ENERGY
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GAIN ENERGY
APPRENTICE
LEVEL1
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THE
ENERGY BLOCKAGE REMOVAL
PROCESS
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THE
KARMA CLEARING
PROCESS
APPRENTICE
LEVEL3
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MASTERY
OF RELATIONSHIPS
TANTRA
APPRENTICE
LEVEL4
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2005 AND 2006 |
PsychopathTHE MASK OF SANITYSection 2: The MaterialPart 1: The disorder in full clinical manifestations 5. Max
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5. Max This patient first came to my attention years ago while I was serving my turn as officer of the day in a Veterans Administration psychiatric institution. His wife telephoned to the hospital for assistance, stating that Max had slipped away from her and had begun to make trouble again. With considerable urgency and apparent distress she explained that she was bringing him to be admitted as a patient and begged that a car with attendants be sent at once to her aid. He was found in the custody of the police, against whom he had made some resistance but much more vocal uproar. The resistance actually was only a show of resistance consisting for the most part of dramatically aggressive gestures made while he was too securely held to fight and extravagant boasts of his physical prowess and savage temper. His general demeanor in this episode suggested the familiar picture of small boys, held fast by peacemakers, who wax ever more eloquently militant as the possibilities of actual conflict diminish. He came quietly with the attendants and on arriving at the admission ward was alert, self-assured, and boastful. Extolling his own mettle as a prizefighter, as a salesman, and as general good fellow, he was nevertheless friendly and even flattering toward the examining physician and the hospital. He was far from what could be called drunk. In fact, it would be stretching a point to say he was "under the influence." He had been drinking, it is true, but he knew well what he was doing, and only by an impracticable flight of fancy could one attribute his behavior primarily to liquor. At the admitting ward of the hospital, accompanying papers promptly revealed that the patient's desire for treatment arose in consequence of some checks which he had forged in Spartanburg, S.C. He had been arrested and convicted, but an agreement was reached whereby, instead of being sent to jail, he might come to the hospital for psychiatric treatment. 30 THE MASK OF SANITY His wife, his attorney, and representatives of a veterans' organization pointed out that he had frequently been in hospitals for the treatment of mental disorder and maintained that he was not responsible for his misconduct. He seemed pleased to be at the hospital and was expansive and cordial but a little haughty despite his well-maintained air of camaraderie. Although a small man, only 5 feet, 6 inches tall, he made a rather striking impression. His glance was fresh and arresting. His movements were quick, and he had an air of liveliness vaguely suggestive of a chipmunk. Though preposterously boastful, he did not show any indications of a psychosis. The hospital records showed that he had been a patient eight years previously for a period of two months. During this time of study he showed no evidence of a psychosis or a psychoneurosis and was discharged with a diagnosis of psychopathic personality. He was found to have tertiary syphilis, but neurologic examination and spinal fluid studies showed no evidence of neurosyphilis. Though at first cooperative and agreeable on this previous admission, he soon became restless and expressed dissatisfaction with the hospital. He was granted parole, but on his first pass into town he got into an altercation in which words were more prominent than blows and was held by the police for disturbing the peace. After losing parole, he became constantly unruly in petty ways, often insulted the nurses and attendants, and several times egged on mildly psychotic patients to fight each other or to resist the personnel on the ward. On being questioned about this conduct by physicians, he glibly denied all and showed little concern at being accused. Since he was not considered as suffering from a real nervous or mental disorder and since it was difficult to keep him on any ward except the closely supervised one among actively disturbed patients, he had been discharged. Records show that he sought hospitalization on other occasions after having been fined a half-dozen or more times for brawling on the streets and for petty frauds. There is every reason to believe, from the evidence of careful reports by the Red Cross and by social service workers, that when his troubles with the civil authorities became too discomforting he sought the shelter of a psychiatric hospital. Several months previously he had spent six weeks at a Veterans Administration hospital in Maryland after getting into similar trouble with the police in Wilmington, Delaware. He complained at the time of having spells during which he lost his temper and attacked people, often, according to his story, with disastrous results, since, again according to his story, he had at one time been featherweight boxing champion of England. THE MATERIAL 31 According to the psychiatric history at the Maryland hospital, he had, in describing these spells, mentioned some points that would suggest epilepsy. As soon as he came to the hospital and was relieved of responsibility for the trouble he had made, the so-called spells ceased. His description of them varied. Sometimes, when particularly expansive, he boasted of superconvulsions lasting as long as ten hours, during which he made windowpanes rattle and shook slats from the bed. After being in the hospital for several weeks and apparently beginning to grow bored, his talk of spells died down and he seemed to lose interest in the subject. He was discharged after the staff had agreed that the alleged seizures were entirely spurious and the patient himself had all but admitted it. The diagnosis of psychopathic personality was made. Between his first visit to the present hospital and his recent return, he had been in five other psychiatric institutions, each time following conflicts with the law or pressing difficulties with private persons. In all the records accumulated during these examinations and investigations, no authentic symptom of an orthodox mental