How Psychiatrists' Beliefs on Free Will Influence Their Clinical Practice

Abstract

Backround: Literature suggests that most people believe in free will and that this belief is associated with more prosocial behavior. However, with the advent of neuroscience, free will seems to have been progressively excluded from psychiatry. This paper is a narrative literature review of the ways in which mental health professionals' premises and beliefs in free will influence their clinical practice.

Methods: The Scopus database was searched for papers concerning free will and psychiatric practice, 24 papers were included. This review looks at explicit links made by authors between free will and clinical practice as well as logical threads linking a premise of free will to clinical implications.

Results: The results suggest that belief in free will leads to trying to strengthen free will in patients. It also appears to be associated with using meaning in psychotherapy, with self-blame in patients, and with ethical questions such as involuntary psychiatric care and assisted suicide requests. Some authors believe the concept of free will should be discarded to make place for concepts such as autonomy, agency, decision-making capacity and self-control.

Conclusion: While definitional ambiguity and paucity of data are limiting, the results indicate that mental health professionals' beliefs concerning free will can influence their clinical practice. Concepts such as autonomy and agency can sometimes hide psychiatrists' underlying beliefs. Increasing mental health professionals' awareness of their beliefs could be beneficial for psychiatric care.

Keywords: psychiatry - free will – belief – autonomy - psychotherapy.