The social model of disability should be extended to include social processes and practices which undermine the emotional well-being of people with impairments.

4. Fertile ground was broken for exploration of the psycho- emotional dimensions of disability. My images on the Serendip website outed the inner turmoil of the impaired self.

5. “Narrative is determined not by a desire to narrate but a desire to exchange.” - (Rolad Barthes, S/Z) Professor Paul Grobstein Founder Serendip Bryn Mawr College

6. Readers commented on my images and narratives. The process:

7. Patterns emerged in the narratives and the dialogues…

8. There were descriptions of feelings, talk of identity, allusion to societal gaze, and integration of bipolar characteristics and the emancipated self.

9. What follows are examples from Serendip web pages: My visual and written reflections and reader comments. All would become the basis of my 5 Phase Model for the Emancipation of the Bipolar Impaired Self. The underscored words relate to feelings, identity, stigma, and integration and emancipation of the bipolar self.

10. My life is a ‘room’ in which I dwell. It's been beaten down, battered and tattered. I do leave the premises and enjoy the outside world, but I only stay out so long. Then I return home where it's familiar, comfortable, albeit sometimes… unbearable.. There is some light coming through the window, perhaps a sliver of hope amidst chaos. There is a sense of isolation in a world of chaos, but there is someone watching over. Submitted by Sophie

11. At their worst, neurological and mental disorders can make you feel like you’ve been stripped of your authentic self and replaced by a mere shadow…of your shadow. When it gets this bad, it can feel as though I inherited my genes from “someone” outside my real family.. This picture makes me aware of the social stigma surrounding mental illness. You are “bad” if you have one… Submitted by Ryan

12. If you knew me personally, you probably wouldn’t see me as impaired as I sometimes feel. I don’t appear crazy, but sometimes I have crazy ideas that can often be reframed as creative or epiphanies from the absolute. Ideas that are actually appreciated or admired by others. An understanding and an acceptance of the self, and a realization that there are others out there with whom community is possible. However at the same time a sense of dissatisfaction, a sense that the author knows he is being judged by the “normal” community… Submitted by k

13. …my “inner eye” sees the world differently than does my “outer eye”. It’s a different kind of observation and vision--more sensitive, intuitive and perceptive. People see my outer eye and if they look closely enough, they may see my inner one as well. And then sometimes its hard to tell the difference. When any part of yourself is hidden or unacknowledged the whole self is limited in every way. Self-acceptance means not only acknowledging the less desirable parts but also allowing every aspect of the self to realize its full potential. Submitted by A

14. …not all disabilities are obvious. Which is When your more problematic: When your disabilities are hidden from those around you or when they’re hidden from yourself? …We all have shortcomings, but our ultimate purpose in life is to reach self- awareness... i.e., to acknowledge where and what we would like to improve/ better about our self, and go about making/ facilitating this change. This (according to Maslow’s hierarchy of needs), refers to trying to attain self-actualization. Submitted by A

15. Laura Kerr explores the use of patient education and presenting psychical pain as disease (as opposed to personal weakness) to dispel stigma so that individuals might seek medical attention for bipolar disorder. Kerr, L (2001).Foucault and the care of self: Educating for moral action and mental illness. Philosophy of Education. However, Kerr finds that being labeled ‘ill’ can make one feel the stigma of being defective, which paradoxically can then cause the individual to avoid seeking medical attention.

16. Kerr states, “ Undeniably, psychiatry is the standard to which other explanations and treatments of the depression and mania are compared. Indeed, it is extraordinarily difficult, and exceedingly frustrating to speak of mania and depression as anything but pathologies and disease states.” Kerr, L (2001). Foucault and the care of self: Educating for moral action and mental illness. Philosophy of Education.

17. Positing The 5-Stage Liberatory Deconstruction of the Bipolar Impaired Self: An alternative discourse to psychiatry for addressing Bipolar Disorder. No it’s not.

18. as opposed to psychiatry’s medical model of “healing the sick mind.” This 5 Phase social model facilitates the “emancipation of the bipolar impaired self”

19. Deconstructing the Title

20. Lib-er-a-tor-y 1. To set free, as from oppression, confinement or foreign control. 2.To free someone from social prejudices. The Liberatory Deconstruction of the Bipolar Impaired Self

21. De-con-struc-tion 1.Critically focusing on how situations in everyday life pass as assumed truths; alternative ways of looking at situations can reveal a hierarchy of power and alternative truths, enabling a ‘restructuring’ for social (or personal) change. 2.To break down into component parts for analysis. The Liberatory Deconstruction of the Bipolar Impaired Self

22. Bi-po-lar 1.A psychiatric diagnosis marked by by alternating periods of mania and depression. 2.A brain disorder that causes unusual shifts in mood, energy and ability to function. The Liberatory Deconstruction of the Bipolar Impaired Self

23. Im-paired 1.Having been diminished as in strength, value or quality. 2.Damage or weakening of physiological, psychological or anatomical function or structure. The Liberatory Deconstruction of the Bipolar Impaired Self

24. Self 1.A bodily felt sense of who one is, distinct from others. 2.The agent responsible for the thoughts, feelings and actions of an individual. The Liberatory Deconstruction of the Bipolar Impaired Self

25. “I’m not quite sure I get it.” Narrative Images: The Liberatory Deconstruction of the Bipolar Impaired Self

26. Think of this concept starting as Humpty Dumpty having been lulled into seeing himself as nothing more than an expendable food item with an imperfect shell. Let’s call it bipolar disorder.