disorder is noted. True enough, there are statements by wives and other interested parties about spells and opinions by the laity, such as the following which was quoted by his attorney on one occasion to shield him from the consequences of theft: I had occasion to be in Dayton, Ohio, recently and talked to the people running the ... Loan Company at ... Street, having stopped there for about an hour between trains en route for Chicago. I was informed by these gentlemen that he had wheels in his head. Statements such as the foregoing, opinions that he is "undoubtedly goofy," that he does not behave like a man in his proper senses, abound in the ponderous stack of letters, medical histories, social service reports, records of court trials, and other material that has accumulated in this man's wake. One who reads his strange and prolix story and, even more, one who knows the hero personally is only too ready to fall into the vernacular and agree. Nevertheless, it was equally true on reviewing his record at the time of his new admission that no symptom impressing a psychiatrist had been manifested and that many groups of psychiatrists had, after careful study, continued to find him free of psychosis or psychoneurosis, in other words. sane and responsible for his conduct and even without the mitigating circumstance of a milder mental illness. Once during this period he had been sent to prison in a southern state for forgeries a little more ambitious than his routine practice. At the instigation of his second and legal wife, who consistently flew to his aid (despite her chagrin at the patient's having meanwhile consummated two bigamous 32 THE MASK OF SANITY marriages), well-meaning officers of a veterans' organization became interested and took up the cudgels. Wearying sharply of prison, the patient had for some time been talking on all occasions about a blow on the head which he had sustained while in service. This alleged incident, though absent from his military records, had cropped up frequently but not regularly during his hospitalizations. Sometimes the blow, which he had sustained accidentally from the butt of a gun that a companion was breaching, had merely left him dizzy for a moment. Again it had knocked him unconscious for a short period and necessitated several days' rest in his tent. Max now became more specific about his wartime injury and explained that he had suffered a severe concussion, lying out stark and unconscious for some eight or nine hours. Attorneys pointed out his many periods of treatment in psychiatric hospitals. The governor soon agreed to parole him into the custody of a federal hospital in Mississippi. During his present sojourn in the hospital he was for several weeks happily adjusted on the admission ward, busy doing small favors for the physician, congenial with all the personnel, and helpful and kindly toward psychotic patients. He was alert, quick-witted, nimble with his hands, and entirely free from delusions, hallucinations, or any of the broader personality changes associated with the ordinary psychoses. He was by no means "nervous," even in the lay sense, and showed no emotional instability or signs of ungovernable impulse. Rather than an excess of anxiety, he showed the reverse, apparently finding little or nothing in his present situation or in all his past difficulties to cause worry or uneasiness. As the time passed, however, he began to grow restive. He became somewhat condescending toward the physician, frequently referring to himself as a man of superior education and culture and boasting that he had studied for years at Heidelberg. Shortly before the time set for him to come before the staff, he demanded his discharge. This was denied. He now became involved in frequent altercations with attendants and sometimes fought desultorily with other patients. These fights always started over trifles, and Max's egotism and fractiousness raised the issue. He never attacked others suddenly or incomprehensibly as might a psychotic person motivated by delusions or prompted by hallucinations. The causes of his quarrels were readily understandable and were usually found to be similar to those which move such types as the familiar schoolboy bully. Usually his adversaries were patients also disposed to quarrel. No signs of towering rage appeared or even of impulses too strong to be controlled by a very meager desire to refrain. He always took care not to challenge an antagonist who might get the THE MATERIAL 33 upper hand. During this period he talked much of his past glories as a pugilist, describing himself as former featherweight champion of all the army camps in the United States. The desire to show off appeared to be a strong motive behind many of his fights. As will be brought out later, he was indeed a skillful boxer. These stories were not delusion but the exaggeration and falsifying, sometimes unconscious or halfconscious, that are often seen in sane people and sometimes even in those who are able, intelligent, and highly successful.* Max was often caught sowing the seeds of discontent among other patients whom he encouraged to break rules, to oppose attendants, and to demand discharges. He made small thefts from time to time. This trend culminated in his kicking out an iron grill during the night and leaving the hospital. He took with him two psychotic patients, and numerous others testified that he had tried to persuade them to leave also. The next afternoon he was returned to the hospital by the police after * Such traits can occasionally be found even in wise and reliable people. A highly regarded and respected friend of mine, a doctor of philosophy, recently appointed professor of physics in a small but distinguished college, and the author of several useful and accurate contributions to scientific literature, is the first who comes to mind. This distinguished man has often regaled groups of acquaintances, myself among them, with accounts of working his way through the university by playing professional ice hockey at night, later setting type on a newspaper for several hours, rising before daylight to stoke tugboats on the waterfront, riding thirty-four miles to a high school to teach one subject and thirty-four miles back, as well as keeping house in a three-room apartment shared with six aviators and relieving the janitor of the building one hour during each twenty-four. All these activities were spoken of as being carried out simultaneously and along with full-time work at the university. He