Authenticity, Depression, and Deep Brain Stimulation

the person a unique individual” (Guignon, 2004). Guignon’s suggestion bears some resemblance to the definition of personality traits according to the DSM-IV of the APA as “enduring patterns of perceiving, relating to, and thinking about the environment and oneself that are exhibited in a wide range of social and personal contexts.” The emphasis of “enduring patters” touches on another important feature regarding the true self; does the true self consist of enduring patterns, or is it “constantly shifting and reacting and altering” (Williams, 2002)? However, two other common features of the notion of authenticity diverge from the definition of personality traits according to the DSM. First, beside the descriptive content the notion of authenticity usually entails a normative claim. To be authentic, it does not suffice to identify the characteristics of one’s true self. In addition, the defining set of characteristics must shine through or be expressed in the person’s way of living; reflecting on undertakings such as relationships, professional life, and hobbies. Thus, we fail to be authentic when we fail to express some part of our defining characteristics (Guignon, 2004; Schechtman, 2004). Second, these characteristics are often more or less explicitly described as “natural” disposition; implying that this set of inclinations and traits are bestowed on each individual by nature. When these two features combine, authenticity urges the person to live in accordance with this given nature; that which “we are” has a privileged position. Thus, on this view diversions from a person’s given nature are morally problematic. Noteworthy, the moral claim of authenticity does not oppose all kinds of alterations of a person; only the changes which distance a person from his or her true selves. Nor is a complete change in personality required for the change to be morally significant; or the rather major changes alluded to within At the heart of the notion of “authenticity” is the idea, with the words of the late British philosopher Bernard Williams, “that some things are in some real sense really you, or express what you are, and others aren’t.” This idea have not only attracted and been elaborated by philosophers (for further orientation, see Taylor, 1995 or Golomb, 1995), it also appears in our everyday lives. Expressions like “Mary wasn’t really herself today” or, “Eric finally showed his true face,” points to the notion that not all which we think, feel, or act on express who we really are. Thus, the notion of authenticity can both provide new perspectives to philosophical concerns regarding MDD and DBS, and in addition captures intuitions and beliefs held by many patients (Kramer, 1996; Bolt and Maartje, 2009). In contemporary analytical philosophy, authenticity has usually been employed in discussions on autonomy (Waddell Ekstrom, 1993, 2005), or in theories on “the Self” (Schechtman, 1996, 2004). In addition, authenticity has surfaced in bioethical discussions on issues like sex changes, human enhancement, and treatment of psychiatric disorders. A full account of these diverse interpretations cannot be given here (for instance, solely accounts of the self range from ideas that there are no such thing to ideas of the self as an immortal soul); hence this article is limited to introducing a few key features and their implications. First one needs to address what the US philosopher Marya Schechtman describes as the characterization question, namely the set of characteristics that makes me the person I am; or, when applied to authenticity, the set of characteristics defining a person’s “true self.” One answer is suggested by the US philosopher Charles Guignon in the book “On being authentic.” He describes this set of characteristics as “the constellation of feelings, needs, desires, capacities, aptitudes, dispositions, and creative abilities that make Authenticity, depression, and deep brain stimulation