Re: the continuity of self

Encountering cases of severe schizophrenia, I find myself questioning—what is “personality”?

Before starting my psychiatry rotation, my image of schizophrenia was a silent, creeping tsunami–the irreversible destruction of the self, with no cure. Subsequently a new “personality” emerges as their insight collapses.

Biologically and genetically, this person is undoubtedly the same individual.

But philosophically, one might see them as someone entirely different.

And yet—the insight returns as the adequate medication improves the symptoms and they begin to resemble their former self. However, is that their original personality resurfacing?

Or is it a third persona created by the medication?

While I’m grateful that advances in modern pharmacology allows many patients and their families to reclaim parts of a once-happy life, I can’t help but dwell on these questions.

Perhaps it’s because my current rotation is in a forensic psychiatric facility, where I encounter patients who have committed serious crimes under the grip of their mental illness.