An Extension to Our Psychological Scheme (As Outlined in Beyond Therapy) 
In Regard to the Nature of Volition and its Distinctive Disorders(?)*

0.   Introduction

	In a set of essays titled Beyond Therapy a scheme was proposed that attempted to topologically relate (and interrelate) various types of psychoses, etc. Psychiatric illnesses were divided between psychotic, neurotic and/or stasic disorders. With respect to the former, psychoses, they were divided non-absolutely between affective, cognitive and judgmental aspects of this scheme, each level in the overall epistemological hierarchy given its own tripartite schema. E.g., w.r.t. affective psychoses we noted mania, depression and agitated depression. However, a difficulty arose as to how to classify obsessive-compulsive disorders (and a number of other conditions such as stalking, etc.). I would like to extend this overall scheme by adding a volitional sub-level superstructurally to our Judgmental Aspect or Appreciative Aspect (also to be treated in a tripartite fashion [both overtly and covertly]). (0)

1.   The Nature of Volition

	When we form a judgment we both prepare its content and may or may not exercise that judgment if relevant to its formation. Our enactment of a judgment I would like to define as an exercise of volition. E.g., I ask myself if I am hungry. If I determine that I am, I might then decide what I might do about this state of affairs. Should I eat now one of the bananas in the fruit bowl that is currently to hand. I form the idea of eating one of these bananas. I might mentally chose one and then act on that choice. I extend my hand and pick up the banana chosen. I peel it and then eat it. In effect, it would appear that we form a response and then decide or not decide to act upon the same. This latter aspect I would define as actively volitional (in contrast to its passively volitional content formation; a response that is both simulated and enacted). (1)

	It is apparent phenomenologically that the formation of a judgmental response and the enactment or non-enactment of the same are two relatively distinctive types of mental function, although, also, obviously not non-related to each other. Hence the application of the following principle: if a distinctive mental operation can be phenomenologically described then a defective process of the same would manifest itself in a distinctive type of disorder (in keeping with the nature of that defective sense of operation). Moreover, invoking gestalt principles that all mental operations on a certain level or in a certain aspect of epistemological organization are virtually delineated or simulated between a field,  field of focus within the same and the gestalt relationship between these two ideal polarities (in its appreciation invoking a sense of  an agent with functions in keeping with nature of those distinctive operations) then it follows that this archetypal tripartite structure can be reapplied to both this distinctive type of metal operation, namely of volition, and to disorders in the same. Conveniently, at this higher level of epistemological integration of judgment (within or superstructural to the Appreciative Aspect), the manifestation of consciousness would be here highly integrated and one might suspect that this tripartite typology is more an artifact of our scheme rather than finding itself demonstrated in three relatively distinctive forms of psychosis (in contrast to, e.g., mania, depression and agitated depression as types of affective disorder). So what might be the defective nature/s of such volitional consciousness? (2)

	I would like to argue that a defective presentation at this level of integration, in terms of volition, might manifest itself in the form of a compulsive-obsessive disorder. Let me examine this proposition. (3)

	Under gestalt focus I would propose the disordered formation of the obsession – the envisualization of a repetitively reinforced pattern of responsive behaviour. The repetitive enactment of that response I would define as the (reiteration of the) compulsion. Furthermore, their interaction I define as the obsession-compulsion along with the unease and/or the anxiety and/or agitation that flows from this disordered type of  state. Why treat a deeply entrenched obsession-compulsion as psychotic in orientation? Although accompanied by insight there is no insight into how the effected person can successfully control and disrupt such a cycle of obsession, compulsion and obsessive-compulsive unease/anxiety/agitation, etc. Similarly, an endogenously depressed person ‘knows’ they are depressed but not how they might currently extricate themselves from the same. (4)

	Let me number these additions as:

23.	Obsession (reiterated through thoughts and envisioned performances),
24.	Compulsions (reiterated as performances envisioned in the obsession),
25.	Obsessive-compulsion (as a complex associated with degrees of unease/anxiety/ and, especially in its psychotic manifestation, agitation). (5)

Paralleling these three classifications in a relatively covert fashion, i.e., in a relatively more background orientation (rather than in a relatively focalized orientation) let me introduce post-traumatic stress disorder(s and allied conditions?). Let me mirror our three previous classifications in a similar fashion along the following lines: in an entrenched stress reaction (say after a month, and its manifestation before that time) in a post-traumatic stress disorder we might like to parallel flashbacks, re-occurring traumatic thoughts, intrusive re-enactments of the traumatic incident/s and any other forms of linkage associated with envisualized forms of possible future trauma along with all stress reactions precipitated by that traumatic incident/s and its re-envisaged aftermath as all part of a post-traumatic complex and that all of this essentially mirrors intrusive thought-content, processes of re-enactment wherein we passively and/or actively participate virtually within, and, a complex state of affairs coupled with stress reactions associated with the former. A psychotic level of stress-reaction assuming the form of an intrusive, non-circumventable and non-obviatable form and format. Thence a recognition of its paralleling of obsessive-compulsive type disorders. (6)

	One might also argue that all psychiatric disorders take degrees of occurrence and could well fall into stasic, neurotic and(/or) psychotic degrees of depth? So, e.g., merely repetitive and routinized behaviour and the experience of disruptions in the same might be construed as stasic, whereas, this type of behaviour when inducing degrees of anxiety might be construed as neurotic (especially if there is a degree of defective learning involved?). Then, if that anxiety escalates and becomes an agitation then we might consider a psychosis is effectively in place. (7)

	Paralleling our three inter-linked categories of obsession, etc., I would like to covertly parallel the same in a more background or field-directed orientation.

