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
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PsychopathTHE MASK OF SANITYSection 2: The MaterialPart 1: The disorder in full clinical manifestations 12. Anna
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12. Anna There was nothing spectacular about her, but when she came into the office you felt that she merited the attention she at once obtained. She was, you could say without straining a point, rather good-looking, but she was not nearly so good-looking as most women would have to be to make a comparable impression. She spoke in the crisp, fluttery cadence of the British, consistently sounding her "r's" and "ing's" and regularly saying "been" as they do in London. For a girl born and raised in Georgia, such speaking could suggest affectation. Yet it was the very opposite of this quality that contributed a great deal to the pleasing effect she invariably produced on those who met her. Naive has so many inapplicable connotations it is hardly the word to use in reference to this urbane and gracious presence, yet it is difficult to think of our first meeting without that very word coming to mind, with its overtones of freshness, artlessness, and candor. She had passed her fortieth birthday some months before. Neither her face nor her figure had lost anything worth mentioning. Despite her composure, she gave a distinct impression of energy and playful spontaneity, an impression of vivid youth. In response to ordinary questions about her activities and interests she spoke of tennis, riding, and reading. More specific inquiry brought out opinions on Hamlet's essential conflict, comparison between the music of Brahms and the music of Shostakovitch, an impressive criticism of Schopenhauer's views on women, and several pertinent references to The Brothers Karamazov. She expressed opinions on current affairs that seemed to make excellent sense and talked with wit about the cyclic changes in feminine clothes and the implications of atomic physics for the future. What she had to say was particularly interesting and she said it in just the opposite of all those many ways of talking that people call "making conversation." As discussion progressed, the picture of a rather remarkable woman became more and more distinct. Here was evidence of high intelligence and of considerable learning without discernible bookishness or consciousness of being "an intellectual." Her manner suggested wide interest, fresh and contagious enthusiasms, and a taste for living that reached out toward all healthy experience. Having a cup of coffee with her or weeding a garden would somehow take on a special quality of fun and delightfulness. Something about her over and beyond her looks prompted the estimate that she would be very likely to elicit romantic impulses, strong sensual inclinations, from most men who encountered her. Here, it seemed, was natural taste THE MATERIAL 103 without a shadow of posed estheticism, urbanity without blunting of response to the simplest of joys, integrity and good ethical sense with the very opposite of everything that could be called priggish or smug. She showed nothing to suggest she meant to give such an impression or that she had any thought as to how she seemed. Even with a detailed record of Anna's career clearly in mind, it was difficult indeed not to come to a conclusion that all the well-authenticated facts of that record should be ignored since they were so thoroughly contradicted by the obvious character of this appealing woman. The banal but nevertheless insistent thought that such a psychiatric history must apply to some other person was hard to dismiss. Prior to this interview a great deal of trustworthy information had been made available to me. Anna's mother and father had given her story at length. A reliable psychiatrist in whose small private hospital she had been treated on numerous occasions furnished not only an ordinary history but many details from his firsthand experience with her over the last twenty years. Her family physician had grown up in the same community with the patient and, through his personal acquaintance with her and her associates since childhood, had access to a remarkable amount of unusual information. He, as well as another medical practitioner who was also a relative, gave further details. Other sources of fact and opinion lay in several patients treated in the past whose relations with Anna at various periods of her life were significant. In the course of treatment, material had emerged in these other cases that rounded out her history and afforded additional means to evaluate her own reactions in interpersonal relations. It is too much of a story to tell in a chapter or in a single book. And, no matter how told, it could not be believed except by those who have already had experience over years with such patterns of behavior. Familiarity with a temporary cross section of such a life (as, for instance, during a single period of hospitalization), plus a generalized account of what preceded, would almost surely convince any psychiatrist of the diagnosis, but this would probably fail to give him the challenging sense of wonder, the awe that arises from a contemplation of the accumulated detail in its specific essence. Her family first became aware that Anna had serious problems through the discovery of a boys' club in the local high school which, if not exactly founded in her honor, had at least been organized about her as the central figure. Comprised of ten or a dozen members in their early teens, a secret society in a sense, the group, like many Greek letter fraternities, had special phrases, symbolic signs, and countersigns. Encountering each other at the soda fountain or passing in the school corridor, two boys might slowly flex 104 'THE MASK OF SANITY the fingers of their hands (so as to suggest a rounded aperture, possibly), leaving their arms dangling as if to veil