How would Szasz reply to the claim that cognitive problems aren't always one's own fault?

It seems only reasonable to claim that. It seems to me that saying otherwise is close to the claim that we are responsible for everything bad that will ever happen to anyone at all, as much as it is to the claim that we are responsible for some things.

It is true that we are uniquely positioned to help ourselves over others: but if we are completely transparent to ourselves, then why not at least the majority of others?

  • if it can't be shown that "the mad" are any more or less responsible for their problems, only that they have more problems, then the discussion could shift away from questions about who is to blame for and what is an illness, onto other moralisms e.g. what is fair
    – user6917
    Commented Jul 12, 2016 at 20:09

4 Answers 4


He might say "Congenital blindness is not anyone's fault. It is a problem. It affects your life profoundly. That does not make it an ongoing illness that must be treated whether you like it or not."

Blindness, could, in some society, constitute a limitation that removed responsibility from a person. But Western society does not see it that way. We retain responsibility and manage expectations around it. We know that this limitation still allows for responsibility.

'Madness' is a very similar problem. It limits the ability to handle certain problems of life that others find simple. But for 'madness' we do remove responsibility and limit rights.

Most basically, he is suggesting the approach to these two things be more similar -- that there be no limitation that automatically deprives you of rights or pushes responsibility for you off onto others.

If you have a kind of madness that means you are perpetually a child in some way -- that you cannot develop impulse control, that you cannot learn to read, etc. -- your life may then become somewhat intractable, and you may need the assistance of others. (Szasz himself did not refuse to help people, with his psychiatric training. He refused to participate in the mechanisms of mental hospitals, court orders, forced prescriptions, etc.)

But the blind man may also need the assistance of others. In fact, at some point we all need the assistance of others. Just like the rest of us, at some defensible point, how that help works still has to be left for you to choose, and even to some degree for you to arrange. Historically, many people have preferred an independent death to having their rights removed.

  • nice answer. one thing i dislike about certain diagnoses is their unlimited scope. not to sound like donnie darko, but there's just nothing that a diagnosis of "psychosis" can't explain away, and that's quite sad
    – user28660
    Commented Oct 3, 2017 at 14:12
  • @user3293056 That might be a meaningful complaint, if psychosis were a diagnosis. But it is not, it is a category of responses, sometimes a symptom (e.g. in alcohol withdrawal or extreme mania), sometimes a category of diseases (e.g. the five different kinds of schizophrenias and all the partially schizophrenic diseases related to them) and at other times an independent phenomenon (as during an extreme event of shock). It is never, alone, a diagnosis. It is quite broad, but it doesn't explain anything, and needs itself to be explained by the diagnosis.
    – user9166
    Commented Oct 4, 2017 at 0:54
  • hm not sure what bearing your technical point scoring has, here
    – user28660
    Commented Oct 5, 2017 at 21:18
  • @user3293056 You are complaining about the unlimited scope of diagnoses. But they don't have one. You are citing as an example something that does have a huge scope, but is not a diagnosis. This is not technical point scoring. It is refusing to allow a profession to be trashed by someone who does not know what they are talking about.
    – user9166
    Commented Oct 5, 2017 at 21:29
  • @user3293056 The stigma or expectation of disability that others assign to the effect of declaring someone mentally ill was no different when it was a sin, a spell of 'lunacy', or a 'weakness of the nerve', than it is now, when it is a medical diagnosis. So you are blaming the wrong thing entirely. It does not matter what the diagnosis is, or how narrow it has to be to be in order to be applied. It only matters that the mind is involved, and people will invent an excuse to sow distrust of those who think differently.
    – user9166
    Commented Oct 5, 2017 at 21:34

I am no specialist of Szasz, but it seems that you are raising both a philosophical (ethical) and a practical (judicial) question.

A priori, I see a weakness in this sentence:

It seems only reasonable to claim that. It seems to me that saying otherwise is close to the claim that we are responsible for everything bad that will ever happen to anyone at all, as much as it is to the claim that we are responsible for some things.

That could be a fallacy of the "excluded middle" since practical experience is complicated and things cannot be open and shut. There is no "quantum shift" (or "slipping") from one absolute proposition to the opposed one.

In more detail, a key distinction exists between responsibility and liability. Responsibility is a much broader concept that covers present (doing one's intended or expected actions), future (predicting, preparing, etc.), and past (assuming causality and consequences of one's actions). When one introduces fault (and hence the liability of a person to repair the damage), then a number of logical pre-requisites are typically required [philosophers of law or law experts do not hesitate to complete or amend]:

  1. Something adverse affected some party B in the past, against its own will (hence there has to be a damage or an objective prohibited action; plus see the maxim volenti non fit iniuria, i.e. if the other party was willing and knowing in the first place, there might be no complaint possible).
  2. A causal effect was established between B (victim) and a person A (defendent).
  3. The action of A violated the expected behavior in such circumstances, either prescriptive (do) or prohibitive (do not).

Fault thus appears in a social context. Hence the question whether "we are responsible for everything that will ever happen to anyone at all" is far too general and we do not need to answer it in order to answer the original question (it belongs to Occam's Razor).

