Lack of Autonomy: A View From the Inside

The most vivid and truly overwhelming response I have to all arguments stressing agency/autonomy, that is, what lay people call free will, is this: that I’ve never had the sensation of acting autonomously since the onset of my mental illness on August 28, 1965. I have never been comfortable with saying that “I made a choice,” or with other people either lecturing me or attempting to reassure me, often at the same time, by saying that I acted with autonomy/primary agency, as it were. That is my overwhelming subjective experience. I usually refrain from attempting to make a general case for determinism about myself or the universe in general, although, again, I feel far more determined than free. (I would note that Mary Midgley [2006] points out that the word determined and the concept, by extension, of determinism have two different meanings in say, social theory and geometry.)

One strong criticism of this article I would put forward is that the Davidson and Shahan seemed to mention only depression among many diagnoses to make their case, although their French mentors/ co-thinkers apparently focused on schizophrenia, however unusually defined by them. In obsessive-compulsive disorder, we all have the very strong impression of the obsessive thoughts having been forced into our mind by something or someone else. My impression is that we all engage in our warding-off rituals, especially in the later, most frequent, most ritualistic repetitions, “against our will.”

My most frequent diagnoses over the decades have been paranoid schizophrenia and schizoaffective disorder, and I more or less agree most of the time with those labels. I find Louis Sass’ “discovery” that our delusions are better thought of as semi-delusions with our simultaneously believing and not believing them, and our usual failure to take action on them, pretty well describes my own long-term experience. I know he is insistent on ascribing some degree of agency/whole personality involvement to us as compared with the standard National Alliance on Mental Illness/biological model, but I feel that he is getting closer to most of the “truth” when he talks about a subtle interweaving of affliction/deficit and agency.

The authors’ reliance on French thinkers almost inevitably sends me back to a once-prominent French intellectual, one of my favorite writers Albert Memmi, the Tunisian-Jewish born socialist and Zionist. In a book that mentions The Story of O, (Memmi 1984) a story of extreme sexual submission or masochism, he makes the striking remark that the mentally ill are “oppressed from within.” I have spoken of this often because it seems to touch perfectly on my experience and that of fellow mentally ill people I have met. From the perspective of the outsider, it seems that the whole and integrated person is involved in every behavior. What looks like agency to others, especially when it comes to undesirable behaviors, when experienced from within, is actually a situation of affliction from a seemingly autonomous place. We experience this as coming, yes, from within us, but not ultimately of us.

I cannot be sure, but a belief in some degree of metaphysical choice from the beginning of one’s life seems to me the only way the authors of this article can firmly, enthusiastically come down on the side of agency as opposed to deficit/malfunction in trying to explain human problems. In contrast, I suppose I could be called a physicalist. I have noticed that physical substances (alcohol, caffeine, psychiatric drugs) have such a vivid and consistent effect on my mind that it makes sense to me to conclude that yes, mind is probably ultimately reducible to brain/body/experience of the senses. That is my private opinion based on experience as mediated through knowledge/intellect.

One final point: Despite the (almost certainly) radical left politics of the authors, as an officially disabled person almost completely dependent on the welfare state, I fear that in competitive individualist America, the authors’ hoped-for far greater emphasis on autonomy will feed into popular “blame the victim” ideology. I believe...