Intersectionality of Identities

While consultants spoke extensively about their illness experiences, additional identities were also expressed throughout the study. The notion of intersecting identities arose from an observation with Willow where we attended a Laverne Cox speech; Cox talked about the intersection of her identities as a transgender, black woman, daughter, and actress that made up her person. After the observation, Willow stated, “I would say definitely obviously being female would be an identity for me. And like, obviously, the one that comes across the most is that I am female and cisgender as far as everyone knows.” As I examined this quote further, the word ‘obvious’ and phrase ‘as far as everyone knows’ stuck out to me. These words highlighted both the visibility and invisibility of identities, specifically the

intersection and interplay between identities. It underscored the idea that some identities are more salient and visible to others:

I think being a bi-sexual person is a thing that a lot of people who know me know just because I do a lot of the photocampaigns in relation to that. And I do participate in the [organization’s] stuff. People see me going into the [organization] office.

Willow’s female, cisgender, and bi-sexual identities were visible based on her participation in certain chosen social occupations. Willow did not mention her mental illness when asked about her identity. Her participation in campus organizations, campaigns, and occupations centered on other identities, not her mental illness identity. Her identities affected her participation in social occupations and those occupations helped to form and sustain her identities. Willow acknowledged her diagnosis though did not pursue occupations related to this identity; however, occupations inherent to the need to manage the illness structured her day and influenced her ability to pursue occupations related to her other identities.

The intersection of identities through occupation was also evident with Leo. Referring to his love for learning languages and writing pen pals all over the world, Leo self-identified as a “charismatic Christian” and “an international person with international friends”. These

studying multiple languages at one time in preparation for changing world events (e.g., New World Order). When he began expressing greater interest in learning languages again, his parents and counselor questioned whether he was heading for a relapse. Leo shared his frustration with having to question himself and worry about how his other identities and associated occupations were framed in relation to his identity as a mentally ill person: “This is a part of my personality. I have been learning languages and writing pen pals for over 15 years.” Since his psychotic episode, his previous identities of Christian and language academic changed due to the mental illness identity. Indeed, his other identities became part of the narrative of his illness and were reframed in relation to his mental illness. As a result, Leo has had to negotiate how his identities influence one another in his life:

From church to church where I’ve gone, people have always found reasons to reject me. And I think it has to do with my mental illness…So now I’ve started to wear the identity of the mental illness on my sleeve a little bit. To try to find like, to make peace with it, you know.

Throughout the study, Leo struggled with how to integrate his illness identity while reengaging in social occupations. His engagement in social occupations changed throughout the study, possibly in an effort to functionally coordinate his intersecting identities. Initially, he was attending several bible study groups and churches for worship, which seemed to fit with his Christian identity. Subsequently, he began volunteering with an organization that served individuals with intellectual disabilities. Leo’s occupational

participation in that organization fulfilled his need for acceptance and belonging. Later in the study, Leo became more involved with Al Anon, which served as more of a support group. Al Anon is a faith-based group, but they were not as religiously oriented as the churches he had previously attended. Though not explicitly stated, I questioned whether Leo’s

occupational choices centered on his need to integrate the illness identity amongst his other identities.

In this study, it was apparent that it is impossible to examine a singular identity. Identities mesh together and influence each other to impact thoughts, behavior, and social participation (Holland et al., 1998). While mental illness positions individuals into an identity, this identity intersects with other identities to produce variable outcomes. Socioeconomic status, age, race, and other social factors must be examined as these factors evoke identities that intersect with one another and push individuals towards particular outcomes (Laliberte Rudman, 2002; Read & Eagle, 2014). Thus, occupational possibilities are further impacted depending on the intersection of identities operating through the individual. This concept was most prevalent in Oliver’s situation. As a second generation immigrant, Oliver identified himself as half Puerto Rican and half white. He stated his family grew up “dirt poor” and he felt pride in his father’s ability to go from being poor to having a college degree and serving in the military. Oliver frequently transitioned our discussions to his family and ancestry, which seemed to be an important and influential identity impacting his life and social participation. His family identity influenced his occupational choices and plans for his future:

I’ve always known that I’m going to end up in the military in some regard…I think that I would find a lot of meaning in being a part of the military…Well, I, I think that's what I'm craving. I talked to the Marine recruitment officer. I really wanted to be amongst them. I was actually in ROTC for a little bit when I was in college but I was uh...I should have just gone to on campus counseling or something at the time because that would have done a lot of good for me, instead of, uh, trying to hold out on my own.

In this comment, Oliver described how his mental illness influenced his occupational possibilities. Although he envisioned a military career, his psychotic episode impacted his ability to commit to the ROTC or Army. Later in the interview, Oliver contradicted these goals and stated: “I don’t identify with liberal democracy at all…That definitely influenced my decisions to not commit to the Army and ROTC because I would rather be in a place like occupy [referring to Occupy wall street] with all of those grand, gigantic fuckups where I

envisioned his life. This seemed to be related to his own internal struggle with identifying possible occupational pathways following his psychotic episode. While Oliver recognized his illness identity as something he had to negotiate into his daily life, he still had many other intersecting identities that factored into his social participation and shaped his occupational choices. Particularly, his socioeconomic status, family, ethnicity, and political orientation evoked different identities that operated together to impact his participation and life outcomes. Oliver attempted to negotiate his multiple identities through the occupations he chose to participate in socially. Similarly, Willow’s engagement in LGBTQI events and campaigns allowed her bisexual and cisgender identities to become more salient than her mental illness identity. Leo’s occupations also shifted as he worked to combine various identities in a functional way. In this study, occupation was a mode through which

consultants worked to merge various identities and undergo identity work towards increased social participation.