Grundstörung) of schizophrenia as loss of natural self-evidence (Natürlichen Selbstverständlichkeit); on the other side, Tatossian’s insight, briefly elaborated in a lecture presented in Heidelberg in 1994 and largely forgotten by the relevant literature. Whereas the former mainly develops an intersubjective reading of schizophrenia, the latter suggests an intrasubjective understanding. Indeed, for Blankenburg, schizophrenic experience can be broadly characterized as a progressive impoverishment of our rootedness in the social world, leading to derealization and depersonalization. In this respect, Tatossian takes schizophrenic autism not as the effect of a loss of originary sociality but as the result of a deeper disproportion. For Tatossian, schizophrenia is characterized, ultimately, by a basic self-disorder or alteration that consists in the breakdown of the twofold dimension of transcendental subjectivity, encompassing both constituting consciousness and phenomenologizing onlooker. In this sense, his interpretation of schizophrenic disorders is closer to the ipseity-disturbance model. I show that while Blankenburg and Tatossian share a dialectical understanding of schizophrenia by pointing to basic modifications of the “transcendental organization” of experience, their divergence originates from a different reading of the phenomenological epoché. Except for the clinical perspective, the point of contention between Blankenburg and Tatossian seems to concern their use of internal resources of the Husserlian phenomenology. By presenting the philosophical presuppositions of their analyses, I discuss two key figures of phenomenological psychopathology by showing how their debate on the meaning of schizophrenic experience can be reframed by looking at the relationship between transcendental subjectivity and intersubjectivity in Husserl’s phenomenology.This paper presents a critical comparison between two phenomenological accounts of schizophrenic experience: on the one side, Blankenburg’s seminal work on the basal disturbance ( Since these authors share similar phenomenological perspectives on psychopathology , here used to make sense of the model of schizophrenic experience proposed by the French psychopathologist.In the second part of the paper, I present Tatossian’s alternative proposal, that, contrarily to Blankenburg and similarly to cf.cf.cf.transzendentale Organisation) of experience.It is worth stressing that while Blankenburg and Tatossian both adopt a transcendental approach to psychopathology, in the sense that they conceptualize schizophrenia by considering the conditions of possibility of anomalous and distressing experience cf., they docontrasts and completes Blankenburg’s approach. In particular, I claim that the point of contention between the two seems to concern the different use of the internal resources of Husserlian phenomenology. By presenting the philosophical presuppositions of their analyses, I discuss two key figures of phenomenological psychopathology by showing how their debate on the meaning of schizophrenic experience can be reframed by looking at the relationship between transcendental subjectivity and intersubjectivity in Husserl’s phenomenology. However, it is worth stressing that I am not interested in endorsing any of these two accounts. Indeed, I do not focus on the phenomenological problem of whether self-disturbances can be de facto conceived independently from impairments of the intersubjective syntheses. In this respect, as Therefore, in this paper, I show in what sense Tatossian’s account of the basal disturbance of schizophrenia simultaneously 2.cf.cf.Ichstörungen), Blankenburg did not view social cognition and reduced empathy as a result of a primary disturbance of experience that originates from within the individual . In the early stages of schizophrenia, individuals frequently experience a tendency to question or challenge commonly accepted practices, customs, concepts, or ideas that are typically considered self-evident or taken for granted. Arguably, the shift of attention from positive to negative symptoms of schizophrenia allowed Blankenburg to reflect on insidious modifications of lived experience that were simply neglected or overlooked at the time  the everyday world. This, in turn, generates a basic mistrust in reality (cf.die Selbstverständlichkeit des Selbstverständlichen) through the case study of Anne Rau’s schizophrenia simplex .For Blankenburg, the progressive impoverishment of common sense found in persons affected by early forms of schizophrenia can lead to a general loss of “familiarity-with”  . Indeed, Anne laments about having lost “something small” (so etwas Kleines) but essential for living . She refers to those elementary “rules of the game”  commonly shared by others in social interactions, which constitute the “basic axioms of everyday life” (cf.Standpunkt), a support  for understanding other persons’ behavior and their life projects. Blankenburg’s exploration of schizophrenic alienation revolves around four interrelated transformations in Anne’s field of awareness: her experience of the everyday world, temporality, self-experience, and relationships with others. However, Blankenburg places particular emphasis on the intersubjective dimension of Anne’s interactions with others, whose analysis is the lengthiest of the four.By drawing on personal memories and some interviews, Blankenburg observes that Anne’s experience is characterized by a persistent feeling of perplexity  that naturally characterizes our daily encounters. Rather than experiencing a sense of belonging and connection, Anne is overwhelmed with a feeling of dismay or horror (Entsetzen) when engaging with others. This is evident in her struggle to stand their gaze, which makes her feeling disconnected from herself . For Blankenburg, Anne’s general discomfort expresses a fundamental non-familiarity with the socio-cultural dimension and discloses the problematic character of her being-in-the-world. This type of non-familiarity and questionableness (Fragwürdigkeit) encompasses any relation she has with others . Blankenburg notes that Anne seems to be obsessed with the others’ sense of trust, confidence, and spontaneity because she cannot be a “world-forming force” (weltbildende Kraft) , namely, an active source of natural self-evidence.In this regard, Blankenburg observes that Anne finds it difficult to participate in the everyday life of mutual communication. In particular, Anne laments a loss of perspective-taking and position-taking, and a general emotional fragility. For Blankenburg, Anna has lost a fundamental reciprocity . Indeed, if, on the one hand, Anna does not know how to live her life or to engage with others, on the other hand, for her it is almost indifferent to live one way or another . Broadly, self-evidence refers to things that are immediately and intuitively clear to us, without requiring further explanation or justification . Beyond our explicit awareness, natural self-evidence belongs to the pre-predicative and pre-reflective dimensions of our experience. Indeed, prior to any conscious reflection or linguistic articulation of our experiences, we have an intuitive and spontaneous way of apprehending and relating to the world that operates almost underneath our explicit awareness through our bodily existence  . In particular, the lifeworld designates the intentional background that characterizes our natural attitude and constitutes “the ground of all our interests and life-projects” . In this sense, the lifeworld is also the world of our practical activities. Indeed, as Husserl writes, the lifeworld is the word “in which we live and in which we carry out activities of cognition and judgment, out of which everything which becomes the substrate of a possible judgment [that] affects us is always already pregiven to us as” . Accordingly, Husserl designates the lifeworld as the “ultimate source of primal self-evidence” (Urevidenz)  rightly because it is the source of any passive belief, including our habitual or taken-for-granted assumptions . Husserl also uses the expression “protodoxa” (Urdoxa) to refer to the “non-modalized belief” of the “ultimate substrate” of pre-given objects of sensuous perception, constituting pre-cognition (Vorbekanntheit) and pre-knowledge (Vorwissen)  cf., §8, 387Vergemeinschaftung) of our experiences . In this sense, Husserl takes the lifeworld as an intersubjective accomplishment because, as the background of everyday reality, it is the very same world of communication, education, tradition, and, in this sense, culture .Yet, if Blankenburg draws on this concept, it is because the lifeworld defines the intersubjective background of any of our cognitive and practical activities, and, in this sense, it can designate “the intentional correlate of common sense” , 306. Inibidem, 371; Nevertheless, from the first-person perspective that characterizes the single individual, the lifeworld is the horizon within which we develop our practical knowledge and make sense of social norms, customs, and expectations. In this regard, it provides the ultimate ground of our social, cultural, and historical situatedness  the intensity, namely in relation to the