Psychopath

THE MASK OF SANITY

Section 3: Cataloging the Material

Part 1: Orientation

27. Conceptual confusions which cloud the subject

 

 

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7 Conceptual confusions which cloud the subject

While preparing the first edition of this volume, many years ago, I was impressed

and sometimes astonished by the dearth of pertinent material about the psychopath in

most psychiatric textbooks. It seemed not only surprising but almost incredible to find

how little space was devoted to this disorder. With psychopaths making up so large a

proportion of the patients who must be dealt with, and their problems being so serious,

it was indeed difficult to understand why they were almost ignored.

If the medical student, the resident physician, or the beginner in psychiatry could

find little help from the textbooks, it would seem that he might obtain from

monographs or special treatises the information he needed. Despite the existence of

several large and scholarly volumes on the psychopathic personality, I was unable to

discover anywhere a book that came to grips with the subject in such a way as to give

real or practical assistance. There was, furthermore, relatively little published at the time

in psychiatric journals that had much bearing on the urgent and major problems with

which so many strove in helplessness and in confusion.

Through the literature of many decades pertinent articles were scattered. Some

of these gave serious attention to the subject. Not always readily accessible to the

average physician who dealt directly with these numerous patients, this largely buried

but valuable material did not regularly influence methods or generally clarify the

fundamental issues.

Surrounded by what almost seemed a conspiracy of silence, a desert of

evasiveness or indifference, not only the relatives of the patients but also courts,

physicians, and medical institutions had, it seemed little to guide them in a task of the

first order.

At present there are indications of more practical interest in the problem.

Popular textbooks, it must be admitted, still have relatively little to

226 THE MASK OF SANITY

say, but in their current treatment of the psychopath there is a happy departure from the

once almost universal procedure of mixing the few pages or paragraphs on this subject

with all manner of unrelated deficiencies as, for example, congenital organic brain

diseases.

The confusion and equivocation in which our subject has been all but lost can be

better understood from a historical survey. Since the first edition of this book was

prepared, Maughs205 has published a thorough and valuable study of this sort. It is not

practical here to do justice to the evolution of concepts which Maughs traces through

more than a century and a half. A few points, however, have so much bearing on our

central problem that they demand notice.

Early in the nineteenth century Pinel recorded his surprise in finding that many

patients do not show the disordered reasoning assumed to be necessary for psychotic

behavior. He is quoted by Maughs thus:205

to find many maniacs who at no period gave evidence of any lesion of the understanding.

Prichard's descriptions of a "moral insanity" and Benjamin Rush's beliefs about

derangement of the "will" suggest that such patients as we now call psychopaths, or

antisocial personalities, were observed and that the absence of delusion and irrationality

of thought was noted. Maughs gives a most helpful account of the efforts to interpret

such disorder in terms of disease that spares the intellect but attacks other "faculties"

such as "moral affections," "will," "sense of Deity," and "emotions."205

It is most interesting to note that these earliest observers* not only recorded that

serious personality disorder occurred in the absence of "a lesion of the intellect" but also

that they were strongly inclined to recognize it as illness, to distinguish it from ordinary

crime or depravity.

Despite the fact that they dealt largely with philosophic abstractions and assumed

various "faculties" which were treated as separate and established entities, their practical

conclusions seem far more realistic than many subsequent concepts and sometimes

perhaps more pertinent than those that now determine the medical and legal status of

the psychopath.

Dr. Ordronaux, Professor of Medical jurisprudence of Columbia University in

1873, expressed a contrary point of view that soon prevailed and, translated into other

terms, represents rather accurately an attitude toward our problem that is still influential

today. As quoted in part from Maughs, Ordronaux makes the following statement:205

_____________________________________

* Pinel, Esquirol, Rush, Woodward, Conolly. 205

CATALOGING THE MATERIAL 227

Moral nature knows no alterations in rhythm, craves no rest, never sleeps voluntarily. The

only disease to which moral nature is subject is sin.

Though still assuming that "intellect" and "moral nature" are in actuality "things"

as separate and independent as the words used to designate them, Ordronaux is quite

sure that one, unlike the other, is not subject to any sort of disease.

