Letting go of the “unwell self” in chronic and life-challenging conditions

Objectives: Individuals living with chronic or life-challenging conditions often face significant psychological challenges, particularly the tendency to identify with an “unwell self.” Drawing on Buddhist philosophy, especially the concept of non-self (anattā), this paper explores how attachment to an illness-based identity can perpetuate suffering and limit psychological wellbeing.

Methods: The present paper synthesizes clinical examples and critically appraises existing research to discuss how identity enmeshment with illness may be addressed by infusing contemporary mindfulness-based techniques with Buddhist wisdom principles, such as non-attachment, emptiness and impermanence.

Results: We explicate how rigid identification with illness, known as schema-enmeshment, is associated with increased psychological distress and reduced quality of life. Practices informed by Buddhist philosophy, such as mindful awareness, recognising impermanence, and cultivating an understanding of non-self and emptiness, are proposed as ways to loosen attachment to an illness-based identity, sometimes referred to as the “unwell self.” These approaches foster self-compassion, psychological flexibility, and resilience.

Conclusions: Cultivating awareness of non-self and practising non-attachment can help individuals with chronic or life-challenging conditions reframe their relationship with illness. This shift can enhance psychological wellbeing, resilience, and openness, with benefits for both clinical practice and personal development. We recommend greater integration of ancient Buddhist wisdom principles into contemporary mindfulness-based interventions for this population.