pervasiveness or radicality of the bracketing of the epoché.Against this backdrop, Blankenburg develops the idea that schizophrenic alienation can be conceived as an extreme form of epoché. However, it is worth mentioning that the phenomenological and schizophrenic epoché have more differences than similarities. In his comparison, Blankenburg recognizes six differences between the phenomenological epoché and schizophrenic loss of natural self-evidence , connected with the efforts of re-establishing a natural attitude through reflection.In relation to (a) freedom, Blankenburg observes that the phenomenologist needs to stand against an “elastic force,” which Fink individuates as “inality” , 24, to Generalthesis), namely our passive beliefs concerning the natural world, (In relation to (b) the intensity, while the phenomenologist through the epoché aims to suspend the so-called “general thesis” .However, to provide more clarity on how the phenomenologist can detach himself from the world and, in doing so, adopt an objective perspective on their consciousness for intentional analyses, Husserl offers further insights in his lecture course ling cf., that weling cf., 291. Fomanner of the interested position-taking, co-believing, co-assuming, co-doubting, and so on” .Arguably, in natural self-reflection, by participating in the interests of the lower I, the reflecting I is almost “identical to it in the d so on” , 299–300mere privation, a mere passivity” ” ” , 535.empty scene. If, as he argues by drawing on Kimura Bin’s ideas, in full-blown schizophrenia there is a “noetic splitting” in the flow of consciousness, then there is more than one distinct subjectivity co-existing in a specific “rapport d’influence” .For this reason, differently from Blankenburg, Tatossian interprets schizophrenic alienation as a “plus qu’une pseudo-epoché,” or a “caricature” of the phenomenological epoché. Indeed, since the schizophrenic epoché lacks the modality of the spectator, namely the high-order self-reflecting I that attributes to himself the intentional performances that constitute his experience, it should not be possible to talk at all of a proper “reduction.” As Tatossian would suggest, the schizophrenic epoché would only present an fluence” , 67.11 Tbjects]” , 294. InArt Schizophrenie) (cf.Einheitlichkeit des Bewusstseinsstromes), through a single continuous stream of living present experience (Lebensstrom der lebendigen Gegenwart). When this unity is disrupted, it is no longer possible to speak of a coherent self . Similarly, cf.Indeed, it is not by chance that Fink refers to the phenomenological reduction as a type of schizophrenia (nie) cf., 114. Inself cf., 67. In cf.ipséité), which cannot appreciate his activity of constitution, “has nothing to look at, neither the world, nor the self” (weltbildende Kraft) that is responsible for the constitution of experience, resulting in a loss of spontaneity or naturality that she finds in the others.Tatossian further distinguishes the case of paranoid schizophrenia from non-severe forms. As he argues, in early schizophrenia an onlooker seems to be still present, in the form of a reflexive I that unifies all subjective acts. In this respect, he argues that what characterizes early schizophrenia is the “spectacle” of the world-constitution, that is, the ongoing process of producing the sense of the “world” through which “constituting subjectivity is at the same time constantly enworlded and constituted as humanity, as a totality of humans living with one another in open, finite mediation” cf., ft. 107soi objectif noématique). Instead, schizophrenic subjectivity is stuck as a noetic self in two simultaneous moments of seeing and being seen. Tatossian defines this type of self-alteration as the experience of being other than oneself. In this respect, Nagai has described this experience as the experience of “simultaneous introspection,” namely “two Is” that simultaneously observe each other  of the human being into the lifeworld. Blankenburg’s attention on the intersubjective sphere to frame schizophrenic disturbances is already evident in the article of 1969, where he rejects the idea that schizophrenia could be understood as a disturbance of cognition or affectivity and writes that “Affectivity and the ability to judge, as we find it in common sense, refer back to an original unity of thinking, feeling, and willing in human existence, which is primarily related to an intersubjective world (mitweltbezogen)” .In this paper, I have presented two distinct perspectives on schizophrenia. I have shown that the difference between Blankenburg’s and Tatossian’s interpretations of schizophrenia stems from their respective phenomenological assumptions. For Blankenburg, the basal disturbance of schizophrenia is a transformation of the anchoring . Indeed, since he became increasingly interested in understanding how the familial context may constitute a risk factor in the development of schizophrenia  of Anne Rau’s experience. In this regard, at the end of section IX of his monography, Blankenburg seems to acknowledge the lack of antepredicative analyses in genetic phenomenology (By considering the impairment of the second- and first-person plural awareness as the most important alterations of lived experience characterizing early schizophrenia cf., Blankenophrenia , Blankencf.cf.Tatossian, on the contrary, grounding his intrasubjective reading of the basal disturbance of schizophrenia on Fink’s idea of a duality of the transcendental life, interprets schizophrenic subjectivity in the sense of a split between two Is normally coexistent in a healthy subjectivity. To be clear, on the basis of a reading of the “transcendental theory of reduction,” Tatossian develops a comparison between the fragmented nature of schizophrenic subjectivity and the split between the constituting consciousness and the phenomenologizing onlooker. I have further developed Tatossian’s by relying on the idea of Ego-splitting, which can be found in Husserl’s phenomenological-psychological theory of epoché and reduction. Typically, the self-alteration produced by the splitting or doubling of our experience is non-pathologic, since it is a necessary condition for our acts of reflection, representation, and imagination cf.. Howeveripseity-disturbance model. cf.mineness of our experience (cf.In this sense, I have shown that for Tatossian schizophrenic autism primarily derives from a disturbance of self-awareness, and, in particular, from a type of self-division that leads to a pathological form of self-alienation. Indeed, in his account, Tatossian draws on Nagai  and Kimuence cf.. In partAs I have shown, the difference in their interpretation of schizophrenic disproportion can be attributed to their reading of the meaning of phenomenological epoché and reduction. Not because they purely apply the epoché and reduction, but because they rely on these notions to actually understand the functioning of schizophrenic subjectivity. Blankenburg uses the phenomenological epoché to conceptualize, by means of some important distinctions, schizophrenic alienation as a loss - and not simply a bracketing - of natural self-evidence, which is, ultimately, intersubjectivity constituted in our everyday engagement within the lifeworld. In contrast, in Tatossian’s account, the phenomenological epoché is used to characterize the transformations of schizophrenic alienation as a modification of the relationship between the phenomenologizing onlooker and the constituting consciousness.de facto pathological. Instead, Tatossian proposes to consider schizophrenia as a disturbance in the balance between our ability to distance ourselves from the world and from our own position-takings and our ability to immerse ourselves in the world with others and to actively engage with it. In this sense, he suggests that schizophrenic existence is characterized by a deficit of self-intimacy because, from this perspective, it is “the incapability to be alone which best characterizes and founds the incapability to meet Others”While Blankenburg and Tatossian seem to present two apparently opposite accounts of schizophrenia, actually there are some fundamental similarities. Tatossian’s approach to schizophrenia is dialectic like that of a priori conditions of experience in general, altogether with the world (cf.cf.cf.cf.cf.In my account, these perspectives are mutually complementary in a methodological sense because they reflect on the psychopathological disturbances by considering two co-originary poles of Husserl’s transcendental phenomenology as orld cf.. Indeed, cf.cf., 118–119cf.Indeed, the debate on the explanatory relationship between different psychopathological phenomena in schizophrenia is still open. Actually, one of the main problems in the philosophy of psychiatry is understanding the relevance and contribution of each level of explanation to the conceptualization of psychiatric illness cf.. This isThe author confirms being the sole contributor of this work and has approved it for publication.The research conducted in this publication was funded by the Irish Research Council under grant number “GOIPG/2021/606.”The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.