described in great detail and with apparent familiarity the duties of these positions. His only studying, he said, was done on the subway en route to his various duties. The same friend once came up from behind while another man and I were commenting on the height of a cliff on which we stood. The hazards of a dive from the position were being idly discussed. The newcomer at once estimated, probably with commendable accuracy, the height, the angle of landing, and all the technicalities of such a dive. He then launched into an astonishing description of a dive he had made in early youth from a bridge 167 feet above the Guadalquiver. One of the students to whom this excellent scholar lectures stated that it is the custom for each succeeding class to tabulate his adventures and their duration in these pseudoreminiscences and therefrom compute his age. The top figure so far is 169 years. Several classes have bettered 150. The students have great respect for him and confidence in him, as a teacher and as a man. They are particularly devoted to him. Let it be clearly understood that the person discussed in this footnote is not being brought forward as illustrative of the subject of this study. He is no part of a psychopath. He is, in fact, a character whose essential traits lie at the opposite extreme. The reminiscences here ascribed to him are not told boastfully or for the purpose of shielding himself or of gaining any material end. He is strikingly free of arrogance, kind to a remarkable degree, and altogether worthy of his strong reputation as a good and reliable man. His word in any practical matter is to be respected. 34 THE MASK OF SANITY being arrested in the midst of a brawl that he had caused by cheating at a game of chance in a low dive. He had taken a few beers but was shrewd, alert, and well in command of his body and his faculties. He now insisted on his discharge from the hospital against advice and was brought before the medical staff. The diagnosis of psychopathic personality was again made. In his demands to be released, he arrogantly maintained that he had been pardoned outright by the governor of the state which had imprisoned him, pointed out vehemently that he was sound in mind and body, and expressed strong indignation at being confined unjustly in what he referred to as a "nut house." It was then pointed out to him that he was not pardoned but merely paroled, and he was told that if discharged at present he would be returned to the penitentiary. Here his wrath began to subside at once and marvelously. Hastily, but with some subtlety, his tone changed, and he began to find points in common with the advice he had been receiving from the staff. He left the room in a cordial frame of mind, tossing friendly and fairly clever quips back at the physicians, nearly all of whom he had known during some of his many admissions to various hospitals. About ten days later he was pardoned outright by the governor and almost immediately took legal action which got him discharged against medical advice. Many similar adventures had occupied his time prior to the recent admission. Some of these had resulted in his being sent, as in the episode just cited, to psychiatric hospitals from which he promptly obtained his release by legal action. Others had led him to jail and to the police barracks dozens of times for charges not sufficiently serious for him to utilize the expedient of psychiatric hospitalization as a means of escape. A series of troubles had led to his reaching the hospital on this last occasion. As mentioned previously, he had many years ago divorced his first wife and remarried. The second legal spouse continued to play an important part in his career. As the proprietress or madame of a local brothel generally conceded to be the most orderly and, perhaps in a limited sense, the most respectable institution of its sort in the city, she was constantly embarrassed by the actions of her husband. Though enjoying a good part of the revenue from this ever-lucrative business, Max troubled himself little to maintain the dignity of the house. In fact, it seemed that he went out of his way to complicate matters for his wife. If not through his daily and nightly brawls or uproars in various low grogshops, dancehalls, or "juke joints," then by putting slugs into slot machines or serving as fence in some petty thieving racket, he brought the police in search of him down on the "house of joy" which maintained him. THE MATERIAL 35 Though satisfactory understandings were said to exist between this institution and the law, policemen suddenly appearing at the door and trooping through the hallways proved anything but conducive to that sense of security and dignity Mrs. - had long and justly boasted for her house. Especially after a few drinks, Max also liked to go about the house bragging to clients and to entertainers alike of his prowess in various lines, intruding on parties still at the "downstairs stage" of the night's activities, minding everybody's business, and inevitably turning the conversation to his superiorities. Most of the time he was quite amiable in this role-a cordial, but an all too cordial, host under circumstances in which people are usually concerned more with definite and perhaps pressing aims of their own than with the glowing reminiscences of another. Occasionally when crossed, he became threatening even with clients and, though open strife was usually avoided, hot, wild words and strenuous scenes sometimes followed, with Max exulting in the aftermath by pacing up and down the corridors of the house, shadowboxing, cursing, crying out his pugilistic titles and victories, and challenging all comers. No one realized better than his wife, a woman of experience and good judgment in such matters, what an unhappy effect these antics had on her clientele quietly seeking pleasure behind doors before which Max roared and paraded. Naturally she sought to silence him and to lead him off to the quarters they shared. Usually, however, her appearance served merely as a focus for his ire, and the tumult she sought to quell redoubled through her efforts. More than once under such circumstances he pursued her into her room, the wrangle having moved on to open violence, and there beat her to his heart's content. Mrs. _____, a tall and heavy person, gave a casual impression of being twice as large as Max. Furthermore, she was a woman of considerable strength. She often fought back vigorously and, though she seldom succeeded