slightly from alien observers a mystic communication. Amid the chattering of groups over their chocolate sodas or hamburgers. certain phrases were thrown out stamped with idiom by the tone of voice and a special knowing quality in the accompanying glance. Small talk proceeded along lines common to pubertal groups. Baseball scores were predicted and estimates were voiced as to whether or not a certain girl would neck or pet or perhaps do a French kiss on the third date. The occasional gestures and the allusive words provoked curiosity among the uninitiated without actually revealing the secret content. Numerous small groups of boys, sometimes only three or four, sometimes more, banded by a common interest in postage stamps, firearms, a secret shack in the woods where they met to gamble, or in some other affair, often reserved for themselves a peculiar connotation in bits of familiar language or devised codes of slang, verbal, digital, and postural, to transmit among the elect understandings of special recognitions best reserved from the surrounding masses. First and fundamentally, the comprehension of the entire adult world was glibly evaded by this communication system. In mixed gatherings, such as at dancing school, allusions could be made, say to a half bottle of cheap liquor stored weeks ago in a hollow tree near the riverbank. This often evoked an arcane deviltry through which the girls could be teased but in which they could not fully mingle. Groping among confused and paradoxical concepts of virility, some boys could find stimulus (or protectiveness) in neologisms and fresh innuendos pertaining to the act of excretion and its subtle relationships to insult, sexuality, and infinite defilement. Like dozens of other small, spontaneously forming and dissolving fraternities centered around interests that ranged from bird study to techniques of mutual masturbation, the group whose special interest lay in Anna did not for a while attract undue or sustained scrutiny from the adult world. The club had come into being after a discussion among several boys heretofore not particularly well acquainted with one another. Chat had veered desultorily front literal accounts of what they had done to certain girls to playful variations on the theme of personal insult by the versatile (and at times fantastic) use of strongly obscene words. As every junior high school boy knows, this argot of double-talk can bring a stimulus of exaggeration into the simplest statement and at the same time literally indicate matters so grotesquely perverse that they probably lie beyond biologic experience. Though at times seized upon to express actual rage or contempt, even the most objectionable formulations are oftener used in amiable or even affectionate badinage and horseplay. The actual nouns THE MATERIAL 105 and verbs, chiefly those of four letters (occasionally those of three or five), denote parts of the body involved in excretion and the genital organs of man and woman, and eliminative and sexual activities. Mingled in a sort of cloacal chaos, seasoned with qualifiers of coprophilic and more broadly scatologic significance, weirdly sadistic, rounded Out with participial references to olfactory and other sensory outrages, this unprintable language is worn so smooth by continuous repetition among pubertal boys that even its more literal meaning often bypasses their awareness. In calling this language unprintable I am not uncognizant of the fact that there is not one of the forbidden words which has not occasionally appeared in books and that all of them can be seen scrawled on the walls of latrines. These words, however, in isolation or in different contexts, cannot even hint at the terrible significance so obvious in the context of speech into which they are woven. Though some attention has, of course, been given by psychiatry to what is now being mentioned, it is an area that deserves further study.74,91,229,248 The material is so highly charged that even in medical or in any other technical writing it cannot be handled freely. The actual discussion that led to the beginning of the club to which we are giving attention cannot be presented to the reader. It is, of course, for one thing not directly accessible to me in full detail, although there is sufficient information to reconstruct a reliable approximation in concrete terms. The nature of Anna's behavior and experience in her relationship to the club can scarcely be conveyed by a generalization, From what material is available about this specific incident and with the aid of confirmatory detail gathered from the review of many similar situations, let us, as best we can (tentatively, but with sufficient evidence to give confidence that the approximation is in substance valid) attempt to reconstruct a little of the scene. Even a few bowdlerized and typical fragments may be helpful. The boys had been hanging around together at a spot near the riverbank where they sometimes fished, talking in the sort of bull session that often arose. "Butch, you sure ___ed me up on that algebra assignment last night." "Aw ___ Jack, you ___ed yourself, you damn old horse's … Just because the prof wouldn't suck up all that bull___ you tried to hand him, don't give me that kind of ___ The prof just up and ___ed on you. That's all there is to it. He ___ed on you good. Right in your eye.