ABULIA

ABULIA. - From the Greek à privative and βουλὴ “will”; abulia is a pathological alteration of the will, consisting in a more or less considerable diminution of normal volitional processes (as in ordinary states of indecision), or indeed in their total abolition.

1. MEDICINE

Most scholars consider the pathogenetic mechanism of abulia to depend on two fundamental elements, which may act simultaneously or separately: poverty of ideation and lowering of the affective tone. This means that, although abulia is considered or called a “disease of the will,” it is not that the volitional faculty, as a spiritual power, is directly and intrinsically impaired; rather, in its free exercise it is weakened or paralyzed by diseases or by modifications of the organism and of the sensitive faculties, both cognitive and affective.

Various forms of abulia are distinguished, each of which is associated with different pathological manifestations: a) abulia due to defective attention and reflection: for example, in an adult the passions are so strong and the feelings so intense that they explode without the possibility of resistance (explosive abulia); b) abulia due to defective decision-making: one discusses or examines matters without ever reaching the point of decision; hence an excess of analysis (fixed ideas in scrupulous, manic, or fearful persons); c) abulia due to inability or serious difficulty in passing to action (velleities, desires to act that fade at the first effort or the first discomfort or at the slightest opposition, yielding to every wind that blows in the environment in which one lives).

These various forms of abulia are more or less severe, and therefore the inactivity that constitutes their outward manifestation is more or less pronounced in the individual illnesses of which abulia is one of the symptoms (neurasthenia, hysteria, epilepsy, amentia, melancholic syndromes, dementia praecox, senile dementia, etc.).

To these various expressions of the degree and severity of abulia, another must be added, known as moral abulia. This consists in a more or less pronounced impotence of the will in the face of moral action. A person so affected, although possessing a clear knowledge of good and evil and of duty, whose obligatory character he or she recognizes, is unable to summon the energy to do good. The volitional powers are as if paralyzed and surrender without a struggle before the difficulties and instincts that supervene upon the development of ethical action.

2. MORAL EVALUATION

If abulia is total (idiocy, dementia praecox, etc.), it removes all responsibility and imputability; if, on the other hand, it is partial, it diminishes responsibility and imputability, especially when external actions are involved. Nevertheless, one remains fully responsible for those groups of actions that do not fall within the sphere of this partial abulia. Furthermore, one may be responsible, if not for the individual actions resulting from total or partial abulia, for their origin and cause (voluntary in cause): for example, abulias brought about by culpable habits, such as the abuse of alcoholic beverages, aphrodisiacs, opium, etc., at least when these were obscurely foreseen. It is not always easy to judge the responsibility of abulic persons; at times it may even be impossible. God alone can know and weigh II. Abulia may sometimes be incurable (hereditary abulia or abulia dependent on incurable organic diseases); but in most cases it can be reduced sufficiently to permit a normally moral life, and it may even disappear. Treatment will at the same time be physical and psychological, adjusted in different ways according to the extent and diversity of the cases.