in landing a telling blow that would discourage her marital opponent, her resistance made the fight much more lively and greatly augmented the uproar of thuds, slaps, crashes, oaths, grunts, and honest yells of pain. Over several years this connubial life had been interrupted frequently by Max's departure, which he usually took in heat after quarrels such as those just described. Often he left voluntarily with obscene curses at his wife on his lips. Sometimes she called the police after he had covered her with minor bruises and abrasions from his practiced fists and had him forcibly ousted. Over the years he spent perhaps two-thirds of his time away, going from city to city and living by his wits, which are sharp indeed. When caught in his minor frauds, which he practiced not only on the public but also on those associated with him in his ventures, he quickly 36 THE MASK OF SANITY left town. Or, if retreat was not quick enough, he spent a few days in jail, from which he soon obtained release by telling of his imaginary head injury, of his "spells," or of anything else that occurred to his fertile mind as a means to make people believe he was incompetent because of "shell shock." When his situation turned out to be more serious, he telegraphed or telephoned to his wife, who at once flew to his aid, usually with some little money at her disposal. He covered the entire eastern seaboard on these trips and made several expeditions into the Midwest. For a few weeks in Texas he lived well off of money he milked from slot machines by some ingenious device or contraption or maneuver. His inventions of this type are numerous and highly practical. He could, perhaps, make an excellent living indefinitely off such takings if he did not, when drinking, and often when sober, boast too widely of his cleverness or otherwise bring himself to the attention of the police. It has been mentioned that earlier in his career, but after his second marriage, he had been wedded to other women bigamously. His wife learned of these episodes and legal action was taken by the deceived women. From these minor troubles he was extricated by his shrewdness, the aid of his wife, and the power of his familiar tactics of claiming incompetency and irresponsibility. This gambit of moves seems to have gained rather than lost effectiveness by repetition. It has become virtually a joker in the deck, or rather up the sleeve, and it has never failed him yet. One cannot but wonder if the juries, the courts, and other authorities are not overwhelmed by precedent and, seeing that his grounds for impunity have been upheld so often in the past, fail to challenge them adequately. Precedent is, of course, freely admitted to weigh heavily in law. On the other hand, these nonmedical observers seem to weigh seriously the plain facts of the patient's conduct when they decide that he is not a normal man, whatever term psychiatrists may use to designate him. The immediate cause of Max's return to the hospital on this occasion was indirectly connected with a third bigamous marriage which he recently made while off on one of his tours from connubial security. With his new partner he tried his hand again at forgery on a somewhat larger scale than usual. He prospered for a while and, flushed with prosperity and bravado, brought his new bigamous partner home with him on a visit to the brothel where his legal wife was struggling to restore standards which had suffered during his presence. As might well be imagined, quarreling broke out at once between the two wives. Max, still in character, did nothing to pour oil on these sorely troubled waters. In fact, his every move seemed designed to whip up the THE MATERIAL 37 already lively doings to a crescendo. The dispute culminated in a vigorous and vociferous set-to during which both ladies were pretty thoroughly mauled, furniture was broken, and the brothel all but wrecked. Max's most important personal contribution to the fray was a broken jaw for his legal wife, the madame of the house. It is interesting here to note that, despite his continual brawling with both men and women over so many years while drinking or while quite sober and despite his ferocious threats of violence and his pretty genuine ability as a pugilist, no serious bodily harm had before this come to anyone at his hands. I believe that the substantial injury was unintentional, an act of thoughtless exuberance committed in the heat of a situation eminently and subtly designed to bring out high enthusiasm in such a man as our hero. Having succeeded in bringing off a scene that even in his career stands out as a little masterpiece, he took the bigamous partner and fled back to the nearby city where his forgeries were in progress. Almost on his arrival detection met him, and hard on its heels came prosecution from home in consequence of the jaw breaking. To these difficulties charges for his latest bigamy were added. As such disasters began to accumulate about Max, his legal wife, finally aroused, decided for the moment to lend her influence to the punitive forces. In the court action that followed, the present and third bigamous wife received an adequate sentence to the state penitentiary, and for a while Max's own fortune seemed none too bright. Wrought upon by his protestations, however, and perhaps influenced as well by the disappearance of her rival from the scene, his old protector, the legal wife, was won over and began to work with her husband. Soon matters were arranged for him to escape the ordinary consequences of his deeds and be sent again to a psychiatric hospital. His last admission, with which this account began, was the result. Safe in the familiar harbor of a psychiatric hospital, he was for a week or more friendly, cooperative, and apparently content. He was at all times shrewd, somewhat witty on low levels of humor, and entirely free from ideas or behavior suggesting any recognized psychosis. He became very friendly with me during this period and talked entertainingly and with enthusiasm about his many adventures. He denied all misconduct on his part but admitted that he had often been in trouble because of his wife and others. It was not the denial of a man who is eager to show himself innocent but the casual tossing aside of matters considered irrelevant or bothersome to discuss. After briefly laughing off all his accusations, he at once shifted the subject to his many triumphs and attainments. 