Psychiatrists and Psychologists

Statement of the Problem: There is evidence both for and against the idea that mental illnesses comprise discreet entities or lie on a continuum of risk.

Findings: In this plenary talk I will review some ideas and evidence that may suggest that, although there are boundaries that define illness, risk for a variety of mental disorders lies on a continuum.

In doing so, I will draw upon ideas from philosophy, psychology and psychiatry that address fundamental aspects of human nature such as free will and sanity as these concepts apply to mental illness.

To act ‘freely’ we need conscious control of choice, motivation, volition, to act as and not to act. Evidence casts doubt on how much we possess genuine ‘free will’.

Our experiences and beliefs depend on our brains (whose genetic programming and much environmental influence is beyond our control).

The brain acts before we are aware of making decisions. In an attempt to make sense of the world our inferences only approximate to reality.

As ‘free will’ depends on motivation, volition, choice, accurate perception, cognition and judgement, altered mental states will impede free will.

Examples include: most conditions that affect the mental state such as psychosis (delusions, hallucinations, passivity phenomena); altered cognitive states (delirium, dementia); addictions, mood disorders; personality disorder.

Conclusion & Significance: These considerations have implications for understanding motivations for behaviour, risk of mental illness and responsibility for one’s actions.