In this editorial to the special collection “Mental Health, Discourse and Stigma” we outline the concepts of mental, health, discourse and stigma as they are examined through sociolinguistic lenses. We examine the sociolinguistic approach to mental health and stigma and discuss the different theoretical frameworks and methodological approaches that have been applied in such contexts. Sociolinguistics views mental health and stigma as discursively constructed and constituted, i.e. they are both manifest, negotiated, reinforced or contested in the language that people use. We highlight existing gaps in sociolinguistic research and outline how it could enrich research in psychology and psychiatry and contribute to professional practice. Specifically, sociolinguistics provides well-established methodological tools to research the ‘voices’ of people with a history of mental ill health, their family, carers and mental health professionals in both online and off-line contexts. This is vital to develop targeted interventions and to contribute to de-stigmatization of mental health. To conclude, we highlight the importance of transdisciplinary research that brings together expertise in psychology, psychiatry and sociolinguistics. This special collection brings together the three broad themes of mental health, discourse and stigma as they are examined through sociolinguistic lenses. We first present what we mean by mental health, discourse and stigma and discuss the interrelationships between these concepts. We then offer a brief overview of existing sociolinguistic research on mental health and stigma and identify continuing areas of under-research that we hope this special collection will contribute to. Finally, we ask the questions of ‘why?’ and ‘so what?’ in relation to sociolinguistic research on mental health and stigma and outline some ways in which this growing area of research could meaningfully contribute to broader professional practice in psychology and psychiatry.A range of theoretical frameworks and methodological approaches have been used to investigate mental health and stigma across different disciplines, including sociolinguistics. Historically, the study of mental health has been dominated by psychology and psychiatry which has led to a “psychiatrization”  of mentaClosely intertwined with the concept of mental health is the concept of stigma that has also been widely researched in psychology, psychiatry, as well as sociology. In his seminal essay, sociologist Erving Goffman  defines Psychological research on mental health stigma has burgeoned since Goffman’s study. Focusing on the “micro-level social interactions”, this research has examined the causes of stigma, its cognitive dimensions, the consequences and the coping responses , 11. FewSociolinguistics studies the interrelationship between language and society  of whichA stretch of language above a clause or a sentence level .Language used by speakers to covey and negotiate certain meanings and achieve particular purposes .Language used to represent various social practices, social actors and ideologies , 17.Relating these different interpretations of discourse to mental health contexts, in its micro-analytic understanding discourse may refer, for example, to negative stereotypical attributes, such as ‘mad’, ‘crazy’, and ‘insane’. Culturally, there exist striking differences in how mental health disorders are described, although negative connotations typically prevail. For example, the term 精神分裂症 in Chinese  has a literal translation of ‘the split-mind disease’. This term is heavily stigmatizing. Substantial efforts have been made by mental health professionals in Hong Kong to introduce less stigmatizing terms, such as 思覺失調  that translates as ‘thought and perceptual dysregulation’ .In relation to discourse as ‘language-in-use’, the following example from an interview with a psychiatrist illustrates how the diagnosis of a ‘schizophrenic patient’ is used to account for the tragic event of mass killing that has marked, in this psychiatrist’s words, “a milestone” in the development of psychiatric services in Hong Kong. It is an objectivized, ‘clinical’ account of a mental health disorder and its impact on one’s behaviour. It also highlights a wider societal impact in response to the recounted incident.Psy – psychiatrist; I – interviewer.6.Psy: Yes. The most well known in Hong Kong is this 1982 tragedy […] Schizophrenic patient, young man killed his mother and sister at home [.] and then went down with two knives and entered a kindergarten and killed four more.11.I: Children?12.Psy: Four kids and wounded forty something. […] This incident created, it may be regarded as a milestone for the development of the service, because after this incident all the society turned attention to mental health, mental patients.The last approach to discourse foregrounds how mental health is constructed through social practices. Mental health and mental health stigma are “socially and discursively constituted”  with a bIn this special collection, we use the term sociolinguistics broadly to include linguistic approaches and methodologies as diverse as corpus linguistics, different types of discourse analysis , conversation analysis, narrative inquiry, to name just a few. While these approaches conceptualise discourse differently, most sociolinguistic studies on mental health and mental health stigma take a social constructivist view, viewing language as a means of constructing social reality. Sociolinguistic studies include quantitative, qualitative and mixed methods studies. They examine diverse discourse data, from interactions in clinical contexts, to online interactions between members of mental health support groups, to large media corpora. Each of these different types of data provides insights into different aspects of mental health and has both strengths and limitations.Arguably, one of the most potent sociolinguistic approaches to mental health research to date has been corpus linguistics –23. CorpNotably, sociolinguistic research often includes the ‘voices’ of under-represented, vulnerable or under-researched demographic groups. For example, Galinsky’s and colleagues’ research focuses on discourses surrounding male depression and suicide –29. SociThese are just a few examples of previous and ongoing sociolinguistic research, and in this special collection we welcome contributions that apply different theoretical frameworks and methodological approaches in sociolinguistics.This brief overview of sociolinguistic research points to some of the possible applications of research to professional practice. Sociolinguistic research focuses on discourses of mental health. These discourses are powerful, they are the means to talk about mental health, the locale where mental health issues are manifest, the means to seek and offer help, and the ways to offer education and develop interventions. They are also the means to challenge and contest negative ideologies. De-stigmatisation of mental health can be achieved through structural changes  but most, if not all, social activities and practices are mediated through language. Therefore, sociolinguistic research continues to make a strong contribution to mental health de-stigmatization, research and practice.There is an increasing emphasis in psychology and psychiatry on participatory research, including with vulnerable demographic groups . As thisSociolinguistic research also ‘weaves together’ the micro-interactions with other contexts, the meso  and the macro , bringing personal and the social aspects of mental health together to provide a more holistic picture.in situ, that is, in real time during an interaction, for example, how diagnosis or possible treatment negotiations are accomplished. There is also limited research on inter-professional communication in mental health contexts which could examine the linguistic repertoires of professional practices, professional ethos, and how diagnoses or treatment recommendations are negotiated inter-professionally, among other issues. Research cited in this editorial mostly comes from Anglophone contexts. Research from ‘global peripheries’ [Our brief overview has identified research gaps. There remains a paucity of empirical sociolinguistic research that uses real-life interactional data in face-to-face communicative encounters in mental health contexts, for example, in counselling or psychotherapy encounters. This may be partly due to ethical considerations of access and the use of sensitive data  . Examinipheries’  remains pheries’ .To conclude, there are ample opportunities for trans-disciplinary research that brings together expertise in psychology, psychiatry and sociolinguistics. While discursive psychology, for example, has long been concerned with investigating issues pertaining to psychology through language, sociolinguistics offers more versatile and nuanced ways of doing it by offering a range of different approaches and methodologies. In this special collection we welcome contributions that demonstrate the value of sociolinguistic research and how it could enhance existing research and practice in psychology and psychiatry. We invite contributions that draw on diverse empirical data from different clinical and non-clinical contexts and that focus on different mental health conditions. We also welcome authors working in diverse sociocultural contexts whose work could advance our understanding of the cultural aspects present in discourses of mental health and stigma. It is through such trans-disciplinary effort that we can challenge the existing social practices and ideologies of mental health and ultimately contribute to addressing some long-standing societal issues of discrimination and stigmatization of people with mental health issues.