38 THE MASK OF SANITY Telling of his early life in Vienna, his birthplace, he spoke of his excellent scholarship in the schools, of his preeminence at sports, and of the splendid figure in general he had cut as a youth in that gay and urbane city. In none of these statements did he lay in details such as might be expected of a man developing a delusional trend. No psychiatrist, and few laymen for that matter, would have had the least difficulty in recognizing all this as "tall talk" designed to deceive the listener and to put the talker in a good light. All the patient's reactions showed that he himself was far from being taken in. His birth and upbringing in Vienna coincide with the facts as obtained from his army records. His alleged experiences at Heidelberg are recorded many times on his own testimony. He described himself as a distinguished student in that honorable university, referring to Kant and Schopenhauer and several of the Greek philosophers as special subjects of his study. He spoke also of a deep interest in Shakespeare during his student days and sought to give the idea that he was celebrated among his fellows for his knowledge of the Bard. The shrewdness and agility of his mind were prettily demonstrated in these references to the picturesque and traditional gaieties of student life, and to the works of the philosophers and poets. No less vividly and convincingly did he reveal an utter lack of real acquaintance with any of the subjects in which he boasted himself learned. He knew the names of a half-dozen Shakespearean plays, several catchpenny lines familiar to the man on the streets, a scattering of great names among the philosophers. He was totally ignorant not only of the systems of thought for which his philosophers are famous but also even of superficial and general facts about their lives and times that any person, however unintellectual, could not fail to remember if he ever had the interest to read of such matters. Of Shakespeare he knew practically nothing beyond the titles that rolled eloquently from his tongue and a few vague and jumbled conceptions that have crept into the ideologies of bootblacks, peasants, and street gamins the world over. Furthermore, he had no interest, as contrasted with knowledge, in any matter that could be called philosophic or poetic. He liked to rattle off his little round of fragmentary quotations, the connections and the connotations of which he realized only in the most superficial sense, to contribute a few pat and shallow saws of his own believed by him to be highly original, iconoclastic, and profound, to boast generally of his wisdom, and then to go on to descriptions of his other attainments and experiences. To my surprise, he was several times taken by psychiatrists who studied him briefly and by social service workers as a man of some intellectual THE MATERIAL 39 stature. His story of study at Heidelberg, though usually discounted, was, if the implication of the psychiatric histories is correctly read, sometimes taken as true or probably true. Although my actual contact with Heidelberg is superficial enough, I had no difficulty in demonstrating in the patient a plain lack of acquaintance with the ways of life there. The general plan of study and the physical setup of the university, matters that would be familiar to anyone who had been an undergraduate there, however briefly and disinterestedly, were unknown to Max. He showed that he might have passed through the town and that he had heard and still clearly remembered gossip and legend from the streets of Vienna about the university and its customs, but he had no more real understanding of it than a shrewd but unlettered cockney would have of Cambridge. This phase of his examination provided, in my opinion, a striking example of the ambiguity inherent in our world intelligence. Here was a man of exceptional acumen. His versatile devices of defraud, his mechanical inventions to overcome safeguards which ordinarily protect slot machines, and other depositories of cash, and his shrewd practical reasoning in the many difficulties of his career demonstrate beyond question the accuracy, quickness, and subtlety of his practical thinking. His memory is unusually sound; his cleverness at manipulating bits of information so as to appear learned is exceptional. He is not a man to be taken in by the scheming of others, though he himself takes in many. One can truthfully say about him that he is "bright as a dollar ... .. smart as a whip," that "his mind is like a steel trap." His ability to plan and execute schemes to provide money for himself, to escape legal consequences, and to give, when desirable, the impression that he is, in the ordinary sense, mentally deranged, could be matched by few, if any, people whom I have known. In such thinking he not only shows objective ingenuity but also remarkable knowledge of other people and their reactions (of psychology in the popular sense) at certain levels or, rather in certain modes of personality reaction. He stands out for the swiftness and accuracy of his thinking at solving puzzles and at playing checkers. At any sort of contest based on a matching of wits, he is unlikely to come off second best. To consider his intelligence (or should one say wisdom?) from another viewpoint, from that of the ordinary man's idea of what is good sense about working out a successful plan of life on a long-term basis, only the story of his career can speak adequately. Be it noted that the result of his conduct brings trouble not only to others but almost as regularly to himself. To take still another point of view and consider him on a basis of those 40 THE MASK OF SANITY
values somewhat vaguely implied by "intellectuality," "culture," or, in everyday speech,
by "depth of mind," we find an appalling deficiency. These concepts in which meaning
or emotional significance are considered along with the mechanically rational, if applied
to this man, measure him as very small, or very defective. He appears not only ignorant
in such modes of function but stupid as well. He is unfamiliar with the primary facts or
data of what might be called personal values and is altogether incapable of
understanding such matters. It is impossible for him to take even a slight interest in the
tragedy or joy or the striving of humanity as presented in serious literature or art. He is
also indifferent to all these matters in life itself. Beauty and ugliness, except in a very
superficial sense, goodness, evil, love, horror, and humor have no actual meaning, no
power to move him.
