Making sense of "senseless actions" in relation to criminal insanity.
Søren Esben Rytter Heilskov, Julie Nordgaard, Unn Kristin Haukvik, Christine Friestad
Frontiers in psychiatry January 1, 2026 DOI: 10.3389/fpsyt.2026.1833835 via PubMed
Summary
Delusions are often used as key evidence of psychosis in insanity assessments because they are verbalized and express faulty reality judgments. However, psychosis can also involve disturbances that are enacted rather than spoken. This paper revisits Klaus Conrad's concept of "senseless actions"—unintelligible behaviors seen in early schizophrenia—and illustrates its forensic relevance through a historical case study from Karl Wilmanns. These actions reflect a global disruption in how a person finds relevance, meaning, and constraint in the world, and may signal the transition from prodromal to manifest psychosis. The authors argue that evaluating such actions requires contextual and biographical information, and that the concept, though imperfect, can help identify reality disturbances overlooked in current forensic practice.
Study at a glance
| Characteristics | Theoretical or philosophical paper Case report Peer reviewed |
|---|---|
| Topics | Philosophy of mind |
| Keywords | Forensic psychiatry Irrationality Psychosis Schizophrenia |
| Key finding | The concept of 'senseless actions' may serve as a behavioral indicator of the transition to manifest psychosis and offers a framework for identifying disturbances in reality understanding that are marginalized in contemporary approaches to criminal insanity. |
Abstract
In the assessment of criminal insanity, delusions play a particularly important role, because they express reality judgments, which, due to their verbalized form, serve well as "evidence" of psychosis. However, psychosis, understood as a fundamentally impaired sense of reality, can also involve disturbances that are neither verbalized nor inferential, but mainly enacted. In this paper, we revisit the psychopathological concept of "senseless actions", employed by the German psychiatrist Klaus Conrad to describe the unintelligible actions observed in individuals in the early phase of schizophrenia. The forensic relevance of this concept is illustrated with a historical case study from the annals of Karl Wilmanns. We discuss how "senseless actions" express a global disturbance in the individual's way of finding relevance, meaning, and constraint in the world, and argue that "senseless actions" may function as a behavioral indicator of the transition between a prodromal phase and manifest psychosis - pointing again to its forensic relevance. We stress the importance of considering contextual information and adopt a Gestalt view of how the actions inscribe themselves in the biography of the individual when determining whether "senseless actions" are indicative of psychosis. In conclusion, we suggest that the concept of "senseless action", though imperfect and context sensitive, may offer a framework for identifying disturbances in reality understanding that risk being marginalized in contemporary approaches to criminal insanity.