Dear Editor, published in your journal in 2022.We read with great interest Tilahun et al’s paper This is a reason to investigate this topic further. However, we wish to point out some methodological issues that could undermine the rigor of mixed methods health research and lead to inappropriate conclusions, often bringing healthcare quality into disrepute.We would like to highlight the authors’ research relevance on a timely topic, access by youth to education and reliable information about sexual and reproductive health services. Globally for instance, the proportion of young people who access comprehensive information on sexual health issues is low, 34%, despite their right to comprehensive sex education. claim that they conducted a mixed methods cross-sectional study including a community-based cross-sectional and qualitative study. But the title only indicates that it was a community-based cross-sectional study. In this regard, it’s strongly suggested by various authors that the words mixed methods be included in the title to let readers know in advance what method was used. Thus, Creswell and Plano Clark (p. 146) assert: « a good mixed methods title includes the word mixed methods to highlight the overall approach being used ».Indeed, Tilahun et al This does not appear in Tilahun et al’s paper. Furthermore, and contrary to other researchers’ suggestions,35 Tilahun et al did not specify whether the design was convergent, explanatory sequential, exploratory sequential, or complex that is, mixed methods participatory and social justice, experimental, evaluation, or case studies. This lack of precision, explicit, and persuasive rationale for methodological approach choice compromises data interpretation and inferences.5 Yet, mixed methods research advantages are now well recognized, including its ability to provide comprehensive answers to complex research problems such as youth’s equitable access to high-quality sexual health services and information.In a journal paper, the need to use a mixed method and specify the study design should be incorporated and justified in the problem statement. consider any methodological combination to be mixed methods research when 3 essential characteristics are met: at least one qualitative and one quantitative method are combined, each method is rigorously used, and data collection, analysis, and/or results are integrated. Integration can be done either by connecting phases, comparing results, or assimilating data through 9 strategies. This perspective is shared by Polit and Beck. Creswell and Plano Clark also recommend that researchers achieve integration at analysis and interpretation stage using mixing, merging, and connecting as strategies. Creamer goes further by advocating full integration in planning and design, data collection, sampling, analysis, and inference development. Therefore, it appears that Tilahun et al haven’t specified in their study qualitative and quantitative data integration in any of above stages as recommended.36 The authors’ 3 explanatory sentences for the study qualitative component (p. 2) do not imply integration:Fortin and GagnonA qualitative study was included to support the findings of the quantitative study. A qualitative study was also meant to address the perspectives of providers. A qualitative study was conducted using focus group discussions (FGDs), in-depth interviews (IDs), and observations of health facilities that provide youth sexual and reproductive health services.”“ did not precise how qualitative interviews explained quantitative results of their study. Nor did they indicate whether qualitative and quantitative results converged or diverged. This simple juxtaposition of quantitative and qualitative methods without integration of data collection, analysis, or results raises questions about Tilahun et al’s study given that integration is the mixed methods research “backbone” or central feature. In support of this view, Creswell and Plano Clark state (p. 18): “Most important in this list is the utilization of two sets of data, one quantitative and one qualitative, and the integration of these data.”Even less so, authorsUltimately, we hope these comments will be helpful in thinking deeply about mixed methods research strengths and challenges in health and nursing, especially with youth seeking reliable information and appropriate sexual health services. It’s essential for researchers wishing to use mixed methods to provide a clear rationale for their choice, write a specific title indicating the use of mixed methods research, specify the research design to be used, and prioritize the integration of qualitative and quantitative data. This would help to promote the rigor, value, and effectiveness of mixed methods research to generate higher quality knowledge to inform health and nursing policy and practice.


Effective Altruism (EA) has become one of the most prominent socio-philosophical movements of recent years. EA is also facing intense scrutiny due to the business practices of some of its most prominent adherents. On the other hand, the dark triad traits of Machiavellianism, narcissism and psychopathy have been getting increasing attention in entrepreneurship research. There is growing evidence that these traits can motivate entrepreneurial intention. We therefore sought to investigate if there was a connection between the entrepreneurship discourse in EA and traits corresponding to dark triad behavior.Using a discursive analytic method, we investigated the discursive threads on entrepreneurship in EA over a 10-year period.While we believe EA brings a much-needed perspective to the overall debate on doing good, we found ample evidence that it might have promoted the sort of dark triad behavior which some evidence suggests can lead to financial success, but can equally lead to the type of morally bankrupt, unethical and even illegal practices of some entrepreneurs. We also discovered a somewhat temporal dimension in EA’s discourse on entrepreneurship, beginning with discourse encouraging some risk taking and entrepreneurship, before moving on to discourses on the benefits of having a smart and illicit character, and ending with a focus on aggressive risk taking.The findings contribute to the still nascent debate on dark personality traits in entrepreneurship, and enriches the theoretical advancement of the field. However, our research differs from prior studies which were almost exclusively focused on the firm. Instead, we examine this phenomenon within a highly influential belief system/philosophical movement. HoweverWhile there is little doubt in the financial and innovative benefits of tech entrepreneurship, there is an increasing body of evidence that this approach, which places persistent growth above anything else, is not just incapable of solving the socio-economic problems facing the world, but it actively creates them. For example, Facebook played a direct role in the devastating genocide of the Rohingya people , and theOne of the earliest investigations of this phenomenon was the analysis of Effective Altruism (EA) has become one of the most influential belief systems of the twenty first century . Seeking2.2.1.According to Nevertheless, EA has faced vociferous criticisms since its inception. The most dominant criticism is its relegation of institutional change and socio-economic action, all of which critics argue have the most profound impact on improving the world . Others 2.2.Studies on entrepreneurship have demonstrated the enormous positive impact it can have on society. For example, entrepreneurship can promote job creation and economic growth , improve2.2.1.According to 2.2.2.Psychopathy is characterized by problems with empathy and emotional intelligence . This ma2.2.3.Narcissism reflects a character with an exaggerated but fragile notion of self-importance and influence . They po3.3.1.This article adopts a discourse analytic approach  to inves1: What are the main threads and content in EA discourse on entrepreneurship?RQ2: Does the entrepreneurship discourse in the EA movement encourage dark triad behaviour?RQDiscourse analysis is a widely used theoretical and methodological approach in social psychology which argues that all forms of talk are important in shaping human life and decisions . AccordiOur data collection and analysis were influenced by four main principles. First, that language and words are among the “most important phenomenon, accessible for empirical investigation, in social and organizational research” . Second,3.2.80000hours.org) on the 16th of January, 2023. 80,000 h was created by two of the founders of the EA movement and is affiliated with the Oxford Uehiro Centre for Practical Ethics within the Faculty of Philosophy at Oxford University. The organization’s website serves as the unofficial content page of the EA movement, providing research/content on pressing issues such as career advice for early career members, and it wields considerable influence within the EA community. The discursive content includes blog posts, articles, podcasts/interviews, and career review, among others, making it a rich source of data collection. To collect data from the 80,000 h website, we painstakingly pored through hundreds of hours of podcasts content, dozens of pages of various content including blog posts/articles and career review. Due to the wide range of themes on the website, we were immediately focussed on extracting discourses solely focussed on entrepreneurship. Consequently, we searched for similar/alternate iterations of the concept including entrepreneur, found, founder, start-up, ambition, and risk taking. We then thoroughly read or listened to the content, and excluded those on non-profit organizations or social enterprise, while narrowing down to those on traditional profit-making entrepreneurship. In addition, we excluded discourses exclusively dedicated to the biography or salary of entrepreneurs. Therefore, contents such as How much do Y Combinator founders earn? Or Biographies of Top Entrepreneurs were excluded. To be included in the results, publications must be directly focussed on the idea of profit making entrepreneurship or starting a business . Following this, all podcasts/audio were transcribed to text and all 44 documents were processed using Microsoft Word. Then, we carried out a corpus analysis using the Tidytext text mining package in the statistical programming tool, R. The result of this analysis was triangulated with a manual analysis of the text. Thirty-one documents were removed for not discussing entrepreneurship in any relevant detail. In total, 13 documents (n = 13), covering dozens of pages, were included in the final data set for analysis. We re-read the texts of all 13 documents, cross analyzed them, and used a data extraction form to retrieve the results  would on average earn $9.2 million by exit .” (see footnote 2).The main rationale for this is that even failing on a startup can potentially earn the entrepreneur a lot of money. This sentiment was expressed consistently across various texts and documents. Entrepreneurship was highlighted as an excellent choice for people planning to earn a lot of money. The potential to donate these earnings to charitable causes was promoted as a reason for this:“If your aim is to maximise your earnings to maximise your charitable donations, you might want to consider entrepreneurship”.In this first phase, the dominant discourse was on encouraging entrepreneurship among the EA community, and justifying the benefits of pursuing entrepreneurship as a career choice. It also includes discourses on the benefits of risk taking, grit and having a technical background for succeeding in entrepreneurship.4.2.From 2014, we found a significant shift in the discursive rhetoric of 80,000 h. Prior to 2014, discourses highlighted the benefits of taking risks with entrepreneurship and the potential to earn a lot of money. Subsequent discourses from 2014 began to promote a darker type of entrepreneurial character, justifying them with research studies such as those by What I learned quitting my job to found a tech start up, gaining power and control were discussed as the primary motivation for becoming an entrepreneur:For example, in “The founder’s dilemma contrasts the two basic motivations of entrepreneurs: to make a lot of money and to be in a position of power. Noam Wasserman calls these outcomes “Rich” and “King”. The “Rich” goals have been elaborated on before, but I would like to give a brief summary of some reasons why King outcomes are interesting for EAs”.