At this point it might be helpful to ask ourselves a few questions. In psychiatry

as in most other fields of human endeavor the belief in faculty psychology has long been

abandoned. Primarily and chiefly through the persistent efforts of Adolf Meyer, nearly

all medical workers agree today that we do not encounter a "mind" independently of a

body, that we had best confine our attention to what we meet in experience, that is to

say, a person who may show disorder in various aspects of his functioning. We reject

the demand to deal separately with an "intellect," a "moral faculty," a "will," as if they

were, apart from the words, things that can be isolated for study or for treatment.174,216-

218

In view of our generally avowed position in this matter, it is not a little surprising

to find how concepts deeply rooted in the long-discarded faculty psychology enter, by

the back door, and influence the attitudes and practices of today. A few of the many

important points made by Korzybski are extremely pertinent here. Without attempting

to go into the deep and general confusion, the ineffective procedures that can arise

through the incompatibility of language and concept with fact, it is worth our while to

consider for a moment what Korzybski and his co-workers refer to as consciousness of

abstracting.121,151,154

It is obvious to us today that what most psychiatrists and psychologists talked

and wrote about some decades ago were verbal abstractions and that these were treated

as if they referred to what can be met in experience. By juggling these verbal artifacts

without realizing (and admitting) that they do not necessarily correspond to real and

separate entities, logical and eloquent arguments can be made, but such philosophizing

usually has little applicability to the world in which we live. In medical problems this

method has been peculiarly unrewarding.*

__________________________________

such concepts may be essential and necessary to human endeavor. Medicine (including psychiatry) has nothing

to say against the value of methods and concepts that apply to the subject in dealing philosophically,

theologically, or personally with matters beyond its bounds and from aspects impertinent to its task. The

methods of medicine do not apply here. Such responsibilities do not belong to the doctor. He may work in

Metaphysics or mysticism, but there is no evidence that by medical methods he can solve such problems.

228 THE MASK OF SANITY

If we grant that mind and body, thinking and feeling, moral faculty and intellect, and

character and personality cannot, except in language, be split apart and dealt with as clearcut

entities, let us keep this fact clearly in mind. This is not to say that such terms must

not be used. It is neither practicable nor possible to avoid them. They convey

something that is important. When the relative of a patient asks, It's not her mind, is it

Doc? and gets the reassuring answer, "No, it's just her nerves," he may receive useful

and valid information (that she is not psychotic). On the other hand, he may receive a

good deal of information that is not only misleading but sometimes distinctly harmful.52

He may find himself automatically instructed to this effect:

2. These nerves are weak (in the most literal sense) or perhaps frayed

and a bit tangled.

3. The nerves have actually, as she has often told him, been jumping

about in her body and knotting up in painful snarls.

4. She really has nothing wrong with her but is just putting on.

5. A little active medicine or a nerve tonic will cure the sickness, which

is fortunately localized far from her "mind."

6. Since she got run down and developed nervous exhaustion, a lot of

rest in bed is plainly the answer.

As psychiatrists it it's no doubt clear to us that "nervous trouble" is a kind of

"mental trouble," and we are not likely to be confused in such a way as the patient's

husband. Nor are we likely, today, to believe that a neurosis is caused by toxins arising

from sexual frustration or that it is something essentially different from a

psychoneurosis.84,130 We are not likely to feel we are talking about a patient with ordinary

psychosis ("mental illness") when we refer to a psychopath, despite the fact that our

term unequivocally signifies illness of the "mind." To escape the unjustified implications

of faculty psychology, we wisely avoid diagnosing "moral insanities," but we often turn

to "neurotic character" as a term to indicate the same type of disorder.","' If we use the

current nomenclature, we may classify those usually called psychopaths under the

general term personality disorder and the subtype antisocial personality.15 Whatever,

terms are used, it is important for us to retain full realization that we abstract in a term

or concept some aspect of what we meet only as an integrated entity.

The early material cited and discussed by Maughs makes clear the difficulties

encountered approximately one hundred or more years ago in trying to solve psychiatric

problems on the assumptions of faculty psychology. Some believe that the chief

medicolegal decisions today are determined

CATALOGING THE MATERIAL 229

almost entirely on the question of whether or not a "lesion of the intellect" can be

demonstrated.

In more recent decades two tendencies particularly seem to have played a major

and persistent role in isolating the psychopath from practical consideration and in

concealing him in a strange and gratuitous confusion. One of these tendencies arose

from efforts to group these patients with many other types by no means similar. The

other seems to have proceeded from ambitious attempts to break down the

psychopath's disorder by fine and largely imaginary distinctions, by all sorts of

descriptive nuances and diagnostic legerdemain, into theoretical entities to be

differentiated and classified under many subheadings.

