‘Mental Disorder and the Concept of Authenticity’ by Alexandre Erler in (2014) 21(3) Philosophy, Psychiatry and Psychology 219-232 comments
Authenticity
has recently emerged as an
important issue in discussions of mental disorder. We
show, on the basis of personal accounts and empirical
studies, that many people with psychological disorders
are preoccupied with questions of authenticity. Most
of the data considered in this paper are from studies of
people with bipolar disorder and anorexia nervosa. We
distinguish the various ways in which these people view
the relationship between the disorder and their sense of
their authentic self. We discuss the principal modern ac-
counts of authenticity within the analytic philosophical
tradition. We argue that accounts based on autonomous,
or wholehearted, endorsement of personal characteris-
tics fail to provide an adequate analysis of authenticity
in the context of mental disorder. Significant elements
of
true self
accounts of authenticity are required. The
concept of authenticity is a basic one that can be of
particular value, in the context of self-development, to
people with mental disorder and to others experiencing
substantial inner conflict.
Erler argues
Authenticity has recently
emerged as
an issue in bioethics principally in two
settings: discussions around enhancement
and with reference to mental disorder. One issue
that is being much debated is whether some methods of enhancement, for example, using drugs, result in the person becoming inauthentic and are for
that reason morally problematic (e.g., see Elliott
1998; DeGrazia 2000). In the setting of mental
disorder, people with a disorder, and those around
them, may seek to distinguish between the authentic and inauthentic characteristics of the person.
Some parents of children with attention deficit hyperactivity disorder (ADHD) are concerned with
the issue of when medication helps to ‘reveal’ and
when it obscures their child’s authentic character
(Singh 2005, 2007). Some people with anorexia
nervosa come to see aspects of their personality
associated with the anorexia as inauthentic (Hope
et al. 2011). Karp reports that many people with
bipolar disorder ask themselves: “If I experience
X, is it because of the illness, the medication, or
is it ‘just me’?” (Karp 2006, 119).
In both settings, the relevant authenticity is of
human psychological characteristics that, in some
contexts, refers to the self as a whole and in others
to specific aspects of the self, such as decisions,
desires, emotions, and behavior. We use the term
‘authenticity’ to apply to any or all such phenomena, depending on context.
In this paper, we argue, on the basis of personal accounts and empirical studies, that many
people with mental disorder find the issue of
authenticity significant particularly in the context
of self-development. We distinguish the various
ways in which people with mental disorder view
the relationships between the disorder and their
sense of their authentic self. We go on to discuss
why the experience of mental disorder gives rise
to questions about authenticity. We then outline
the three principal modern accounts of authenticity within the analytic tradition. We consider
how these accounts relate to the uses made of
the concept of authenticity in the cases we discuss. We argue that only those accounts that give
prominence to the idea that there is a ‘true self’
to be discovered provide an adequate analysis of
the majority of ways in which those with mental
disorder use the concept of authenticity. We argue
that the concerns about authenticity are distinct
from concerns about best interests and autonomy.
Finally, we consider the normative implications of
considerations of authenticity in the context of
mental disorder (and further contexts). Although
the concept of authenticity in the context of mental
disorder is mainly of value for prudential reasons,
it can also have moral implications.