“My direct employment career path was a progression from “writing code” to “telling people to write code”.… It turns out that I actually enjoy some of these things and would probably pursue them even if I decide startups aren’t a good idea.” (see footnote 4).The discourse also began to call more attention to, and encourage a particular type of entrepreneurial character: the ‘smart and illicit’ type. According to “I’m hesitant to describe what it’s like running a company, because my description will be “hard” and then we will have even more of a bias towards overconfident people starting companies. Additionally, the things which seem to indicate that a person will be a good entrepreneur verge on the tautological… One interesting predictor though is a “break the rules” attitude.” (see footnote 4).“Successful tech entrepreneurs are very intelligent, motivated, deeply interested in entrepreneurship, and willing to break the rules”.Discourses went further to encourage people with the ‘smart and illicit’ mindset to pursue entrepreneurship:“In fact, the people who most exemplify these traits – what the authors call “smart and illicit” – tend to get the biggest earnings boost from switching to self-employment”.“We also saw earlier that those who have the combination of “smart and illicit” traits tended to do better when they made the switch, so especially consider it if you’re in that group.” (see footnote 6).By the end of this phase, the smart and illicit trait had become one of the most dominant qualities of a successful entrepreneur within EA discourse. Crucially, none of the examined discourse included any reference to the consequences or possible harm that could arise from illicit behavior.4.3.Sam Bankman-Fried on taking a high-risk approach to crypto and doing good. In this phase, the discourse was focussed on taking aggressive risks and the benefits it can provide to the world:The main entrepreneurship discourse between 2017 and 2022 was the podcast interview titled: “If your goal is to have impact on the world — and in particular if your goal is to maximize the amount of impact that you have on the world — that has pretty strong implications for what you end up doing. Among other things, if you really are trying to maximize your impact, then at what point do you start hitting decreasing marginal returns? Well, in terms of doing good, there’s no such thing: more good is more good”.“That means that you should be pretty aggressive with what you’re doing, and really trying to hit home runs rather than just have some impact — because the upside is just absolutely enormous.” (see footnote 7).The interviewer went even further by encouraging people to be more open to taking what he termed “radical gambles”:“So you kind of want to just be risk neutral. As an individual, to make a bet where it’s like, “I’m going to gamble my $10 billion and either get $20 billion or $0, with equal probability” would be madness. But from an altruistic point of view, it’s not so crazy. Maybe that’s an even bet, but you should be much more open to making radical gambles like that.” (see footnote 7).end justifies the means approach was dominant.In summary, our results show that discourse on entrepreneurship began as a way to encourage EA believers to earn a lot of money which can then be donated toward charitable causes. As such, the first phase included discourse on the benefits of taking risks and choosing tech entrepreneurship. However, discourses in subsequent phases began to shift toward promoting traits of entrepreneurship specific to the dark triad character. This culminated in the interview with Sam Bankman-Fried where the Machiavellian 5.This research contributes to the existing studies on the dark triad behavior in entrepreneurship . Using aSam Bankman-Fried on taking a high-risk approach to crypto and doing good, where donating money to good causes was used to justify an aggressive form of risk taking which would eventually lead to the fraudulent indictment and criminal prosecution of the interviewee. In addition, having a direct impact on the world was among the factors used to dismiss legitimate concerns on the impact of the interviewee’s business on issues like climate change. Furthermore, other discourses included texts on how achieving domination  funds, who can emphasize psychological support as part of the fund-raising requirements for entrepreneurs. In addition, the level of ethical regulation, oversight and criminal prosecution has failed to keep up with the unethical behavior of entrepreneurs . Policy-Our research is limited in a number of ways. First, because the research topic was specific to entrepreneurship, we only included EA content exclusively focussed on entrepreneurship or the idea of starting a business venture. Second, the 80,000 h website was used as the primary source of data collection. Finally, the analysis and findings of this paper should not be taken as a clinical confirmation of the presence of dark triad behavior in the EA community.https://80000hours.org/topics/.All data used in this study can be found in the online repository of 80,000 hours: MO was responsible for the conceptualization, data collection, data analysis, and writing the original draft of the manuscript. MM and ZS were responsible for revising the original draft. All authors read and approved the final version of the manuscript.


The aim of this research is to look into how signals carried by names can contribute to the explanation of why rental discrimination is measured. Ethnic discrimination on the rental housing market is a widespread phenomenon that is increasingly captured in an objective way by means of correspondence studies. This methodology assumes that the trigger for the measured discriminatory behavior is the signal of ethnic origin in names. Nonetheless, previous research found that names also contain other signals such as religiosity, social class and educational level.The current study relates data of 3.753 correspondence tests on the Flemish rental housing market in Belgium to survey data about the perception of the used names in the correspondence tests in terms of ethnic origin, gender, religiosity, social class and educational level. By doing so, we can set a step in the direction of why discrimination is measured.We find that realtors discriminate based on the perception of a name as religious, which we describe as religious taste-based discrimination. Besides, we also find indications for statistical discrimination. For landlords, the perception of a name as non-European increases discrimination, indicating ethnic taste-based discrimination. Already many studies have shown persistent patterns of discrimination against ethnic-cultural minority groups in both labor and housing markets , but since the enlargement of the European Union in 2004 as regular EU-citizens tastes” toward certain ethnic minority groups. Here, a subdivision can be made between agent taste-based and customer taste-based discrimination  Europe is characterized by a rather color-blind ideology, whereby the importance of ethnic origin is downplayed or even ignored Lewis, . DespiteTo analyze which theory—statistical or taste-based discrimination—researchers find support for, additional explicit cues are provided, such as information regarding a person's job, which conveys signals of his or her social class. If statistical discrimination is the main driver, additional information should reduce the risk for realtors and landlords and consequently lower discriminatory behavior  Europe, other characteristics are emphasized to distinguish migrant-origin groups Christian identity remains significant Alba, . This isThe human capital of the immigrant origin population might also be a relevant source of boundary creation Bail, . AlthougIt follows that, depending on the context and time being studied, there may be several boundaries of interest that distinguish an “us” from a “them” group and may give rise to discrimination, among other things. These boundaries and their consequences can be extended to invisible signals in contexts where contact happens indirectly, like names in the first stage of the rental application process, and might explain—at least to some extent—measured differences in accessibility to rental housing.Hypothesis 1: Candidates with non-European names (here Moroccan names) are expected to face higher levels of discrimination than candidates with European names (here Polish names).Hypothesis 2: The strength of ethnic signals (and thus brightness of ethnic boundaries) is expected to have an effect on the level of measured negative discrimination.Hypothesis 2A: The perception of a name as European or not is expected to have a stronger effect on the measured negative discrimination than the precise ethnic origin perceived.→ European–non-European boundary:Hypothesis 2B: The perception of a Moroccan name as non-European is expected to increase the measured discrimination.→ Hypothesis 2C: The perception of a Polish name as European is expected to decrease the measured discrimination.→ Ethnic boundary based on precise ethnic origin:Hypothesis 2D: The perception of a Moroccan name as Moroccan is expected to increase the measured discrimination.→ Hypothesis 2E: The perception of a Polish name as Polish is expected to increase the measured discrimination.→ Hypothesis 3: If we find that the perception of names as religious has an effect on the measured negative discrimination, we measure ethnic discrimination which arises through distastes toward religiosity. This is in line with taste-based discrimination, whereby tastes related to religiosity or the specific religion matter (religious and/or religion-specific taste-based discrimination).→ If religiosity only has an effect on discrimination toward candidates with Moroccan names, we argue that we find religion-specific taste-based discrimination, whereby (dis)tastes are directed at Islam in spite of (Judo-)- Christianism.