The relevant question about liability is establishing an objective (observable, documented, etc.) causality link (there cannot be fault without it), or at least a "faulty" action/inaction. Furthermore, one could directly cause a damage to someone else, without being considered liable: typically a person who falls from a stair in mall, hurting another one, can be held innocent of the injury, in the case the owner failed to apply a prescribed safety measure that would have prevented the damage, in which case the owner is considered at fault).

It is correct to also frame the question from a subjective perspective of "cognitive", i.e. what one can be cognizant about, but as a subordinate question. In judicial matters, that is of course very relevant, together with another key aspect: intention. This applies to civil and criminal law, and more generally to adjudications according to the accepted morals of a human group.

Note, however, that they come second in the adjudication (on the part of a judge, peers) as extenuating or aggravating circumstances. Hence ignorance or inability of seeing the consequences of one's actions can be invoked, but it is subordinated to the establishment of an objective (observable, demonstrable) causality as well as the violation of rules of behaviour.

Hence an adjudication on subjective factors removes neither the objective causality nor the violation of the rules (e.g. if a mentally irresponsible person killed another, that person still killed the victim and that is still considered inacceptable).

That is from the perspective of society. From a personal perspective, person B (victim) could clearly chose or not chose to take more responsibility for their own actions (e.g. the person who got hurt in the stairs could have looked around while walking, instead of at their mobile phone; and they might draw a lesson for the future, on the danger of it). But as long as any legal/moral obligation (prescriptive or prohibitive) was not violated, the rest of society society will not interfere. And that reconnects with the political philosophy of the social contract: that the aim of the rule of law is not to interfere with personal behaviours, but to provide the largest individual freedom that is reasonably achievable in an organized society.

  • so what option have i excluded in my implicit "fasle dilemma". it's not clear what you mean, and mentioning quantum level events doesn't seem to help. do you mean that we are only responsible for that subset of cognitive limitations which stop us helping ourselves, not others, at least not everyone. that distinction seems quite ad hoc
    – user6917
    Commented Feb 8, 2017 at 18:00
  • However, how does this address "liability" for a cognitive problem ? It is suggesting about liability for actions resulting from the problem , not for the problem itself ? How are you "liable" for, say, mental retardation due to Down syndrome? What did you do to cause that? Commented Mar 11, 2017 at 5:42
  • That is a profound philosophical question! It could also apply to differences in any abilities (why A is more able than B in ability x), and even social, economic circumstances. What I can observe, is that it is often a carefully avoided issue and assumed as a fait accompli (likely because there are no consensual answers in our society's frame of reference). It might deserve a question all by itself.
    – fralau
    Commented Mar 18, 2017 at 8:22

Your question is not very clear, but I will address issues of personal responsibility and how they are related to deeming people mentally ill as I think Szasz would address the issue.

Szasz's position was that everyone is responsible for his actions and ideas. It is common to deem some people mentally ill and deny that they are responsible for their actions and ideas. Psychiatrists, courts, the police and so on treat those deemed mentally ill differently from people not deemed mentally ill. A mentally ill person may be imprisoned or drugged against his will without trial, or he may be set free without prosecution for an illegal act. In addition, psychiatrists will often intercede on behalf of a patient in a personal conflict, e.g. - he may talk to an unhappy spouse on behalf of the patient.

A person may do something bad because he has adopted a bad idea somebody else told him. The person concerned is responsible for continuing to hold that idea and act on it. He could have learned a better idea.

Sometimes a person will adopt an idea partly because of mistreatment by other people. Parents routinely use tactics other than rational discussion to try to get a child to adopt an idea. A parent may use physical violence to make a child obey: 'spanking' is the standard euphemism. Or he may resort to stealing property that he gifted to the child. It is difficult for a child to stand up to this since he is dependent on his parents for his physical survival. But once the child moves out he is no longer under his parents' control and could learn better ideas without being tortured. His parents' bad actions don't excuse any bad actions he takes. And if a person does something criminal locking up his parents won't protect the public, only locking up the perpetrator will provide protection. Dealing with bad parents is a difficult moral problem, but obscuring it with talk about mental illness makes that problem more difficult to solve.

For non-criminal personal conflicts, what matters is the ideas and values of the people involved. This problem can't be solved except by addressing those ideas and values. You have to treat the people involved as responsible to solve the problem.

A person may sometimes commit a criminal act under duress, e.g. - with a gun to his head. The law recognises that a person is not necessarily responsible for what he does under duress. There are moral issues to examine in such cases, but mental illness doesn't address such problems since it obscures agency, responsibility and morality.

  • hey you're right my questions are often unclear, sorry :) ! thanks, will read closely, in a moment mate :)
    – user6917
    Commented Jan 9, 2017 at 13:24

cognitive problems aren't always one's own fault?

It seems only reasonable to claim that. It seems to me that saying otherwise is close to the claim that we are responsible for everything bad that will ever happen to anyone at all, as much as it is to the claim that we are responsible for some things.

As pointed out, there's a stark difference between any cognitive limitation which stops us helping ourselves, and one which stops us helping everyone.

So Szasz can hold every individual responsible for every mistake they make, at the same time as implicitly excluding the possibility that it can't be OK for everyone. There's a definnite anti utiopian tone to him, even if that doesn't collapse into anything more individualistic.

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