There is a phrase that appears in every mental health awareness campaign, every destigmatisation effort, every well-meaning poster in a university corridor: make it visible. Shine a light. Break the silence. Reduce stigma by talking about it.

I agree with the impulse. I am less sure about what the phrase actually asks of us, or what it assumes is possible. This post is my attempt to think through that question — and to document a small project that emerged from it.

A Personal Starting Point

I am on the spectrum. I was diagnosed in adulthood, which is not unusual, and the diagnosis explained a great deal about a life spent finding some things effortless and others bewildering.

Code is easy. The internal structure of a problem, the satisfaction of a clean abstraction, the deep rabbit holes that open when a concept catches my attention and refuses to let go — that is the natural medium. Hyperfocus is not a metaphor for me; it is literally how I spend a Tuesday afternoon. I have written entire systems because I could not stop.

Emotions are harder. Not absent — that is a misconception I will address in a moment — but differently structured. Reading a room is work. Social cues that seem to operate as obvious background noise for most people arrive for me as data that requires conscious decoding. The reverse appears to be true for most neurotypical people: emotional processing runs in the background, effortlessly; formal abstraction requires deliberate effort.

Neither is better. They are different cognitive architectures, and both come with costs.

I raise this not to centre myself, but because it is relevant to the question the post is actually about. I spent years navigating a social world that was not built for how I process it. That experience sits close to the experience of people with mental illness — not the same, but adjacent. And it made me think hard about what “understanding” across neurological difference actually means.

Mental Illness Is Still a Grey Zone

The progress on mental health stigma over the past decade is real. People talk about therapy more openly than they did. Burnout is acknowledged at work. The language of mental health has entered mainstream use — sometimes usefully, sometimes in ways that dilute clinical concepts into lifestyle descriptors. Anxiety is now a brand attribute. Trauma is a metaphor for mild inconvenience. This is a problem, but it is a second-order problem; the first-order problem — that serious mental illness is still heavily stigmatised, underfunded, and misunderstood — is the one that matters more.

Corrigan and Watson [1] documented what the stigma research consistently shows: people with mental illness face two compounding problems. The first is public stigma [3] — the prejudice of others, leading to discrimination in employment, housing, relationships. The second is self-stigma — the internalised application of those same prejudices to oneself. The second is often worse. It is the mechanism by which stigma becomes a barrier to seeking help, creating the feedback loop that keeps serious mental illness invisible precisely because the people experiencing it have been taught that it is shameful.

The phrase “make it visible” is a response to this dynamic. If mental illness is visible — discussed, depicted, normalised — the argument goes that stigma decreases. There is evidence for this. Contact-based interventions, where people without mental illness interact with people who have it, consistently outperform education-only approaches [2]. The visibility of real people matters more than information campaigns.

But there is a difference between visibility and understanding.

What Visibility Actually Achieves

When we say “make it visible”, we usually mean one of several different things, which are worth separating.

Normalisation means that a condition becomes part of accepted human variation rather than a mark of failure or danger. This is achievable through visibility and is genuinely important. Knowing that a colleague takes antidepressants, or that a public figure manages bipolar disorder, reduces the sense of aberration. It does not require the observer to understand the experience — only to register that it exists and is survivable.

Representation means that people with a condition see themselves reflected in culture, media, and institutions. This matters for the affected person; it is about recognition, not about inducing empathy in the non-affected.

Empathy is the hardest and most frequently over-promised goal. It is what the simulation approaches aim for: put a neurotypical person in a room with distorted audio and flickering visuals and tell them this is what psychosis sounds like. Does it work?

The honest answer from the research is: somewhat, temporarily, and with significant caveats.

The Empathy Gap

Let me be direct about something. A person who has never experienced severe depression cannot know what it is. Not in the way that a person who has experienced it knows it. This is not a failure of empathy or imagination; it is a structural fact about how knowledge of mental states works.

Philosophers call this the problem of other minds. We have no direct access to another person’s experience. We infer it, imperfectly, by analogy to our own. For experiences that have no analogue in our own history, inference breaks down. You can read every clinical description of dissociation ever written and still not know what dissociation is, because the knowledge that matters is not propositional — it is not a set of facts — but experiential.

This is the gap that simulation approaches try to bridge, and it is genuinely unbridgeable. What simulation can do is something weaker but not worthless: it can create an affective response, a discomfort, a disruption of the observer’s normal processing, that functions as a rough proxy signal. Not “now you know what it is like”, but “now you have a small, incomplete, distorted approximation of some dimension of the experience”.