→ If religiosity has an effect on discrimination toward both candidates with Moroccan and Polish names, we argue that we find religious rather than religion-specific taste-based discrimination.Hypothesis 4: If we find that the perception of social class and educational level has an effect on the measured negative discrimination, we measure ethnic discrimination which arises through socioeconomic related stereotypes and prejudices. This is in line with statistical discrimination.Hypothesis 5: If we find no effect of the perception of social class, educational level or religiosity in names on negative discrimination, then this is in line with taste-based discrimination, whereby tastes related to ethnic origin matter (ethnic taste-based discrimination).The data of this study consists of a combination of two different data collections: an online survey on the perception of names and correspondence tests on the rental housing market in Flanders. The respondents of the survey are not the same as the correspondence tested realtors and private landlords in order to avoid detection. Both data collections were performed between April and June 2021. The housing market in Flanders is dominated by home owners with outstanding mortgages, which were for long heavily subsidized by the government. Private renters account for a relatively small proportion of tenure types, and is especially popular among young people and lower income groups  means that the respondent was successful in perceiving the intended ethnic signal Gaddis, . We creaThe distinction between European and non-European origin: For Belgian names, we rated the option “Belgian” and “another European origin” as congruent. For Moroccan names, “Another non-European origin” and for Polish homogenous names “Another European origin” is seen as congruent.The congruence on the specific ethnic-national origin: Here, naming the correct country of origin (Morocco or Poland) in the open answer field was rated as congruent. As respondents were only asked to name a specific country of origin if they chose another answer category than “Belgian”, Belgian names have no congruence rate on the specific ethnic origin.Afterwards, we calculated the congruence rate on the aggregated level of the name: the percentage respondents that correctly perceived the ethnic signals for each name, which is used in the current study as the congruence rate.th option “Don't know”. These answers were recoded in three variables with three categories: (1) “Not religious”, (2) “Neutral” (including the option “Don't know”) and (3) Religious; (1) “Lower social class”, (2) “Middle social class” (including the option “Don't know”) and (3) “High social class”; (1) “Low educational level”, (2) “Middle educational level” (including the option “Don't know”) and (3) “High educational level”. For the current study, we calculated for each name the percentage respondents that perceive the name as religious, of a low social class and of a low educational level (aggregated level). Nevertheless, it might be that respondents would have perceived other signals or no signals in this regard if it was not asked for.For the perception of religiosity, social class and educational level, the respondents were asked to rate their perception of each name on 7-point Likert scales with an 8Between April and June 2021, we conducted 3.753 pairwise matched correspondence tests on the Flemish rental housing market. This method is, next to situation tests, a widely used method to measure rental discriminatory behavior in the field Flage, . More spDuring the tests, two (or three) rental candidates—one (or two) test profile(s) and one control profile—reply to the same rental advertisement on Immoweb and ask for a viewing.The results are analyzed by considering the responses made by real estate agents and private landlords. Here, there are four possible response categories: (1) nor the test nor the control profile is invited for a viewing, (2) both the test and control profiles are invited for a viewing, (3) only the test profile is invited for a viewing and (4) only the control profile is invited for a viewing. In As we aim to focus on discrimination toward ethnic minority candidates and thus negative discrimination, we analyze category (4) compared to category (1), (2), and (3). We conduct binary logistic regression analysis, given that our dependent variable is a dichotomous variable. We conduct the analysis separately for realtors and private landlords, given their profoundly different selection behavior Flage, .As seen in p < 0.001). As invitation rates need to be compared to a reference category (here Belgian names) in order to infer discrimination, the ratings of Belgian names are included in these analysis. Both forms of analysis, however, come to similar results.In addition, we analyze the odds to be invited for a viewing for both ethnic minority and majority groups as robustness check see , 5. We cdiscrimination. This is a dichotomous variable whereby 1 stands for “negative discrimination” and 0 stands for “no negative discrimination”. We talk about discrimination when the control person was invited for a viewing, but not the test person.The dependent variable, when looking at the responses made by realtors and private landlords, is Moroccan name” is a dichotomous variable whereby 0 “Belgian name” and 1 “Moroccan name”.“Polish name” is a similar variable, with 0 “Belgian name” and 1 “Polish name”.“Gender” is a dichotomous variable, with 0 “man” and 1 “women”.“Congruence European vs. Not-European origin” and “Congruence specific ethnic origin” are continuous variables. They represent the percentage respondents that correctly perceived the ethnic signals in names on either the distinction between European and non-European names or the specific ethnic origin.“Religious', “Low social class” and “Low educational level” are continuous variables and represent the percentage respondents who perceive the names as religious, of a low social class or of a low educational level.“monthly rent” and the “number of bedrooms'. Both are continuous variables.We take two control variables into account, namely the “p = 0.054). The result for private landlords is not significant. We therefore reject hypothesis 1, that expected to find more negative discrimination toward candidates with Moroccan as compared to Polish names.From the 3.753 correspondence tests, we found 10.7% discrimination against candidates with Moroccan names and 7.4% discrimination against candidates with Polish names among real estate agents. Among private landlords, these percentages are 14.2 and 11.4% respectively. Firstly, although the congruent perception of a name as European or not has no influence on discrimination by realtors, it does for private landlords. Per one percent increase in the number of respondents that successfully categorized names as European or not, the chance to be discriminated by private landlords increases with 50.8%hypothesis 2A and 2B: the clearer the signals names carry as being of non-European origin—and thus the clearer the ethnic European boundary, the higher the level of rental discrimination by private landlords.The congruence rate on the perception of the specific ethnic origin of a name (models 2) has no influence on the level of discrimination by realtors. Regarding private landlords, the congruent perception of the specific ethnic origin of a name is borderline significant. However, if we split the results according to rental candidates' names , neitherAlthough the origin of a name origin is of importance for discrimination by private landlords, gender discrimination is at play among realtors . Women ahypothesis 3: Real estate agents discriminate against ethnic minorities because of distastes toward religiosity, which is in line with taste-based discrimination in a color-blind ideology, whereby distastes are directed at perceived religiosity. We do not find this result for private landlords.Secondly, perceiving a name as religious increases the odds to be discriminated against by 1.024 by realtors for both Moroccan and Polish names. The perception of religiosity in names does not appear to be influential for negative discrimination by private landlords. Thus, we find support for hypothesis 4 and aligns with statistical discrimination, whereby stereotypes and prejudices about a candidate's ability to pay rent and take care of the dwelling matter. The perception of a name as of a low social class has a borderline significant effect on negative discrimination by private landlords and this effect is rather small. Consequently, the results for private landlords indicate ethnic taste-based discrimination, as neither the perception of religiosity, social class or educational level have a significant effect on the measured discrimination. This supports hypothesis 5.Thirdly, negative discrimination by realtors seems to also be based on the perception of a name as of a low social class and educational level. The higher the percentage respondents that perceive a name as of a low social class and educational level, the higher the ethnic discrimination by realtors. This supports In Ethnic discrimination on the rental housing market is a well-documented fact that knows no spatial or periodical boundaries Flage, . Often, Based on our research, we find no significant indications that candidates with Moroccan names are confronted with higher levels of rental discrimination as compared to candidates with Polish names. However, when considering only names with clear signals as being European or not, Moroccan names face higher discrimination by private landlords than Polish names, but not by realtors. This is partly a variation on other research conducted in other European countries, such as Italy tastes” toward the perceived religiosity of rental candidates, which is in line with taste-based discrimination. Because we find that perceiving a name as more religious increases discrimination against both candidates with Moroccan and Polish names, it might imply that it is religious rather than religion-specific taste-based discrimination that is at play. Moroccan names often have Islamic roots, whereas Polish names rather have a Christian influence Christian but secularizing Europe on the one hand and other religions, specifically Islam, on the other tastes” toward certain ethnic minority groups. The increased Europeanization and the emergence of a European identity created a European ethnic boundary differentiating European-migrants from non-European migrants Ponce, . ConsequAlthough the origin of a name directly relates to discriminatory behavior among private landlords, gender discrimination is measured among realtors. Female rental candidates are less likely to be discriminated against as compared to male candidates. However, an intersection is at play with having a Moroccan name: the gender advantage found for women only holds among the candidates with Moroccan names, and thus not among the candidates with Polish names.These results have implications for methodologies like correspondence testing that generally use names as the only signal. First, names carry rich and multiple signals. When thoroughly testing these signals, they can be used as indications as to what type of discrimination  is at play. Second, if researchers have in-depth knowledge about the signals conveyed by the names used, these signals can be adjusted or additional signals can be added in a much more accurate way for deeper analysis. By doing so, more precise measures of the proportion of statistical and taste-based discrimination might be uncovered.Moreover, this study has also a few policy implications. The current policies to combat rental discrimination in Belgium range from voluntary diversity training courses for realtors and landlords to applying correspondence testing as a policy tool. Although the long-term effects of voluntary trainings are still contested . Secondly, the respondents of the survey in which the perception of names were tested are not the tested realtors and landlords whose behavior was investigated during the correspondence tests. Using the same sample in both data collections would increase the likelihood of detection. Realtors and landlords might have, however, different ethnic perceptions of names than the general public. Thirdly, because we conducted correspondence testing, we only measure discrimination in the first phase of the rental process. Discrimination, however, can occur throughout the whole rental process. Fourthly, in this study we measure opportunity denying. This means that the real proportion of discrimination is underestimated, given the parallel practice of opportunity diminishing . The Ethics Committee waived the requirement of written informed consent for participation.BM created the conception of the study, organized the database, performed the statistical analysis, and wrote the first draft of the manuscript. Both authors contributed to manuscript revision, read, and approved the submitted version.