These attempts at elaborate differentiation have been applied not to a

distinguishable group having in common fundamental features that could be brought

into conceptual focus but to an essentially heterogeneous referent. A good analogy

would arise if someone set out to establish and list scores of inconsequential differences

between Buicks, Oldsmobiles, Plymouths, Cadillacs, and Lincolns by studying

assiduously a general material in which automobiles, oxcarts, demolished freight cars, jet

planes, rural woodsheds, and the village pump were undistinguished, embraced under a

single term, and treated through such concepts as can be formed in such an approach.

Would it not be wiser to put all our automobiles together in a field of reference before

attempting to take further steps?

It is perhaps worthwhile to say here that the more types our writers enumerate

and the more seriously they take these philosophic artifacts, the less likely is any

relationship to be found between what is in the book and our direct experience with

psychopaths. Before these fine distinctions can be made to any good purpose, there

must first appear some recognition of the basic group that is to be further differentiated.

This seems notably lacking where wordplay is most extensive and ambitious.

Either of the two practices just mentioned would in itself have introduced more

than enough obscurity. Together they have worked to make a confusion unparalleled in

the whole field of psychiatry.

As the psychoses were recognized and the psychoneuroses distinguished from

these, it became increasingly popular to put virtually anything that failed to fit into these

categories with the psychopath in a veritable diagnostic salad of incompatibles. The

term psychopathic personality, of course, invites such practice with its literal

applicability to all psychiatric disorders. The new official term Personality Disorder

does not totally avoid similar implications of a very broad application.

Early in the present century Meyer called attention to the importance of

separating patients now generally called psychoneurotic from the heterogeneous

230 THE MASK OF SANITY

conglomeration of types among which the psychopath was then and is still, to some

degree, officially placed.214 Through persistent efforts the mental defective was also

distinguished and today is considered apart.

When mentally defective patients, in all their degrees of disability, were not

distinguished from the psychopath, while both were listed under the same official term,

it is not surprising that many excellent observers found and reported physical

abnormalities, stigmata of degeneration, and gross neural pathology in the general

group. It is not remarkable to see that such findings became associated with (and

regarded as characteristic not only the patients in whom they occurred but also with the

psychopath and other unrelated patients, all of whom were considered together as

closely related examples of a constitutional defect state.123 It is, however, truly

remarkable that such errors persisted through the years and decades. A good example is

afforded by material from Sadler's popular textbook published in 1936.249

In this ponderous volume, totaling 1,231 pages of text, less than five pages were

spared for our subject. After several descriptive statements that could apply accurately

to the behavior of the real psychopath and that seem to indicate him as the subject

under discussion, physical characteristics of "constitutional psychopathic inferiority" are

given through an extensive quotation from another authority.131 Some of these physical

characteristics, presumably of the psychopath, deserve a moment of consideration:249

The abnormalities may be due to defective development, injury, tumor, infection, or

vascular accidents, such as cerebral hemorrhage, or to interference with the circulation of

cerebrospinal fluid such as occurs in hydrocephalus. Associated with these abnormalities

are weakness and paralyses of various parts of the body as well as varying degrees of

intellectual defect. The spinal cord likewise may be affected with resulting weaknesses or

paralyses. There may be gross physical defects in the development of the eyes, ears, nose,

mouth, arms, hands, legs, feet, rectum, anus, and external urogenital organs. Minor

physical defects sometimes referred to as stigmata of defective development include

abnormalities of the cranium, malformations of the external ears, nose or mouth

(abnormal spacing, position, or defective development of teeth; high-arched palate, harelip

or cleft palate), webbing of fingers or toes, distorted or supernumerary digits, excessive

amounts or absence of hair, undescended testicles and infantile uterus. [pp. 881-882]

Just what bearing this curious compendium of deformities may have on the

question of the psychopath I am scarcely prepared to say. A causal relation, to which