	Let me number these additions as:

26.	Intrusion (reiterated through thoughts and envisioned performances),
27.	Intrusive responses (reiterated performances envisioned in the obsession), 
28.	Post-traumatic complex (as a complex associated with degrees of unease/anxiety/ and, especially in its psychotic manifestation, agitation). (8)

Presented in parallel both obsessive-compulsive complexes and post-traumatic stress complexes would appear to be linked to some degree or other. Hence their assumed volitional orientation, although, I perceive hormonal differences, etc., might allow us to differentiate them (e.g., cortisol levels?)? Even if that were not be the case I would envisage other distinctive phenomenal-phenomenological indicators would allow us to separate them (despite their volitional proximity?)? (9)

	If we were able to pin down accurately the distinctive phenomenal-phenomenological natures of these conditions then I would envisage that processes of treatment, evidenced based, might eventually be arrived at? In the meantime we must make do with tentative procedures often allied with other conditions and disorders. Theoretically I envisage that these processes of treatment would fall under some of the following categories:

1.	Medication,
2.	Relaxation,
3.	Mutual peer support,
4.	Amelioration of life-circumstances (in order to de-stress overall non-associated factors),
5.	Hypnotism,
6.	Distraction therapy, 
7.	Enforced diversional treatment, etc. E.g., intense and intensive activity such as boot camps, fun parks, overseas travel, high activity sports, busy program schedules, etc.
8.	Meditation and other positive forms of visualization, etc. (10)

The above are only suggestive headings. However, I would imagine that a large combination of the above would need to be utilized in the effective treatment of both obsessive-compulsive disorders and post-traumatic stress disorders. (11)

2.   Allied Considerations

	Lastly, let us ask could we also link psychotic-like acts of stalking, rumination, etc., within this overall category of the Volitional? (12)

	An obvious solution here would be to see the particular ‘content of an obsession and its compulsive performance’ as interchangeable. In this light ‘stalking’ could be understood as having ‘a certain person’ as the intentional objective and the compulsion ‘to follow them, etc.,’ follow on from the formation of that obsession. Or, we could substitute ‘traumatic replays’ or ‘ruminations’ in a post-traumatic stress disorder. Or, ‘rituals of cleaning’ in a particular obsessive-compulsive complex. (13)

	As to the (misdirected) psychology of such (abnormal) motivation what might we be able to say in that regard? In my opinion we need to note various parallel time horizons here. That the performance of x might be perceived by the subject to lead to a diminution of the desired state not currently realized whilst in immediate and longer-term horizons might actually contribute to an elevated sense of the psychic discomfit of that current state not being able to be realized. Briefly, let me apply this idea to the ritual of repetitive hand-washing. (14)

	In a self-perceived state of contamination an act of hand-washing is self-perceived to relieve, to some extent, that self-perceived state of contamination. Relief is sought thence the act of hand-washing. However, that self-perceived state of contamination is then perceived as being still present or being re-instated by some means or other (say by contact with a new self-perceived unclean object). The habit of relief acquired through an individual act of hand-washing is then re-sought to the extent that an individual act becomes an iterated set of acts (with or without other acts directed to the same self-perceived end desired in the form of adequate relief). In this overall process short-term relief might be obtained whereas immediate relief and long-term removal of their self-perceived sense of self-anomaly is not removed but rather intensified through the overall non-successful nature of the compulsive actions being iterated and re-iterated in the short-term. (15)

	All this might be simplified along the following lines: obsessive formation is compulsively put into effect with short-term relief that is neither immediate (in a fundamental and absolute sense) nor long-term (in an overall sense). In other words, short-term relief cannot successfully substitute or counteract an immediate sense of a thoroughly successful overall sense of relief nor establish a sense of relief that is effectively long-term in its horizons. Can this formula be applied to stalking? (16)

	Let us say x stalks y because they know y loves them. In stalking they find a short-term sense of relief being near the beloved, etc. However, annoyance and resistance, etc., of y frustrates this sense of relief and hence its immediate non-successfulness (which, in order to preserve the delusion y loves x, gets interpreted/re-interpreted by some ‘analytical’ means or other as ‘they must love me by doing z, etc.’). Furthermore, to be expected there is also a long-term sense of frustration and resistance put in place for x by y, etc. It would seem we have here, at least to begin with, a provisional model for examining the abnormal psychology behind such forms of psychotic behaviour (whose key identifier is that of an excessive iteration/re-iteration of behavioral patterns with little or no immediate and long-term forms of relief). (17)

2.   Conclusion

	Volition seems to necessitate passively envisaged content that may or may not be actively enacted. Disorders in volition were provisionally described as actively obsessive-compulsive complexes and covertly as post-traumatic stress-like complexes. These conditions being treated as psychotic when the degree of the disorder is deeply entrenched through iteration/re-iteration with concomitant agitation. A parallel tripartite structure was proposed along an overt (focalized) sense of perspective and a covert (background oriented) sense of perspective. Treatment was proposed in outline under a number of tentative headings. (18)

		      					  Noël Tointon, Sydney, 24.11.07.

* Latest version of paper: www.homestead.com/noelshomepage/noelpsyphil.html