Frankenstein has, fittingly, assumed a life of its own. In today’s cultural landscape, the mere mention of ‘mutant’ evokes the language of Othering, including Frankensteinian metaphors, such as those used to describe the omicron variant of SARS-CoV-2. When scientists referred to omicron as a Frankenstein variant, they demonstrated the inherent mutability of the myth—a myth that is crucial in biomedicine. In this article, the authors examine the shifting nature of Frankenstein metaphors and consider how they function in what Priscilla Wald refers to as outbreak narratives in the context of the USA’s COVID-19 policies. The authors point to the ready instatement of travel bans as evidence of how such a potent myth is used to create and sell public policy. In response to such xenophobic policies, the authors apply Donna Haraway’s concept of ‘boundary breakdowns’ in order to reimagine relationships with mutancy. They examine how moving past the idea of mutant is other in contemporary virus narratives may offer a way to reconfigure our relationships of self and other and move beyond the hegemonic and nativist policies of the present.Since its debut, Mary Shelley’s  The Hill. These mutations, according to the same article, ‘reportedly enhanc[e] [omicron’s] ability to infect people’. Both news and fear of this ‘mutant’ spread swiftly around the globe—and with it came metaphor: ‘The thing is a Frankenstein mix of all the greatest hits’, declared Stephen Hoge, president of Moderna . However, a return to the text of Frankenstein, when paired with an understanding of what Haraway calls the ‘boundary breakdowns’ of the late twentieth century, may well offer a wedge with which we can pry open a different understanding of and relationship with the viral narratives that are quickly becoming commonplace in the twenty-first century.That ‘Frankenstein’ stands in for the creature (not creator) I is an Other: The Secret Life of Metaphor and How it Shapes the Way We See the World, James Geary offers an at once concise and broad definition. Metaphor, he says, is x=y  is more amalgamation than variation. If the definition of a mutant in biology is ‘an organism, gene, etc., which has undergone or arisen by mutation; a mutated form’ , then thAnd yet the creature is modelled after a human, using human parts. In this sense, he is mutant. Moreover, Frankenstein’s creature certainly meets the other definition of mutant: one that is ‘originally science fiction’ and is ‘an individual imagined as having arisen by genetic mutation’, especially ‘one with freakish or grossly abnormal anatomy, abilities, etc.’ . His ‘hoHow fitting, then, that this creature both is and is not a mutant. How appropriate that this pliant definition of ‘mutant’ applies to a myth in which there is common conflation of the maker and his creation vis-à-vis the name, ‘Frankenstein’. And while the cultural metaphor of Frankenstein as mutant relies on a simple, direct formulation, Frankenstein’s creature = mutant = Other , a closeFrankenstein in news coverage of omicron and other variants are further evidence for Jon Turney’s argument from the late 1990s: that Frankenstein is ‘the governing myth of modern biology’ (Frankenstein may help explain the nature of this variant (as that of a mutation), it would be naïve to assume we could easily divorce this association of mutation, and Frankenstein, from alarm. Just as Victor Frankenstein rushed from his room on witnessing his creation, heart full of ‘horror and disgust’  evaporates. Like in the novel, the label of ‘Frankenstein’ becomes a call to arms, a common understanding that any ‘mutant’ ‘creature’ is an Other worthy of not just aversion and caution, but attack. Like many medical metaphors, the word ‘mutant’ inspires certain action. Consider how the idea of mutancy maps onto Susan Sontag’s analysis of the metaphors of cancer—a diagnosis that may well involve a conversation about mutant cells: ‘To describe a phenomenon as a cancer [substitute: mutant] is an incitement to violence. The use of cancer [substitute: mutant] in political discourse encourages fatalism and justifies ‘severe’ measures’ , but rather in terms of ‘yes, and’ . If, that is, we are willing to realise the power and potential of such narratives.Indeed, the pattern of contagion, including the ‘identification of an emerging infection, (which) includes discussion of the global networks throughout which it travels, and chronicles the epidemiological work that ends with its containment’ is what Priscilla Wald calls the outbreak narrative . By deconstructing these patterns in film, literature and reportage, she highlights how the circulation of microbes shapes attitudes and fears, and contributes to social transformation. Even in the face of an outbreak narrative in which medicalised nativism can thrive, Wald argues for the How might we begin to analyse outbreak narratives to contribute to more equitable and effective responses? According to Wald, a communicable disease that risks infecting large portions of the population emphasises our own interconnectedness, despite defensive strategies of border closures and isolation. In contagion narratives, the wall never holds; the bucket always leaks. In an epidemic, ‘communicability configure[s] community’ , 12. In It is this boundary breakdown, and its implications, that Donna Haraway explores, and when applied to contagion narratives, this concept offers a way to realise Wald’s ‘conviction’ that studying outbreak narratives can lead to more ‘effective, just, and compassionate responses’ in global health. Writing ‘The Cyborg Manifesto’ almost four decades before COVID-19 and two decades before Wald, Haraway discusses the breach of (1) The ‘boundary between human and animal’, (2) The boundary of ‘animal-human (organism) and machine’ and (3) Its subset ‘physical and non-physical’ . The parallels to our current pandemic are clear: (1) COVID-19 is a zoological virus spreading across a world in which (2) The distinction between ‘natural and artificial’ is ‘thoroughly ambiguous’ , 11 as sIn the face of these dissolutions, Haraway argues, we have an opportunity to see ourselves as cyborgs—a ‘slightly perverse shift of perspective’ that ‘might better enable us to contest for meanings, as well as other forms of power and pleasure in technologically mediated societies’ . Under this premise, we are positioned to see both ourselves and the world as hybrid; we are both mutant and not, both transmitters and victims of virus. With this in mind, the Patient Zero or ‘super-spreader’ Wald describes  is narratively complicated, rather than easily blamed. ‘A cyborg world might be about lived social and bodily realities in which people are … not afraid of permanently partial identities and contradictory standpoints’ , 13. Undwe—us humans—create the next generation of the virus. We serve as both host and stranger, both self and other, as the mutants form inside us and spread among us. In the same way that a close reading of Frankenstein allows the reader to see the creature as both Victor’s curse and his responsibility, we too can see the newest COVID-19 mutants as both a direct product of our collective actions and as a site to be acted on.Haraway’s vision of mutancy and regeneration offers powerful metaphors in the face of our current totalising narratives: in the cyborg world, we are all mutant. As such, we can collectively channel our energy towards the site of the wound—the mutant virus and its damage—and simultaneously see it not as Other, but as part of our own creation, a product of our deforestation, globalisation and climate change. When the virus spreads through our population and gives rise to its own, mutating, evolving, populations within us, Frankenstein creature forces us to reckon with the confusion of figure and reference. It is a confusion that bears political, social and policy consequences, from global vaccine funding to local mask ordinances. As Haraway explains, ‘There is a myth system waiting to become a political language to ground one way of looking at science and technology and challenging the informatics