ABULIA. — From the Greek *a* (privative) and *boulē* (“will”); abulia is a pathological alteration of the will, consisting in a more or less notable diminution of normal volitional processes (as in states of common indecision) or even in their total abolition.
I. MEDICINE. — By most scholars, the pathogenic mechanism of abulia is considered to depend on two fundamental elements, which may act simultaneously or separately: poverty of ideation and lowering of affective tone. By this is meant that while abulia is considered or termed a “disease of the will,” it is not that the volitional faculty, a spiritual power, is directly and intrinsically impaired; rather, in its free operation it is weakened or paralyzed by diseases or modifications of the organism and of the sensitive faculties, whether cognitive or affective.
Various forms of abulia are distinguished, each of which is to be connected with different morbid manifestations:
a) due to defect of attention and reflection: e.g., in an adult, passions are so strong, feelings so intense, that they erupt without possibility of resistance (explosive abulia);
b) due to defect of decision: one discusses or examines without ever reaching a conclusion; hence an excess of analysis (fixed ideas of the scrupulous, the manic, the fearful);
c) due to inability or great difficulty in passing to action (velleity, desires to act that fade at the first effort or discomfort or the slightest contrariety, yielding to every wind that blows in the environment where one lives).
These different forms of abulia are more or less severe, and thus the inaction that represents their outward manifestation is more or less pronounced in the individual diseases of which abulia is one of the symptoms (neurasthenia, hysteria, epilepsy, amentia, melancholic syndromes, early dementia, senile dementia, etc.).
To these various expressions of degree and severity of abulia, another must be added, known by the name of moral abulia. This consists in a more or less pronounced impotence of the will in the face of moral action. The person so afflicted, though having clear knowledge of good and evil and of duty, whose obligatoriness is felt, is unable to engage his energy to perform the good. The volitional powers are as if paralyzed and yield without struggle in the face of difficulties and instincts that superimpose themselves upon the development of ethical action.
2. MORAL EVALUATION. — If abulia is total (idiocy, early dementia, etc.), it removes all responsibility and imputability; if, however, it is partial, it diminishes responsibility and imputability, especially when it concerns external actions; yet one remains fully responsible for those groups of actions that do not fall within the scope of this partial abulia. Moreover: one may be responsible, if not for the individual actions of a total or partial abulia, for their origin and cause (voluntary in causa); abulias, for example, provoked by culpable habits such as the abuse of alcohol, aphrodisiacs, opium, etc., are at least dimly present. It is not always easy to judge the responsibility of abulics; sometimes it may even be impossible; only God can know and weigh II.
Abulia may at times be incurable (hereditary abulia or dependent on insuperable organic diseases); but in most cases it can diminish to the point of allowing a normally moral life, and may even disappear. Treatment will be at once physical and psychological, varied according to the extent and diversity of the cases.