Authenticity—Psychiatric Perspectives

Authenticity as it is discussed in philosophy and psychotherapy has a relatively low impact in psychiatry. In order to discuss this topic, referring to mental disorders, not only a multidimensional definition of this construct but also a reference to an integrative conceptual framework of the mind is useful. In line with this, it is remarkable that the category “mental disorders” is closely linked to the concept of personal identity (or self): The person behaves in the crisis objectively and subjectively not like before, she is apparently essentially “changed” at the level of the core of her personality (i.e. trans-situational invariant affective-cognitive dispositions of behavior). In several mental disorders, that can last several weeks, these individuals behave “unusual”, so that they do not only wonder about these personality components afterwards but they even are ashamed. In this regard, the concept of authenticity might be a useful construct to highlight basic mechanisms of consistency of mental organization. Here, according to the descriptive power of the category “authenticity”, the critical question arises to what extend the personality/self versus the situational social role contribute to the conditions of the respective disorder. This aspect is relevant in psychiatric practice, as in the rehabilitation phase patients are advised to be “authentic”, when a role-play is too risky and can induce secondary stress. For instance, in situations where alcohol is offered to individuals who are addicted to alcohol, they have to argue for reasons not to drink. In role-play, they have to find out the most authentic argument not to drink (best case: “I am an alcoholic”). In addition, it is also recommended that therapists who basically are committed to affective neutrality should exhibit a selective affective authenticity in order to improve the patient-therapist relation. Also the concept of an “authentic empathy” is increasingly important regarding “empathic” medical robots. Finally, for theoretical issues a revision of concepts and models in psychopathology is recommended.