of domination’ .In the cyborg feminist structure, dissolving frameworks of dominance is paramount. These frameworks, in which power is exercised over an Other, take the form of dualisms: ‘self/other, mind/body, culture/nature, male/female, civilized/primitive, reality/appearance, whole/part, agent/resource, maker/made, active/passive, right/wrong, truth/illusion, total/partial, God/man’ , 35. CybFrankenstein , to be feared. In this image, we see the creature sprawled out on the floor, while a divine light shines on their body, suggesting supernatural origin as well as a gesture towards the notion of regeneration. The shocked expression on the creature’s face directs the reader’s attention to Victor Frankenstein. He is depicted in motion, already fleeing the scene. Dr Frankenstein’s partially cloaked face is of special interest: both protected from the creature and protected from our gaze. We bear witness to his act and his shame, his look of horror foreshadowing his desire to conceal his creation. But the divine light reflecting from his creation’s body illuminates Victor Frankenstein’s face, despite his best efforts to shield and flee. Thus, man’s engagement with science serves a revelatory purpose: we see the human, Victor, more clearly, more deeply in this interaction than were we to observe the two characters separately. In this moment, man and ‘mutant’ illuminate one another. Such illumination suggests a mutuality in knowing, and here one can consider the implications of co-recognition between maker and mutant in light of Wald and Haraway: human and ‘mutant’ are irretrievably bound to one another, sharing the narrative frame, even as one attempts to flee, closing the door to contain. This image shows us that even from its inception, the myth of Frankenstein intertwines the concepts of creator and creation, of culture and nature. We do not live separately from the virus, neither literally nor metaphorically; just as our bodies are the catalysts of viral replication and, therefore, evolution and mutagenesis, we are the catalysts of our viral stories.The Week that was published in August 2021, just months before the Omicron variant surfaced. The cartoon references the 1931 film version of Frankenstein starring Boris Karloff, in which the trope of the mad scientist who screams, ‘It’s alive!’ is born. In this version, Uncle Sam, representing the US government and American citizenship, stands aghast, in contrast with the scientist’s fascination and ecstasy. The label VARIANT (read: mutant) on the creature’s jacket leads to the politician’s scream of ‘AGAIN!’—yet another variant has emerged; containment has not prevented the revival of the viral threat. The cartoon depicts a cycle of mutability, an ever-changing and emerging sphere of communicable disease: variants will emerge, and they will be nested within our larger COVID-19 narrative. In this cartoon, science and governance are separate entities with different motivations and reactions to events, forming additional dualisms of dominance: science/governance, science/virus, governance/virus. This fragmented view of outbreak dilutes and transfers responsibility away from the body. The regimented separation of science, governance and creature in the cartoon communicates a disjointed reality; the body of the viewer is not one with the virus nor with the science behind it.When we tell outbreak and viral narratives that emphasise perceived distance between us (humans) and nature (viruses), we reinforce our harmful predisposition to create a militant Other. Such is the case with the political cartoon from The viral stories we tell define us, and, as microbiologist, queer activist and writer, Joseph Osmundson writes, ‘viral stories will change, their center will not hold’ . These stories have defined us, do define us and will define us. From the inception of Frankenstein up to the present, the myth has been told and retold, shifting, transforming, mutating with each iteration. We have then and now, the future comes next. ‘The virus. Our body. Our biomedicine. Only through the three together can meaning be made; that meaning will shift over time as the virus, our bodies, and biomedicine do change’ . Rather than continue with the failing logic of separation and fragmentation, we can reconfigure the body and its relationship to a viral reality.Creating, investing in and perpetuating outbreak narratives informed by cyborg feminism, wherein artificially drawn boundaries are acknowledged and dissolved, may be one way forward. ‘As long as we live, viruses will almost-live alongside us’, Osmundson writes . ‘This is not to minimise the lives lost to HIV or COVID-19 or to any other virus’, but rather to acknowledge a basic fact: ‘We live on a viral planet. They were here first. We are their guests, not hosts. That is a viral story worth telling’ .be like to live in a world in which the metaphor of a mutant as an Other is not the foundation of messaging and policy—is not used to drive ineffective, fear-based, racist responses to emerging viral variants? It is not enough to simply pose this question: it is incumbent on us—individuals and the institutions we form—to respond with serious, thoughtful imaginative labour.What might it look like, feel like and indeed even Certainly, one place to start is language. Public health crises tend to introduce new phrases and acronyms into the lexicon. One need not look further than the new and omnipresent ‘social distancing’ phrase or the now widely known abbreviation of ‘PPE’  to see how public health crises bring new rhetoric. What other terms might we create? What kind of conversations and policies might we construct if we extended our ‘pandemic bubbles’ to include vaccine access for all?Such imagining may lead us to the material issue of funding for COVID-19 Vaccines Global Access, known as COVAX, a public health, multipartner, global delivery programme of COVID-19 vaccines. It may steer us away from accepting a world in which the pandemic is ‘over’ for some yet rages on for others in ‘Other’ places. As of the authors’ writing, COVAX remains severely underfunded, despite the reality that global vaccine distribution is essential to the health of a global body politic. After all, with widespread gaps in immunisation, viral replication persists, yielding new variants that can evade vaccine-induced immunity.These imaginings may also provide inroads for new ways of teaching and conceiving of public health. As the organisation Public Health Liberation explains, ‘Language Legacy’, is ‘the tendency of dominant culture to keep in place those traits in the language that maintain power and dominance over the social structures of the society’. This includes and relies on, the report continues, ‘symbol systems—verbal and nonverbal’ , 16. As feel to live in a world in which the binaries of ‘human/virus’ and ‘self/other’ are seen as false, one must consider the role of horror as an affect. Osmundon reminds us, ‘Horror grabs our attention, even when it’s a lie, even when it’s a metaphor’ . Indeed the very backbone of the Frankenstein novel is the mixture of horror and science fiction—it is, one could argue, a mutant of the two. Horror plays a crucial role in capturing attention and is a powerful mechanism for propagating myth and its metaphors. ‘HIV, COVID-19, Ebola, and rabies can kill,’ writes Osmundson, ‘The problem wasn’t illness. The problem never is. Illness is a fact of life. The problem is our inability to provide care to all’.And in considering how it would A litmus test, then, of our metaphors may be: Does it move us in the direction of extending care? Does it provide imaginative possibilities that expose, rather than reinforce, false boundaries and binaries? And what is the role of horror in the narrative schema?If COVID-19 has taught us anything, it is that there will be more variants and future chapters of the pandemic narrative. When the next variant emerges, will we default to existing, oppressive frameworks? Or will we find ways to regenerate, embracing our own mutancy and imagine more equitable and effective pathways to respond?