Metaphor and Epistemic Injustice in Schizophrenia

Today we interview Francesca Ervas and Lina Lissia on their project entitled: “Metaphor and Epistemic Injustice in Mental Illness: The Case of Schizophrenia” funded by PRIN, an Italian funding scheme to support research project of national interest. The project investigates epistemic injustice in metaphorical communication in the case of mental illness. A series of seminars has been planned as part of the project and the final meeting will be a conference held in Cagliari on 22-24 October 2025.

Metaphorical communication

Lisa: What are the research interests that gave rise to this project? 

Francesca and Lina: The project was born due to a common interest in metaphor as a way to express the self/mental illness relationship. The link with epistemic injustice, defined as the injustice towards a person as a knower, came later, and was based on the idea that metaphor can precisely be seen as an epistemic device. We were interested in both forms of epistemic injustice, as Miranda Fricker defined them in 2007: 1) as a failure to attribute credibility to people with mental illness (testimonial injustice), and 2) as an attempt to marginalize their epistemic resources thus not recognizing their ability to interpret their own experience of illness (hermeneutical injustice). 

The project builds on understanding and empirically investigating both the cognitive and social mechanisms behind testimonial and hermeneutical injustice, where people with mental illness often face epistemic challenges in credibility and interpretation. We hypothesized that metaphor can have a role as a communicative tool to overcome the ineffable and inarticulate nature of the mental illness experience and, notwithstanding social stigmas and interpretive difficulties, to reach an affective attunement with the relevant others (families, friends, doctors, healthcare professionals, other people in their social lives, etc.). 

Lisa: What are the main objectives of your project?

Francesca and Lina: Focusing on schizophrenia, the project analyzes the cognitive and bodily mechanisms at the root of the failure to attribute credibility (testimonial injustice) and interpretive capacities (hermeneutical injustice) to people with mental illness, when they communicate their illness to other people via metaphors vs. their literal counterparts.

We hypothesized that affective attunement in communication is a cooperative enterprise that needs to overcome both patients’ difficulties in embodying metaphors in illness communication and interpreters’ negative social and moral stereotypes, which concur to create the case for epistemic injustice.

The project involves three research units: the University of Cagliari (UniCa), the University of Messina (UniMe), and the University of Chieti (UniCh), respectively exploring:

1. the interpreter’s perspective (UniCa, Prof. Francesca Ervas, PI of the project)
2. the mental-ill speaker’s perspective (UniMe, Prof. Valentina Cuccio)
3. the mental-ill speaker/interpreter interaction (UniCh, Prof. Francesca Ferri)

Such factors help us understand the cognitive mechanisms responsible for the missing attunement between people with mental illness and interpreters. 

Metaphor is proposed as a valuable resource to foster a better attunement between the speakers with schizophrenia and the interpreters and to possibly prevent or overcome epistemic injustice in illness communication. Metaphor is indeed a necessary tool for people with schizophrenia to express their illness and themselves in relationship with the illness, but also for relevant others to access what the speaker feels as meaningful to articulate of their experience of illness.

Working together

Lisa: Does your project involve different disciplines and perspectives? 

Francesca and Lina: The three research units have different disciplinary backgrounds and methodologies: philosophy of language and experimental pragmatics (UniCa); philosophy of mind and psycholinguistics (UniMe); cognitive neuroscience and psychiatry (UniCh). UniCa and UniMe embrace a theoretical-philosophical approach to the problem of epistemic injustice in the case of metaphor. 

All the units adopt an experimental approach to empirically investigate the cognitive mechanisms at the basis of the problem, focusing on schizophrenia. However, each unit tackles the very same problem from different angles and via different empirical methodologies. Check the members and the disciplinary background of all our teams.

Lisa: What do you expect the impact of this project to be?

Francesca and Lina: Results will significantly advance the understanding of the theoretical, linguistic and cognitive aspects of metaphor use in mental illness communication, with interdisciplinary scientific and academic impact and social impact on public policies and health institutions. A social campaign, based on the experimental data on metaphors production/understanding and the active engagement of stakeholders, will also be designed and produced, with an impact on the general public. 

Finally, the outcomes have the potential to lead to the development of novel rehabilitative interventions and novel social behaviors to prevent epistemic injustice.

The Metaphor and Epistemic Injustice in Schizophrenia project team:

Francesca Ervas, Martina Montalti, Valentina Cuccio, Alice Guerrieri, Francesca Ferri, Lucienne Huby, Lina Lissia.