Will and its disorders: a conceptual history

Abstract

Objective: to resuscitate the old clinical category of 'disorder of the will'. Method: a detailed conceptual study is presented of the origins and history of the will as a mental function, and of its disorders as they were first described during the nineteenth century. An account is also offered of the historical changes that led to the decline of the will, and to the dispersion of important clinical phenomena such as aboulia, obsession and impulsiveness which have since not received satisfactory causal explanation. Results: historical analysis shows that the decline and fall of the will was due not to any major piece of empirical work demonstrating that the concept was unsound but to general changes in philosophical fashion, and to the temporary influence of the anti mentalistic tenets of behaviourism and the anti-volitional assumptions of psychoanalysis. Conclusion: clinical disorders like aboulia, impulsiveness and obsessions seem to share conceptual features which nineteenth century psychiatrists managed to capture very well in their clinical category of disorder of the will. Current accounts, which include semi-explanatory concepts such as 'drive' , 'motivation' or frontal lobe 'executive', are not conceptually better than the old notion of will nor are they superior as correlational variables for neurobiological studies. It is suggested, therefore, that the will, updated according to modern work in the philosophy of action, is re-adopted as a research category in current psychiatry.