27. However, through Humpty’s introspection and dialogue (through his narrative images) he has been able to discover his inner egg, understand his imposed limitations within a social context, recognize his strengths, become a more effective self-advocate, and experience the viable nature of his unimpaired identity and self.

28. — M. Foucault The person is not the problem. The problem is the problem.

29. The bipolar impaired self is not emancipated. And what is the problem? Bipolar characteristics and the self are not integrated.

30. How can bipolar characteristics become integrated with the self and the bipolar self become emancipated?

31. Through The 5 Phases of The Liberatory Deconstruction of the Bipolar Impaired Self

32. Phase 1 Exploring Feelings Relating To Bipolar Disorder

33. Phase 2 Exploring Personal Identity Related to Bipolar Disorder

34. Phase 3 Exploring the Social Gaze and Stigma Related to Bipolar Disorder

35. Phase 4 Integrating Bipolar Characteristics and the Self

36. Phase 5 Emancipation of the Bipolar Impaired Self

37. Exploring Feelings Relating to Bipolar Disorder.

38. Phase Exploring Feelings Relating 1 to Bipolar Disorder - depression - anxiety - sadness - agitation - lethargy - frustration - insecurity - inadequacy - burdensome - hopelessness - hyperactive

39. Phase Exploring Feelings Relating 1 to Bipolar Disorder Cont. - embarrassment - shame - envy - fear - pessimism - confusion - inferiority - helplessness - out of control

40. Exploring Identity of Bipolar Disorder.

41. Phase Exploring Identity 2 of Bipolar Disorder - confrontation of impaired self - ‘dys-appearance’ of impaired self - ‘normal’-ization - condescension - ‘passing’; disclosing

42. Phase Exploring Identity 2 of Bipolar Disorder Cont. - fear of being exposed - information control - undesired differentness - low self esteem/concept/efficacy - BPD community attachment - need to be ‘cured’

43. Exploring the Social Gaze and Stigma of Bipolar Disorder.

44. Phase Exploring the Social Gaze and 3 Stigma of Bipolar Disorder - employment restrictions - custody restrictions - insurance restrictions - stereotyping - labels - pejorative comments - social exclusion - undesired differentness - infantilizing - generalizing - judging

45. Integrating Bipolar Characteristics and the Self

46. Phase Integrating Bipolar 4 Characteristics and the Self - exploring feelings, identity, social gaze and stigma related to bipolar disorder - social model of disabilities - environment specific - labeling/medical descriptors - ‘normal’/neurodiverse

47. Phase Integrating Bipolar 4 Characteristics and the Self Cont. - successes - culture and world view - autobiographical memory (for trauma-related impairment) - embracing one’s bipolar characteristics - practicing assertiveness - universality of feelings

48. Emancipation of the Bipolar Impaired Self.

49. Phase Emancipation of the 5 Bipolar Impaired Self Definition of “Emancipation” - to free from restraint, power or control of another - to free from any controlling influence - free from traditional social constraints

50. Phase Emancipation of the 5 Bipolar Impaired Self Cont. Self-Actualization “…intrinsic growth of what is already in the organism, or more accurately of what is the organism itself… self-actualization is growth-motivated...”

51. Phase Emancipation of the 5 Bipolar Impaired Self Cont. Positive Self-Regard “People have a need to view themselves positively. This is easily the most common and consensually endorsed assumption in research on the self….positive self-regard is thought by many to be essential for achieving mental health.”

52. Phase Emancipation of the 5 Bipolar Impaired Self Cont. Self-Advocacy - understanding your strengths and needs - identifying your personal goals - knowing your legal rights and responsibilities - communicating these to others

53. Phase Emancipation of the 5 Bipolar Impaired Self Cont. Self-Advocacy, Cont. - making life decisions without undue influence from others - being in charge of your own care in the medical system - take a more active role in your own care - assertively communicating these to others

54. Phase Emancipation of the 5 Bipolar Self Cont. Self-Advocacy, Cont. - increase self-esteem and self-confidence - increase independence - break the stigma of ‘dependency on others’

55. The Result: The bipolar impaired self becomes the self integrated with legitimate bipolar characteristics.

56. Research Questions…

57. Q If a positive integration between the self and bipolar impairment can be formed, is there a potential for generalizing the ability of the self to positively integrate with other types of impairments?

58. Q Can a positive integration between bipolar impairment and one’s self be attained across age of onset, comorbidity, duration and intensity of the bipolar impairment?

59. Q Can a positive integration between bipolar impairment and one’s self help to inform the development of humane psychiatric-related disability policies?

60. Special thanks to Professor Paul Grobstein Eleanor A. Bliss Professor of Biology Department of Biology Bryn Mawr College Founder of Serendip Exploratory Website http://serendip.brynmawr.edu/exchange/

61. Much Gratitude to Serendip Website Visitors Your comments and insights on my images are invaluable to expanding my knowledge base on the Self, Impairment and Society.

62. David A. Feingold DEE National-Louis University

63. End