The risk is misrepresentation. Schizophrenia simulations have been criticised — fairly — for reducing a complex condition to its most dramatic phenomenological features (auditory hallucinations, paranoia) while omitting the cognitive, relational, and longitudinal aspects that define how people actually live with the condition. A five-minute visual experience of “what depression feels like” that emphasises darkness and slow motion tells you almost nothing about the specific exhaustion of getting through a Tuesday morning, or the way time warps over months.

So: you cannot truly understand what you have not experienced. But you can try to approximate something, and approximation, done honestly and with appropriate epistemic humility, is better than nothing.

Metaphor as a Communication Tool

There is a long tradition of using metaphor and art to communicate internal states that resist direct description. This is not a bug; it is a feature of how language handles subjective experience.

The poet uses metaphor because “my heart is heavy” is not literally true but captures something that “I am experiencing low mood” does not. The musician uses dissonance and rhythm to structure emotional experience in the listener. The visual artist uses colour and texture to evoke states rather than depict them. None of these are representations in the scientific sense — they do not accurately model the referent — but they create a kind of resonance that purely descriptive language cannot.

Mental health communication has increasingly moved in this direction. The vocabulary of “emotional weight”, “spiralling”, “crashing”, “the fog” — these are metaphors that have become clinical shorthand precisely because they communicate something essential that clinical terms do not. When someone says “I couldn’t get out of bed”, they are not describing paralysis; they are describing a particular quality of anhedonia and executive dysfunction that no diagnostic manual entry captures as well.

This is the space where a project like inner-echo operates.

Inner Echo: The Idea

inner-echo is a browser-based audiovisual experiment. It takes a webcam feed and applies condition-specific visual and audio effects that function as metaphorical overlays on the user’s own image. The output is not a simulation of a mental health condition in any clinical sense. It is an attempt to construct a visual and auditory language for internal states, using the user’s own presence as the anchor.

The technical architecture is deliberately minimal: React, WebGL/Canvas for video processing, optional WebAudio. Everything runs in the browser, client-side, with no backend. No data leaves the device. This is not incidental — privacy is load-bearing for a project that deals with sensitive self-reflection. Safe Mode and an emergency stop function are built in.

The condition-profile system supports three modes:

  • Preset mode: a single-condition metaphorical composition — one set of effects mapped to one cluster of experiences
  • Multimorbid mode: weighted stacking of multiple condition profiles, acknowledging that most people with mental health conditions do not have one thing
  • Symptom-first mode: dimension-level control, letting the user build from individual symptom representations rather than diagnostic labels

The last of these is, I think, the most honest design choice. Diagnostic categories are administrative conveniences as much as they are natural kinds. Two people with the same diagnosis can have radically different experiences. Structuring the system around dimensions of experience rather than labels is both clinically more accurate and communicatively more flexible.

What It Is Not

Being clear about limitations is not false modesty; it is the only way this kind of project retains its integrity.

inner-echo is not a simulation of any condition in the sense of accurately modelling its phenomenology. It does not claim to show you “what depression is like”. It offers metaphorical approximations of some dimensions of some experiences, and it does so using effects that are legible to the observer — visual distortion, audio modification, altered feedback — that bear a designed but non-literal relationship to the internal states they are meant to evoke.

It is not a diagnostic tool. It is not a therapeutic intervention. It is not a substitute for any clinical process.

What it might be is a starting point for a conversation. Something a person experiencing a condition could use to gesture toward an aspect of their experience. Something a person without that experience could encounter with enough curiosity to ask a better question than they would have otherwise.

That is a modest claim. I think modest claims are appropriate here.

Why This, Why Now

Mental health awareness has become a genre. The awareness campaigns, the celebrity disclosures, the workplace wellness programmes — these are real goods, and I do not want to be cynical about them. But the communication problem has not been solved. The words exist. The willingness to use them, in many contexts, exists. What is still missing is a language for the texture of experience that the words point to but do not reach.

I find myself better able to build something than to explain it in words. That is probably a spectrum thing. inner-echo is an attempt to build toward a language that I do not fully have — for my own internal experience, and for the experiences of people navigating conditions quite different from mine.

The gap cannot be closed. But the attempt to reach across it is worth making, and worth being honest about.

References

[1] Corrigan, P.W. & Watson, A.C. (2002). Understanding the impact of stigma on people with mental illness. World Psychiatry, 1(1), 16–20.

[2] Corrigan, P.W., Morris, S.B., Michaels, P.J., Rafacz, J.D. & Rüsch, N. (2012). Challenging the public stigma of mental illness: A meta-analysis of outcome studies. Psychiatric Services, 63(10), 963–973.

[3] Goffman, E. (1963). Stigma: Notes on the Management of Spoiled Identity. Prentice-Hall.

inner-echo repository: https://github.com/sebastianspicker/inner-echo