He is, furthermore, lacking in the ability to see that others are moved. It is as
though he were colorblind, despite his sharp intelligence, to this aspect of human
existence. It cannot be explained to him because there is nothing in his orbit of
awareness that can bridge the gap with comparison. He can repeat the words and say
glibly that he understands, and there is no way for him to realize that he does not
understand.
I believe that this man has sufficient intelligence, in the ordinary sense, to acquire
what often passes for learning in such fields as literature and philosophy. If he had
more stability and persistence he could easily earn a Ph.D. or an M.D. degree from the
average university in this country. If he had this stability and became a doctor of
philosophy in literature, the plays of Shakespeare, the novels of Joseph Conrad or of
Thomas Hardy would still have no power to move him. He would remember facts and
he could learn to manipulate facts and even to devise rationalizations in such a field with
skill comparable to that with which he now outthinks an opponent at checkers. If, for
the sake of theory and speculation, such changes were granted to him, my contention
that he would still be without this sort of understanding is, of course, impossible to
prove. It is maintained, however, that this would be clear to all observers who have real
interest in such aspects of life, however diverse might be their own formulated opinions
on what is good, bad, true, or beautiful about art or about living.
But let us abandon speculation and return to the patient's conduct. He talked at
length of his ability as a fencer, maintaining that he was the best swordsman, or one of
the best, at Heidelberg during his student days and was also well known and feared in
Vienna. He spoke of the championship he had won at boxing while in the army,
boasting often of a belt which he still possessed symbolizing this achievement. On
hearing that I had had a slight experience in amateur boxing, he offered to demonstrate
his skill and to teach me some points. Ostentatiously he insisted that I stand up and,
THE MATERIAL 41
pulling his punches, went through a number of sequences. He did this several times,
always choosing a place on the ward where he could be observed by a large group of
patients and attendants. He gave every indication of being a practiced boxer. This is
borne out also by army records which indicate that he won some small prize as
champion of his battalion or regiment.
Even before his presentation at the staff meeting, he again became dissatisfied,
making complaints against the nurses and attendants, demanding special foods and
privileges, bullying other patients, and inciting them to make trouble. At staff meeting
the diagnosis of psychopathic personality was reaffirmed.
On failing to get his discharge at once, he became even more fretful and unruly
and threatened to break out of the hospital. It became difficult to care for him on the
ward for well-adjusted patients in which he had been placed, so he was transferred to
the closely supervised ward, where he found himself surrounded by actively disturbed
and egregiously psychotic companions.
He complained at once of this to his wife, who came to the hospital authorities in
tears and with angry protestations, saying that it was an outrage to put her husband with
all those crazy men who were violent and combative and who might hurt him. Earlier
on the ward she made the same protest to an attendant, who saltily remarked on the
inconsistency of such worries about a husband so well known for his boasts of might
and ferocity and pugilistic skill. She made the matter so sharp an issue that Max, after
promising to cooperate, was moved to a quieter ward.
Now, for a short while, he was more agreeably disposed. Boastfully he told me
that he was, in addition to all his other parts, an artist of remarkable ability. He asked to
be given a loaf of bread, stating that he would mold from it creations of great beauty
and worth. On getting the bread, he broke off a large chunk, placed it in his mouth, and
began to chew it assiduously, apparently relishing the confusion of his observers. After
proceeding for a length of time and with thoroughness that once would have met with
favor from advocates of the now almost forgotten cult of Fletcherism, he at last
disgorged the mess from his mouth and with considerable dexterity set about modeling
it into the figure of a cross. Soon a human form was added in the customary
representation. Rosettes, intertwining leaves, garlands, and an elaborate pedestal
followed. The mixture of saliva and chewed bread rapidly hardened.
He now requested a pass to go into town, saying that he must obtain shellac and
appropriate paints to complete his creation. He made it plain that he was molding this
statuette for me, and it was clear that he regarded
42 THE MASK OF SANITY
it as a most flattering favor. Since it was judged unwise to send him out alone, he was
allowed to go in company of an attendant. He returned with his materials but also with
the strong odor of whiskey on his breath.
The whiskey had been obtained in this manner: Pleading a call of nature which,
judging by his frantic tone and impressive grimaces, the attendant deemed urgent, he
hurriedly sequestered himself in a toilet. After waiting for what seemed like a most
liberal interval, the attendant went to inquire into the delay. On receiving no response,
he forced the door only to find that Max had made his escape through a small window
near the top of the room, a feat which would have been extremely difficult for an
ordinary man.