Sadler249 does not openly commit himself but seems somewhat evasively to imply, is

scarcely to be assumed, even if it is not to be

CATALOGING THE MATERIAL 231

dismissed at once as fantastic. None of the many hundreds of psychopaths whom I

have observed showed any such pictures as one gets from reading this quotation in the

context that is given. Although such stigmata and such gross brain changes are

sometimes associated with mental deficiency, cerebral agenesis, and various organic

diseases, they are certainly not regarded as characteristic of psychopathic personality. In fact, if

such abnormalities as these were found in a patient, the diagnosis of organic brain

disease, mental deficiency, or of some definite heredodegenerative condition would

become inescapable and the diagnosis of psychopathic personality (or personality

disorder, antisocial type) unlikely if not impossible.*

After other brief descriptions the author under discussion adds a statement which

is all but incredible. Following the opinion that prognosis is hopeless for complete

recovery, it is asserted that psychopaths are not likely to improve "unless a psychiatrist

can take them in hand for six months to a year and teach them how to live."249 Under

these conditions great improvement is considered probable. It is quite clear that more

than a few different and extremely unlike things are being considered. Though all these

are grouped under one name, they do not thereby gain homogeneity. Nor does it seem

helpful for purposes of description, study, or treatment to approach either the

psychopath or patients of these other types in such a manner.

A few paragraphs beyond the account of physical defects and gross neurologic

abnormalities just quoted we find the description of a subtype, "the feebly inhibited,"

which includes these interesting statements:249

Specifically, we find tremors, facial or other tics (habit spasms), abnormal movements of

the eyes, headaches, little attacks of dizziness, enuresis, prolonged throughout childhood,

and so on. The organs of the special senses are particularly apt to show signs of

inferiority; defective vision is very common. [p. 883]

Any person familiar with the psychopath as he is met in clinical experience will

need no prompting to realize what confusion is likely to ensue if the medical student

tries to reconcile books and facts at this point.

Let us give a little more attention to these statements. The book from which they

are taken was published in 1936. The last quotation is to be found, repeated precisely to

the last comma, in another volume by Sadler published in 1945.250 It is of interest to

note that the entire passage also

______________________________________

and organic brain and spinal cord diseases and abnormalities precedes a description of mental

deficiency, to which it has pertinent application.

232 THE MASK OF SANITY

appears in The Individual Delinquent (William Healy, 1915),123 a work which expresses

concepts widely accepted and congruent with the terminology at that time but at

confusing variance with official standards in 1936* and long ago discarded by Healy.

Though no longer representing the thoughts of the original author or the criteria of the

American Psychiatric Association, we find this archaic concept carried verbatim in a text

book published twenty-one years later and in another published thirty years later.

And with all this we find other statements, some applicable to the real

psychopath and apparently so directed but plainly incongruous, if not indeed fantastic, if

we attempt to correlate them with the material just quoted from the same volume. For

instance, it is said of these people that "they suffer from no physical or mental disease

that would account for their deficiency." (What about those brains abnormally large or

small and defective in part or as a whole? What about tumor, infection, cerebral

hemorrhage? What about paralyses and "gross physical defects of the … nose. ... legs ...

anus"?)249

The confusion about our subject as it has been so often presented in psychiatric

textbooks should not be peremptorily attributed to carelessness or ignorance on the part

of the authors. It is worthwhile for us to remember that these authors are attempting to

treat many disparate and not a few distinctly incongruous matters under a single

heading. Even today our officially approved standards demand that a good many

different disorders be so treated.15 Often we find much broader and more

heterogeneous areas embraced, and such a motley conglomeration of diverse subjects

appears under a single label that even the most sagacious author can say little without

falling at once into paradox, error, and soon into absurdity. His statements may be

sound, accurate, and entirely pertinent to the various subjects he, perchance, has in mind

and at the same time ring loud with nonsense as they strike willy-nilly upon other and

alien subjects all forced under a single identifying term that applies to nothing except in

language.

The second tendency, already mentioned, is illustrated in the brief space (five

pages) of the textbook we have been discussing.249 Not only do we find many dissimilar

subjects treated under one term, but also a record of ambitious attempts to devise

subtypes on a superficially descriptive basis unrelated to the real and obvious differences

(such as, for instance, between a

____________________________

of the type of patients we are discussing with other sorts of disorder related to organic brain disease.

His work, on the contrary, stands out among the most valuable efforts of those who have helped

clarify these matters.

