Self-management for bipolar disorder and the construction of the ethical self

Abstract

The promotion of the self-managing capacities of people has become a marker of contemporary mental health practice, yet self-management remains a largely uncontested construct in mental health settings. This discourse analysis based upon the work of Foucault investigates self-management practices for bipolar disorder and their action upon how a person with bipolar disorder comes to think of who they are and how they should live. Using Foucault's framework for exploring the ethical self and transcripts of interviews with people living with bipolar disorder, this discourse analysis finds that the discursive practices of self-management for bipolar disorder are prescribing a restricted regime for living based upon the quintessential neo-liberal subject using practices that are focused upon managing an unreliable and problematic self. The article concludes with the proposition that the problem of bipolar disorder (for which self-management is an answer) is less about the object itself and more about how we construct the nature of the self. A Māori indigenous ontology is used here as an example of an alternative discursive resource through which people make sense of the self and which allows ways of thinking about self-management that engage with ambivalence and ambiguity rather than restriction and regulation.