Guided by a happy instinct, the attendant hurried to a nearby dive where bootleg
whiskey was sold and surprised our hero in the midst of his second or third potation.
He was drinking to his own cleverness at outwitting the attendant and in loud,
imperious tones commanded all present to drink with him and at his expense.
The attendant found him insolent and intractable at first but, with strong moral
support from the proprietor and others, led him out after settling charges for drinks to
all, which Max had grandly assumed without a cent in his pockets.
For the rest of the day he was surly and idle except for his efforts to promote
quarrels, but on the morrow, extolling again his virtuosity as a sculptor, he settled down
and finished his gift to me. It was indeed an uncommon production. The chewed
bread had become as hard as baked clay. The whole piece was very skillfully and
ingeniously shaped, dry, firm, and as neatly finished as if done by a machine. It was,
furthermore, one of the most extravagant, florid, and unprepossessing articles that has
ever met my glance. Max presented it with mixed pride and condescension, with an air
of triumph and expectancy that seemed to demand expressions of wonder and gratitude
beyond reach of the ordinary man. I did my best but felt none too satisfied with my
efforts.
Max now asked for daily bread and for a room to be set apart as an atelier where
he proposed to work regularly and without distracting influences. In the hope that this
activity would keep him out of trouble, all his requests were granted. He immediately
demanded full parole also but, when it was not obtained, agreed to wait a short while for
this.
For a week he worked steadily, his mouth crammed with the doughy mass, his
jaws chewing deliberately, his hands nimbly shaping spewed-out hunks of the mess into
various neatly finished and exact, but always garish, forms. His coloring of the flowers
and garlands and imitation jewels, vivid red, pale purple, sickly pink, always struck a high
level of the tawdry
THE MATERIAL 43
blended with the pretentious. The most gaudy atrocities of the dime store must give
ground before such art.
He sent messages to the medical director of the hospital, to the supervisor of
attendants and the chief nurse, and to many others whom he felt it well to ingratiate that
objets d'art awaited them in his studio. He was visited by these people and by various
prominent ladies of the city interested in welfare work and active in helping disabled
veterans. To most of these he made presentations as well as moving speeches about his
misfortunes, his gifts, and his ambitions. His demands for parole now became more
vehement. Many influential citizens begged that he be given this chance to rehabilitate
himself. As a matter of fact, he had been reasonably cooperative while at his new work.
Parole was granted.
The police brought him back after a few hours. His left hand showed a painful
laceration, the result of a severe bite inflicted in retreat by a barroom opponent who had
resorted to this vaguely Parthian maneuver after finding Max's pugilistic skill too great
to cope with in the ordinary manner.
He showed some evidence of drink but was by no means sodden. Nor did he in
any way give the impression of a man sufficiently influenced by liquor to have his
judgment appreciably altered or any violent and extraordinary impulses released. In
contrast with some of the other patients discussed here, Max, though a ready drinker,
never or very rarely drank to the point of confusion. There is no record in all the saga
of his being brought in senseless from the highways or fields. At the worst he could
scarcely be classed as more than a moderate drinker.
He made no excuses for violating his parole but blamed others in full for the
trouble he had started and felt grossly misused by the man he had attacked, by the
police, and by the hospital which revoked his parole.
His wife at once pled for restoration of his parole, and a number of other
influences supported her. Max reiterated the familiar argument: why deny liberty to a
man classed as sane? Parole was restored after a week. Surprisingly, Max got through
two days without difficulty, but on the third, burst into the office of the supervisor of
attendants and vehemently demanded that a former attendant, dismissed for
incompetence, be reinstated at once. He had brought this man with him into the office.
Inspired by a couple of highballs but by no means drunk, he thundered and swaggered,
threatening to use political influences to have the supervisor discharged if all his
demands were not met forthwith. He named various political powers which he boasted
that he could command. These influences, he very truly pointed out, had lent
themselves to his efforts to get out of jail and out of hospitals in the past. He insisted,
furthermore, that certain other attendants
44 THE MASK OF SANITY
whom he disliked be discharged. Storming and cursing and threatening, he was
removed to a closed ward.
Somewhat disgruntled, he ceased his modeling in postprandial bread and sulked,
irritable and aggressive, among his psychotic companions. Soon, however, he became
more agreeable and after a few days came swaggering into my office to display a new
product of his ingenuity. Borrowing a dollar bill and a pair of scissors, he cut out five
rectangles of plain paper identical in size and shape with the bill and poised himself with
a faintly prestidigitatorial air. "Watch this," he boasted.
As he cut up his models of the bank note and manipulated the pieces, he called
for paste to be brought. Then, after a shrewd and tricky rearrangement he pasted
together his fragments. "Count them," he ordered in the grand manner. Not five but
six paper models lay on the table, all plainly patched, but all defying the ordinary eye to
detect any appreciable loss of substance.