CATALOGING THF MATERIAL 233

"types" as listed by Kraepelin, Schneider, and Partridge:

1. The excitable

2. The unstable

3. The impulsive

4. The eccentric

5. The liars and swindlers

6. The emotionally unstable

7. The quarrelsome

2. The depressive

3. The insecure

4. The fanatic

5. The self-seeking

6. The antisocial

7. The explosive

8. The affectless

9. The weak-willed

10. The asthenic

2. The inadequate

3. Those with general

incompatibility

To these Sadler219 adds his own list of types:

2. Pathologic liars

3. Eccentrics

4. Sex abnormalities

5. The feebly inhibited

Is it an exaggeration if we say that the difficulties confronting the psychiatrist

who has had to approach the psychopath through such a tangle of concepts (and it has

been our traditional method) are comparable with those that would be faced by a

general practitioner discussing leukemia if this term meant also a broken leg,

hemorrhoids, pregnancy, brain tumor, and the common cold? And if there were no

other term available?

Throughout the second quarter of this century Kahn's treatise entitled

Psychopathic Personalities156 was, judging by references in textbooks and in the

psychiatric journals, generally regarded as the authoritative and the most useful source

of information about our present subject. This I believe to be scarcely less unfortunate

than paradoxical. Here we have a valuable and scholarly work by a distinguished

psychiatrist, a large volume embodying the author's fundamental concepts of personality

structure and psychopathology in general. But we find little or nothing in all this

material that has any pertinent relation to our group of patients. We find, in fact, all the

psychoneuroses treated under the heading "psychopathic personality" and a list of

sixteen categories that seem occasionally to touch but never to clarify our subject.

Kahn's use of the term psychopathic Personality is, in my opinion, not only justifiable

but more in accordance with its obvious literal

234 THE MASK OF SANITY

meaning than our customary use. Such questions are, however, not particularly

germane. The point that demands emphasis is that our chief scientific work generally

regarded for a couple of decades as authoritative in the field turns out not to be a book

about the psychopath but a careful and valuable study of other subjects. Among these

subjects it is difficult to find material related to our problem.

In his work, which is primarily concerned with psychopathology in general,

Kahn, in accordance with established practice, lists types which have been almost

universally quoted as characteristic subdivisions into which the psychopath can be

classified:156

2. The anxious 10. The weak-willed

3. The sensitive 11. The impulsive

4. The compulsive 12. The sexually perverse

5. The excitable 13. The hysterical

6. The hyperthymic 14. The fantastic

7. The depressive 15. The cranks

8. The moody 16. The eccentric

The authors whom we have quoted and briefly discussed are not responsible for

the confusion that surrounds the psychopath. Such an approach to the subject was the

traditional approach that for decades prevailed in psychiatry. Even the most wise and

painstaking efforts cannot clarify a subject unless the subject is available. Many of the

works mentioned I hold in high respect. In them other subjects are handled in such a

way that those who seek reliable information can find it without undue difficulty.

It is hoped that these points may help us keep in mind that in our attempts to

understand the psychopath we must struggle not only with the intrinsic problem of

trying to distinguish and evaluate a complex psychiatric disorder but also with an almost

impregnable approach. To touch our subject itself we must somehow make our way

through a surrounding zone dense with false or dubious assumptions, mined with terms

that at the same time make sense and nonsense. The approach to our subject is,

furthermore, still skillfully camouflaged by traditional influences that may, before we

know it, have us talking about two or four or seven other things, no matter how

earnestly we strive to speak of one at a time.

Since the last edition of this book was published in 1964 discussion of the

psychopath has continued and further attempts have been made to evaluate his status.

A remarkable, and curiously misleading, presentation of the subject was offered only a

few years ago by a lay writer, Alan Harrington, first in the popular magazine Playboy and

later in Psychopaths, a book amplifying his theme.118

CATALOGING THE MATERIAL 235

A serious and regrettable confusion, I believe, is likely to come from opinions

quoted by this author that seem very plainly to advocate that the psychopath be

admired, chosen as a leader, or at least as a model for other men. Referring to one of

these opinions, the author says, "The menacing psychopath is embraced. Incredibly …

it seems at first shock … we are urged to turn into an 'antithetical' version of the outlaw

and find our way to his radical vision of the universe."118

Some of the people quoted or cited by the author of the Playboy article (and the

subsequent book) seem to be spokesmen for, or prominent figures in, the recent

movement of rebellion often referred to as the counterculture. In this movement we

find zealots who embrace hallucinatory confusion under the influence of potentially

brain-damaging psychedelic drugs and aggressively proclaim it as religious experience.

Here, too, we find the antihero, often a figure flaunting treason and dishonor along with

his unkempt beard, barefootedness, and defiantly frayed blue jeans. In this so-called

counterculture the antihero was not only welcomed but by some virtually enshrined. It

has been fashionable also in this movement to degrade the high passion and glory of

sexual love to a significance not far from that of a belch. Perhaps, in this general and

heedless effort to reverse the basic values, almost anything traditionally regarded as

undesirable, or despicable, might be automatically stamped with the sign of approval.

