Notwithstanding the compatibility of freedom and determinism (in my view), freedom is not an either/or condition. Rather, actions may be more or less free, and more or less responsible, depending on a number of contingent factors. There are, in short, degrees of freedom. Psychiatrists can be most helpful insofar as we can describe, study, and categorize these degrees of freedom and the psychopathological conditions that so tragically undermine them. (This last point was poignantly driven home by the recent shootings at Virginia Tech.)
And yet, while I do not believe that the notion of an "autonomous self" free of causal law (contracausal free will) can be scientifically defended, I do not want to jettison the concept of the autonomous self. Indeed, with proper conceptual rehabilitation, the concept still has what philosopher William James might have called "cash value"; it can still do useful philosophical "work" for us if understood properly. (As the pragmatic James famously put it, "Theories thus become instruments, not answers to enigmas."8)
To appreciate all this, let's begin with a thought experiment. Imagine that some nefarious inventor has contrived a device called the assault machine (AM). This evil machine is attached to a person's arm, rather like a blood pressure cuff, and has an electrode that penetrates the substance of the brain. The AM has a visual recognition component that activates its motor apparatus—the purpose of which is to "whack" the nearest person within one's reach! The AM has the ability to override the person's higher brain centers, such that he is absolutely powerless to resist carrying out the assault. Let's now suppose that Jones is hooked up to the AM, quite against his will. Smith happens to walk by Jones and, as expected, Jones (well, his arm at least!) whacks Smith in the head. Now, in my view, the AM provides what my old Cornell philosophy professor Max Black9 used to call a "perfectly clear case" in which free will and agential action are essentially in-operative, based on what Black would call our "ordinary language." That is, Jones' assault on Smith was not causally related to the hopes, wishes, goals, and rational purposes unique to Jones; rather, the proximal cause of the assault was the action of the nefarious device.
How is this thought experiment related to the concept of the autonomous self? Essentially, the AM vitiates our ordinary language understanding of the autonomous self. To appreciate this, let's consider another vignette on the opposite side of the continuum that is being developed here.
Our friend Jones—having been acquitted of any criminal charges in the Smith assault incident—now returns to his home, where he is enjoying his hobby of painting. He stands, brush in hand, deliberating as to what he will now paint, in what style (eg, abstract expressionism, realism, etc), and with what colors. Jones has not been externally constrained, so far as we know, in any way; he has not been commissioned to produce one particular kind of painting; and he has no limits as to available art supplies, choice of paint, etc. Again, I would argue that this is a perfectly clear case in which the autonomous self and agential action—action taken by a rational and deliberative person—are essentially preserved. Now, this is surely not to argue that any of Jones' artistic decisions are somehow uncaused or supernaturally liberated from the laws of physics and neurochemistry! Jones' actions are, to be sure, mediated by his brain—and his brain is a physical entity constrained by physical laws. Yet, in our ordinary language, I believe we would consider Jones to be acting freely—using free will. We would also say, in my view, that Jones, as artist, is now responsible for his actions in a very robust sense.
Before relating all this to psychiatric disorders, let's consider, finally, a middle case. Let's suppose that it is the year 2025 and neuroscientists have isolated a neuropeptide dubbed "assaultin." Assaultin, it turns out, is coded for by the gene "BAD2U." Behavioral scientists have established, in 32 randomized controlled studies, that when this neuropeptide is injected into the cerebrospinal fluid of human subjects, 65% become immediately and dramatically assaultive. Ah—but 35% of them do not become assaultive. Indeed, psychological studies of these nonassaultive subjects reveal that nearly all employ a certain cognitive strategy to overcome the powerful impulse to become assaultive—they repeat a sort of mantra that helps them retain self-control.
Moreover, when the 65% of subjects who do become assaultive are taught this marvelous mantra, 50% are able to resist the effects of subsequent assaultin injections. The key question is where on the "degrees of freedom" continuum would we place the brain state associated with "assaultin injection" in relation to (a) the condition of having the assault machine strapped to the arm (Jones, case 1) and (b) the condition of being left alone with one's paints and canvas (Jones, case 2)? I would argue that we would place the neuropeptide-induced brain state somewhere between the other 2 instances—probably closer to Jones, case 1 than to Jones, case 2.Conclusion
If this heuristic model has any utility in psychiatry, we ought to be able to place a variety of brain states and psychiatric disorders somewhere along the degrees of freedom continuum. (I am assuming here that psychiatric disorders are essentially highly complex, aberrant brain states.) I have suggested a few purely speculative placements in the Figure. The actual placement of brain states and putative disorders would depend crucially on the empirical evidence gathered in understanding these conditions; for example, to what degree does a person who has schizophrenia have the ability to resist obeying so-called command hallucinations to harm someone? The answer undoubtedly differs from patient to patient—depending on a multitude of genetic, biochemical, and psychological factors. (The term "psychological" is not intended to imply something nonmaterial; rather, it is shorthand for brain processes that we experience and express in terms of motivations, wishes, understandings, fears, etc.)
In part 2 of this editorial, I will elaborate on the "naturalistic" model of freedom and autonomy and suggest how it may be applied to psychiatric disorders and medico-legal determinations of culpability.