Obsessions, Compulsions, and Free Will

Obsessive-compulsive disorder (OCD) and other psychiatric disorders can interfere with a person’s capacity to control the nature of his mental states and how they issue in his decisions and actions. Insofar as this sort of control is identified with free will, and psychiatric disorders can impair this control, these disorders can impair free will. The will can be compromised by dysregulated neural networks that disable the mental mechanisms necessary to regulate thought, motivation, and action. Neural and mental dys-function result in the maladaptive and pathological behaviors associated with these disorders.

In “Obsessive-Compulsive Disorder, Free Will, and Control,” Gerben Meynen (2012) rightly characterizes OCD as a disorder of control. Rejecting the view that obsessions and compulsions are signs of increased control, he agrees with those who take the opposing view and makes his own case for the claim that OCD is “a state of decreased freedom” (p. 327). Meynen asserts that “the concept of control is central in the philosophy of free will, and control is considered to be required for free will” (p. 326). Following Henrik Walter (2001), Meynen identifies three necessary conditions for free will: (1) having alternative possibilities, (2) doing things for (understandable) reasons, and (3) being the genuine source of one’s actions. Although the first condition might suggest a libertarian worry about causal determinism, one can interpret it in compatibilist terms as the ability to act or refrain from acting on different sets of motivational states and reasons. This involves the capacity for conscious planning and execution of intentions in actions by utilizing mental resources internal to the agent, quite apart from any external influence of natural laws and events in the past. This is significant because psychiatric disorders impair or undermine control internally by constraining one from acting or compelling one to act. For compatibilists, it is not causal determinism but constraint and compulsion that impair or undermine free will. Meynen maintains that the three conditions “can be interrelated” (2012, 326). However, it is not entirely clear from his discussion how they are interrelated and how impairment in the corresponding mental capacities affects the will. We need a more precise account of what the relevant sort of control consists in, as well as the degree to which OCD diminishes this control in persons who are afflicted with it.

In the third endnote, Meynen cites Fischer’s (1994) and Fischer and Ravizza’s (1998, Chapters 7, 8) concept of guidance control. He says that this is “a special kind of control, embedded in a complicated philosophical discussion” (Meynen 2012, 331) and does not discuss it. Yet this is arguably the most plausible concept of control in the debate on free will. Articulating the defining features of this concept can shed light on free will as a function of control, how the three conditions of free will are interrelated, and how the OCD patient is diminished in having the relevant sort of control. It can also help to highlight the implications of control for therapy that can attenuate or resolve the debilitating symptoms of the disorder.

Guidance control consists of two components. The first component is that an agent must have the capacity to take responsibility for the mental states issuing in his actions. One takes responsibility for these states when one has the capacity to critically reflect on, evaluate, and accept them as the authentic springs of one’s actions. In this way, one comes to identify with or endorse them as one’s own. This account is similar in many respects to the earlier accounts of identification and free will developed by Harry Frankfurt (1988, Chapters 2, 5). He defines persons as individuals with the capacity to form first-order desires to perform certain actions. They also have the capacity to form general second-order desires to have particular first-order desires. The will is the effective first-order desire that moves or would move a person all the way to action. One wills and acts freely when one’s first-order desires align with one’s second-order...