Within a week his wife, after haunting the hospital and begging for his parole,
insisting that she needed him at home, that she was in want, succeeded in taking him
out in her custody. Late that night local policemen brought him back. After giving his
wife what might be called an average beating, he had caused considerable uproar at the
bawdy house and fled to another dive where, after trying to get loans from a few idlers,
he boasted and quarreled until the police intervened.
He remained then on a closed ward for about a week. After this time, legal
charges against him having been dropped, he demanded release against medical advice.
Since he was sane and competent in the eyes of law and science, he was discharged.
Two months later local newspapers carried small headlines calling attention to his
being taken by federal agents after a protracted investigation in Texas. For weeks
patched-up five-, ten-, and twenty-dollar bills circulated in several Texas cities, and Max,
decked in flashy finery, drove about in his own car and splurged lavishly on food, drink,
and women. The surprising volume of mutilated notes at last caused comment and
finally suspicion. After skillful and persistent efforts, the federal agents finally worked
out the puzzle and brought it to Max's feet.
My colleagues and I felt that perhaps our acquaintance with Max had ended.
Federal justice is widely regarded as less relenting and less distractible than municipal
and state justice. For most lawbreakers this may, indeed, be true. Max's old play,
however, had not lost its charm. Some months later he was in a psychiatric hospital and
shortly afterward at large.
His career continued. The records show that once, while under a fiveTHE
MATERIAL 45
year sentence to a state penitentiary, he stressed his former syphilitic infection and
boasted so vehemently in his old style that a physician who saw him in prison made a
diagnosis of dementia paralytica. No neurologic or serologic findings supported this
opinion, which was offered by a general practitioner after one interview. This was
enough to start the familiar cycle of prison-to-hospital-to-freedom.
Once again, when anxious for shelter, he boasted that he could communicate
with ancestors who had died thousands of years ago. His wife joined in and claimed
that he had seen monkeys and baboons chasing him. At a general hospital a tentative
diagnosis of schizophrenia was offered. Back at another psychiatric hospital he showed
no evidence of an orthodox psychosis and after a short time got his discharge.
Again when pressed by a court verdict, he claimed amnesia for a period of two
years, during which he had been active at defrauding. A suspicion of hysteria was
expressed by some physicians. At the psychiatric hospital he stuck for a while to this
story of amnesia, but, his vanity being aroused, he recalled in detail all his experiences.
It was plain from his manner that he had not suffered from any true amnesia, and he no
longer took pains to make anyone believe that he had.
A few years later he was again brought to the hospital. This time his wife insisted
that his beatings were too much to bear and stated that he had threatened to kill her
with an axe, explaining that he could do so with impunity since he was a mentally
disabled veteran and that, as she well knew, he had always succeeded in escaping the
consequences of any crime. She soon recovered from her fears and asked for his parole.
At the insistence of both man and wife, he was discharged after a few weeks.
Be it noted that despite his vigorous threats such as the one just mentioned, Max
seldom, if ever, tried with deliberate intention to do anyone serious physical injury. This
fact has especial weight in view of his boasted and pretty satisfactorily demonstrated
immunity from penal consequences. In important respects he appears to differ
fundamentally from those who are regularly or often inclined toward major violence, or
toward murder. In his innumerable conflicts with the law he has appeared usually in the
role of petty bully, perpetrator of frauds, sharper, con-man, swindler, thief, and peacedisturbing
braggart.
Some months later I, with other psychiatrists, testified at court when efforts were
being made to have Max committed by law as "insane." Several citizens whom he had
defrauded and seriously troubled in other ways, finding that he was not vulnerable to
fines or sentences in the municipal courts, hoped to obtain relief and protection by
getting him into a psychiatric hospital.
46 THE MASK OF SANITY
The psychiatrists could not avoid admitting that he showed no evidence of
anything that is officially classed as a psychosis. Despite some sort of misgivings I had
to agree. Yet it seemed plain that this man, though free from all technical signs of
psychosis, was far less capable of leading a sane, or satisfactory, or acceptable life, less
safe or suitable to be at large in any civilized community, than many, perhaps than most,
in whom psychosis can be readily demonstrated and universally accepted as
unquestionable. Was there any means I could suggest by which he might through
existing laws and institutions be more adequately controlled and kept from destructive
folly? Or by which the community might be better protected from his persistent
antisocial activities? As I groped without avail for an answer the sense of futility became
truly oppressive. Max, neat and well groomed, insouciant, witty, alert, and splendidly
rational, rose, beaming, to hear again the verdict of freedom.
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Next: Section 2: The Material , Part 1: The disorder in full clinical manifestations, 6. Roberta
Energy Enhancement Enlightened Texts Psychopath The Mask Of Sanity
Section 2, Part 1
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