Literature and project-review cutoff: 11 July 2026.

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, 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, but differently structured in my experience. Reading a room is work. Social cues can arrive as data that requires conscious decoding. I have sometimes experienced neurotypical communication as the reverse. That is a personal impression, not a population-level model of two cognitive architectures.

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

Mental-health language is visible in workplaces, media, and public campaigns. That visibility can coexist with stigma and discrimination. This article does not measure whether stigma has improved over a decade or rank stigma, underfunding, and changing everyday language against one another.

Corrigan and Watson [[1]] distinguish public stigma—the prejudice and discrimination of others—from self-stigma, in which stereotypes are applied to oneself. Both can affect disclosure, self-esteem, opportunity, and help-seeking. The review does not establish that self-stigma is universally worse or one feedback loop for every condition.

The phrase “make it visible” is a response to this dynamic. Corrigan and colleagues’ meta-analysis found different average effects for contact and education across included outcomes and age groups [[2]]. It does not establish that contact always outperforms education or that visibility alone causes improvement.

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 sources cited here do not evaluate audiovisual symptom simulations, so their effectiveness and risks remain open.

The Empathy Gap

Someone who has not experienced severe depression does not have first-person knowledge of it. How much understanding can nevertheless be built through testimony, clinical work, art, and relationships is a philosophical and empirical question, not a boundary established by the stigma studies cited here.

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.

Simulation approaches try to address part of this gap. An audiovisual effect can create discomfort or disrupt ordinary processing, but without validation we do not know whether it communicates the intended experience, teaches a stereotype, or does something else.

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: an approximation should be presented as an invitation to listen, not as transferred experience. Whether it is better than no intervention must be tested rather than assumed.

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 often uses terms such as “emotional weight,” “spiralling,” and “the fog.” I find such metaphors useful. This article does not establish that they are clinical shorthand or more accurate than clinical description.

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 intended architecture is deliberately minimal: React, WebGL/Canvas for video processing, optional WebAudio, client-side operation, Safe Mode, and an emergency stop. Those are repository-level design claims, not a privacy audit of a pinned deployed build. Browser permissions, dependencies, analytics, hosting headers, and future changes must be checked before promising that no data leaves a device.

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 intended to represent co-occurring dimensions
  • Symptom-first mode: dimension-level control, letting the user build from individual symptom representations rather than diagnostic labels

The last of these is the design choice I prefer. People with the same diagnosis can report different experiences, but that does not make this symptom-first interface clinically validated or “more accurate.” It is a communication hypothesis that needs participatory evaluation.

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.

An interface cannot transfer first-person experience. It may still help people ask better questions. Whether this one does is not yet known.

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

Changelog

  • 2026-07-11: Added a current evidence boundary: inner-echo is a metaphorical communication project, not a clinical simulation, diagnostic instrument, therapy, or deployed privacy guarantee; removed population-level autism generalisations and unvalidated claims of clinical accuracy, empathy transfer, and universal contact superiority.