Description
It is commonly accepted in the scientific community that psychological processes are governed by neural activity. Since neural activity is deterministic in nature, subject to laws of physics, some have viewed this as posing a fundamental challenge to the existence of free will. However, philosophers and neuroscientists increasingly accept “compatibilism” as the preferred position, which states that (neural) determinism and free will/moral responsibility can be reconciled. According to compatibilism, free will exists if an action is responsive to the reasons available to the agent at the time of action. In other words, free will depends on an awareness of what we do and why we do it. In this interactive workshop, we wish to provide a brief and accessible overview of free will with respect to clinical and forensic psychiatry.
Exercising free will requires agency (ability), choosing (acting on reason), and causing (the unaffected self as the source of an action). Accordingly, one may lack free will if compelled (e.g., unable to repress a tic or move in a catatonic state). One may lack free will if unable to choose (e.g., acting while sleepwalking or in a delirium). Or, one may lack free will if the self is not the source of an action (e.g., responding to a delusion or a hallucination, or to an extreme craving for a substance). Psychiatrists should understand and consider their patient's view of free will; it may be that psychiatric illnesses erode free will as they manifest and worsen.
Optimizing free will is a frequent aim of psychiatric treatment. We first review how pharmacologic treatment can promote aspects of free will by reducing the intensity of delusional beliefs, enhancing consciousness, decreasing cravings, and other mechanisms. We then outline how psychoanalysis has called into question the notion that our actions represent singular, rational desires--emphasizing instead a multiply determined and internally conflicted self whose actions may or may not be consciously directed. We discuss how DBT prizes mindfulness practice as the “path to emotional freedom” and asks participants to consider whether a given emotional choice is “likely to increase freedom or decrease it.” Meanwhile, acceptance and commitment therapy steers patients to identify core values and “commit” to making choices that are in line with them. Do these and other “talking cures” have the potential to impact a person’s free will? What does that say about the nature of psychiatric illness and the doctor-patient relationship?
Finally, we will examine how free will relates to basic questions of criminal responsibility, reviewing forensic psychiatry concepts such as "irresistible impulse," "awareness of the nature of an action" and "the ability to conform one's conduct to the law."
Scholarly responses to these questions will be presented in an approachable manner, and attendees will be encouraged to examine how the issue of free will manifests in their own practice.
Format
Recorded webinar.
This content was recorded during the APA 2023 Annual Meeting.
Learning Objectives
- Appreciate contemporary perspectives on free will and neuroscience.
- Recognize varying degrees of free will in psychiatric practice.
- Understand how the law has considered free will in psycholegal contexts.
- Understand how various psychotherapies incorporate ideas of free will
Target Audience
Residents/Fellows, Psychiatrists, Psychologists
Estimate Time to Complete
Estimated Duration: 1.5 hours
Program Start Date: May 1, 2025
Program End Date: May 1, 2028
How to Earn Credit
Participants who wish to earn AMA PRA Category 1 Credit™ may do so after completing all sections of the course including the evaluation. After evaluating the program, course participants will be provided with an opportunity to claim hours of participation and print an official CME certificate (physicians) or certificate of participation (non-physicians) showing the completion date and hours earned.
Continuing Education Credit
In support of improving patient care, the American Psychiatric Association is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
The APA designates this live activity for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Faculty and Planner Disclosures
The American Psychiatric Association adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Medical Education. Any individuals in a position to control the content of a CME activity — including faculty, planners, reviewers or others — are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of the activity.
Instructors
- James Scott, MD
- Awais Aftab, MD
- Lawrence Belcher, MD
Planners
- Vishal Madaan, MD, Chief of Education and Deputy Medical Director at the American Psychiatric Association.
Accessibility for Participants with Disabilities
The American Psychiatric Association is committed to ensuring accessibility of its website to people with disabilities. Please contact the American Psychiatric Association at 202-559-3900, if you require assistance seven (7) business days prior to the start of a live webinar.
Technical Requirements
This internet-based CME activity is best experienced using any of the following:
- The latest and 2nd latest public versions of Google Chrome, Mozilla Firefox, or Safari
- Internet Explorer 11+
This Web site requires that JavaScript and session cookies be enabled. Certain activities may require additional software to view multimedia, presentation, or printable versions of the content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Acrobat Reader, Microsoft PowerPoint, and Windows Media Player.
Optimal System Configuration:
- Browser: Google Chrome (latest and 2nd latest version), Safari (latest and 2nd latest version), Internet Explorer 11.0+, Firefox (latest and 2nd latest version), or Microsoft Edge (latest and 2nd latest version)
- Operating System: Windows versions 8.1+, Mac OS X 10.5 (Leopard) +, Android (latest and 2nd latest version), or iOS/iPad OS (latest and 2nd latest version)
- Internet Connection: 1 Mbps or higher
Minimum Requirements:
- Windows PC: Windows 8.1 or higher; 1 GB (for 32-bit)/2 GB (for 64-bit) or higher RAM; Microsoft DirectX 9 graphics device with WDDM driver; audio playback with speakers for programs with video content
- Macintosh: Mac OS X 10.5 or higher with latest updates installed; Intel, PowerPC G5, or PowerPC G4 (867MHz or faster) processor; 512 MB or higher RAM; audio playback with speakers for programs with video content
For assistance: Contact educme@psych.org for questions about this activity | Contact learningcenter@psych.org for technical assistance