This chapter reviews the interdisciplinary field sometimes called “philosophical psychopathology”
(Graham and Stephens 1994), which is also related to “philosophy of psychiatry” (Fulford,
Thornton, and Graham 2006). I’ll focus first on various psychopathologies with special attention
to how they negatively impact and distort conscious experience, such as amnesia, somatopara-
phrenia, schizophrenia, visual agnosia, autism, and Dissociative Identity Disorder (DID). Many of
them are disorders of “self ” or “self-awareness” which force us to consider related philosophical
problems, such as the problem of personal identity. There are of course many other abnormal
conditions not discussed in this chapter. I’ll then discuss “philosophy of psychiatry,” covering
the overlapping topics of psychopathy, mental illness, and moral responsibility. In addition to
the work of philosophers, recent interest is also due to the accessible writings of neurolo-
gists, most notably Oliver Sacks (starting with his 1987 book), Todd Feinberg (2001), and V.S.
Ramachandran (2004). One of the results is the important interdisciplinary interest that has
been generated among philosophers, psychologists, and scientists.^1
Let us begin with a number of disorders that challenge our notion of personal identity and self.1 Disorders of the Self and Self-Awareness
Philosophers have always been intrigued by disorders of consciousness. Part of the reason is
that if we can understand how consciousness goes wrong, then we can better theorize about
the normal functioning mind. Locke (1689/1975) discussed the philosophical implications of
something like multiple personality disorder (MPD) which is now called “Dissociative Identity
Disorder” (DID). He recognized that difficult questions arise: could there be two centers of con-
sciousness in one body? What makes a person the same person over time? These questions are
closely linked to the traditional philosophical problem of personal identity. Related questions
also arise for various memory disorders, e.g. does consciousness or personal identity require
some kind of autobiographical memory or psychological continuity?
DID describes a condition in which a person displays multiple distinct identities (or “alters”),
each interacting with the environment in its own way. Each alter has its own pattern of behav-
ing, perceiving, thinking, and pattern of speech. The alters seem to emerge involuntarily and not
all alters are even always known to the patient. Thus, there is significant amnesia on the patient’s
part for periods of time. This would seem to imply that there are really two (or even more)25
CONSCIOUSNESS AND
PSYCHOPATHOLOGY
Rocco J. Gennaro
Rocco J. Gennaro Consciousness and Psychopathology