Peer-review started: October 31, 2016
First decision: December 1, 2016
Revised: December 7, 2016
Accepted: January 2, 2017
Article in press: January 3, 2017
Published online: March 22, 2017
Processing time: 142 Days and 22.7 Hours
Many individuals with schizophrenia have occasional difficulty defining both to themselves and to others who they truly are. Perhaps for this reason they make attempts to change core aspects of themselves. These attempts may be delusional, but are too often unjustly dismissed as delusional before the potential value of the change is considered. Instead of facilitation, obstacles are placed in the way of hoped-for body modifications or changes of name or of religious faith. This paper discusses the various changes of identity sometimes undertaken by individuals with schizophrenia who may or may not be deluded. Ethical and clinical ramifications are discussed. The recommendation is made that, when clinicians respond to requests for help with identity change, safety needs to be the main consideration.
Core tip: Everyone tries at times to change aspects of their identity. When people with schizophrenia do it, it should not necessarily be interpreted as delusional, but safety issues need always to be kept in the foreground.