Clinician and patient perceptions of free will in movement disorders: mind the gap

Journal of Neurology, Neurosurgery & Psychiatry
Published online 11 March 2017

Sandra MA van der Salm1Daniëlle C CathAnne-Fleur van RootselaarJohannes HTM KoelmanRob J de HaanMarina AJ TijssenGerben Meynen

Abstract

Introduction

Most people perceive that their actions arise from their own ‘free will’, commonly defined as the ability to choose how to act.1Neurological disorders, such as epileptic seizures and movement disorders, are often regarded as conditions in which free will is undermined.2 Clinically, an action is considered involuntary when it is automatically performed and cannot be controlled. Our study aim was to explore patients’ views as well as clinicians’ views on ‘free will’ and voluntariness in three hyperkinetic disorders: tics, functional movement disorders (FMD, previously ‘psychogenic’ movement disorder) and myoclonus. We developed a questionnaire to determine to what extent patients in these three groups consider their ‘free will’ to be undermined by the movements induced by their disorder. We compared these findings with clinicians’ views of voluntariness in each of these movement disorders.

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