After many quotations from people who may be reflecting elements of this

movement, the author, himself, encourages us to "ask … if the psychopath's time has

come, if there may be a world-wide need for him." He goes on to say, "Could the

coming of the psychopath be a natural and inevitable result of our drastically

deteriorating environment (which helps fling him up) as well as one answer to it and,

who knows, a potential remedy for such deterioration?" 118

Other opinions expressed by the author include these: "Although originally

founded upon an anti-social condition, it [psychopathy] offers exciting new alternatives

to the way we have lived until now … the distinction blurs hopelessly between present

day psychopathic patterns as observed in prisons, institutions and clinics, and equivalent

behavior, which may often be put to use in good causes outside of these places... would

it be best," he asks, "to teach our children the psychopathic style in order that they may

survive?" He speaks of "Brilliant individuals among us that are basing their own lives

on the psychopathic model" and, referring to them, he cites the opinion that, "What was

formerly diagnosed mental illness has turned into the new spirit of the age." He seems

quite serious in repeatedly asking if we should imitate the psychopath, if we should

"yield to insanity accepted as normal? Cultivate one's own latent psychopathy, perhaps

trying

236 THE MASK OF SANITY

to adapt it to good ends?" He also says, "Conceivably the times ate railing for an

idealized version of the psychopath as savior."118

Other quotations are given from writers who claim that psychopaths should be

considered as having found the great answers to life. In response to such opinions, the

author asks, "Rave we come to the hour of the psychopath, the advent of psychopathic

man . . . when what was once presumed to be a state of illness is abruptly declared to

be a state of health, . . . can it be true that, with the dramatic appearance of the

psychopathic ideal, a new man has come upon us, that in order to survive the turbulent

years ahead, far from seeking to treat the psychopath in clinics, we should rather

emulate him, learn how to become him?"

Such opinions as these, and many others quoted or expressed directly by the

author, give rise to a number of thoughts. First, let me say that the question of whether

or not it is desirable to be a psychopath seems not so much a real question as a pretext

for sophistry. For a sophistry that is not only obvious but monumentally frivolous. It

strongly suggests to me the sort of argument that might arise about whether or not a

physician should use treatment in behalf of the patient or in behalf of the

microorganisms which are in the process of killing him."

It is true that the psychopath is extremely difficult to understand or to explain.

Confusion has often arisen about just what is indicated by the term. Any reasonable

sane person who feels or says that we should emulate the psychopath must, one might

presume, have a poor understanding of what the term indicates and must, surely, be

talking about something else. Textbooks over the years, as we know, have often listed

widely differing disorders under this term. A sincere choice of the real psychopath as

model or leader by anyone familiar with the Subject would be beyond absurdity.

Even in these times of fiercely dictated permissiveness, this choice would have to

be called by the currently censored, but quite accurate terms, perverse and degenerate.

A true taste for the psychopath as leader or model, or as object of admiration, also

suggests to me the peculiarly pathological and unappealing aestheticism of Huysmans'

fictional character, des Esseintes, who, after withdrawing from nearly all natural

activities, takes another step:142

nourishing enema compounded with peptone and informed his master that he was to

repeat the little operation three times every twenty-four hours.

The thing was successfully carried out and des Esseintes could not help secretly

congratulating himself on the event which was a coping stone, the crowning triumph, in a

sort, of the life he had contrived for himself. His predilection for the artificial had now,

and that without

CATALOGING THE MATERIAL 237

nourishment thus absorbed was surely the last aberration from the natural that could be

committed.

What a delicious thing he said to himself it would be if one could, once restored to

health, go on with the same simple regime. . . . Last but not least, what a direct insult

cast in the face of old Mother Nature, whose never varying exigencies would be forever

nullified. [p. 325]

The basic judgment and the moral orientation underlying a deliberate choice of

the actual psychopath as model or leader could hardly deserve more consideration or

respect than the judgment and orientation leading to a militant demand that Richard

Speck be installed as National Supervisor of Nursing Education in the United States and

that the Congressional Medal of Honor be awarded to the Boston Strangler.

 

Next: Section 3: Cataloging the material , Part 1: Orientation, 28. Clarifying the approach

 

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Section 3, Part 1

 

 

 

 

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