___ ,. to Prof. Blankl Why that ___ halt ___sted ___sucker almost ___ed me out of a pass on the last test." Another boy diverted this trend of conversation by claiming he got: 106 THE MASK OF SANITY a piece of ___ from the colored woman who washed dishes at the Greek's hot dog stand, boasting that it was plenty good… and cost only fifty cents. "____ on that old black…" Butch commented disparagingly, "If you put a croker sack over her head I might give two bits for it." Thoughtfully he added, "Nigger ___ ___s too bad for me. You can have my share of that ____y stuff!" Butch had been raising his .22 rifle to his shoulder from time to time as he talked, idly glancing down the sights as he aimed it at distant objects. "Lemme see your gun a minute," Jack asked, impatiently stretching out his hand. When Butch signified refusal by silently shifting the rifle out of reach, Jack expressed mild vexation: "Well, stick the goddamned thing up your ......" Bill, another one of the group, caught up the momentarily abandoned subject. "Some fellows say nigger women got the best damn ____ in the world." Bill referred to an ingenious method learned from his older cousin, now a grown man at college. The boy had overheard him and another man discussing their exploits of miscegenation. Bill had not yet had an opportunity to try the technique personally, but this he did not disclose. It involved the use of an old towel (a hole having been cut near the middle) and offered advantages worth knowing about. He went on to explain how you could, in this way, "____ it to 'em" with no bodily contact except that imperatively necessary and with minimal suggestions of intimacy. Jack laughed and expressed approval of the approach described by Bill, then tilted his head toward the boy with the rifle, shouting, "Reason old Butch talks so finicky is because he can't even get up a___ I Betcha a hundred dollars if all the ____ in the world was sprawled right there in front of him that he couldn't even raise a ____ !" "You dirty _____ you," Butch answered, slightly irritated, "You're talking about your ____ self. Everything you say goes back on yourself." Apparently feeling this was a little lame, he added quickly, "Bet old Jack ain't ever even ____ off in his pants!" "Maybe all he's done is just to_____ in 'em," Bill commented merrily. "Bet that's what old Butch would do if a girl had no better sense than to let him think she'd let him ____ her." Turning now from this exchange of compliments, the boys offered bits of information and speculation about several girls with whom all had some acquaintance through classes, dancing school, or Sunday school. "I understand Sue White's begun to put out a little ____," Bill said. "____ no!" Butch disagreed. "Sure would like to get myself a little of that ____ But Sue's a nice girl." "Pete Green says he finger ____ed old fat ____ed Rita ___." Pausing a moment he continued listlessly, "Can't think of her last name. You know who I mean. Lives in the big house next to Sam Beech's uncle." "Wouldn't be surprised," Butch agreed. "I dry ___ed her myself the THE MATERIAL 107 second time I ever got her alone. On the other hand, you can't believe anything that damn mother ___ing ____ Green says," Butch added. Feeling his enmity to Pete Green, who, a month or two ago, had made him back down with the threat of "slapping the living ____ out of him, Butch continued in unspoken thought, "Damn that Pete Green! If that _____ ever tries to cross me up again I'll tell him I'll ____ his ____ mother up the _____ with a two by four and then ____ in his ____ face! That would shut him up, maybe!" Pete had intimidated Butch several times in the past. He knew he wouldn't dare to provoke a fight by talking to Pete in any such way, but it eased his feelings a little to think about it. "Tell you what I'd like to try," Bill admitted, after a moment of silence, "is some of that ____ Anna Blank packs. Every day in Latin class I keep thinking I'll take a shot at it ... but somehow with a girl like that… I just don't know…" Bill could not quite express what made him cautious. It was not only that her father and mother were rich and prominent and powerful in the community and her older brother strong enough to beat him half to death if anything, even about a try, was found out. It was more than that. Most of the girls you did these things to were sort of from the other side of the tracks. But by no means all of them were. You could get away with it lots of times with ones supposed to be real nice. Lots of goofy fellows still thought some of them were nice, Bill realized in an inexpressible wave of superiority and vague elation. Some poor damn ____s would even marry them some day. The sort of thin, ruthless exuberance that glowed in the boy screened an underlying stratum of personal insecurity probably common to all mankind and sometimes particularly disturbing at this age. He did not try to account for the triumphant feeling or to ask if it sprang chiefly from ideas of debasing the female or, perhaps even more, from the scornfully superior position he thus attained in fantasy to the other male. Thoughts of this sort did not enter Bill's consciousness, but factors influenced his feelings which, if he had understood them, might have produced such thoughts. By no means given to violence in action, this boy would not have inflicted physical injury on another. In imagination, as in the comic strips, all sorts of fatalities occur without anyone really getting hurt. Still musing on Anna, Bill continued. "She sure is built, that girl! She's built just like a brick ___ house." Butch and Jack, who had been looking slyly at each other, gave a low whistle almost simultaneously. Then they began to interchange a sort of chuckling that was half laughter and half teasing, designed to provoke curiosity in their companion. After a while Bill was told how easy it was to get ____ from Anna. Each of the other boys gave a detailed account of his own experiences, including one success by Jack in the storage room at school. These experiences were quite recent and until now had not been widely discussed by either Butch or Jack. 108 THE MASK OF SANITY Each had, in fact, been surprised and, though this was not admitted, also shocked to discover that Anna was not a "nice girl." A confused disillusionment no doubt played some part in their present emphasis on the opposite evaluation of this girl who had, rather typically, represented the "sacred" (sexless) female in their thoughts. The fear of so honoring a female who turned out to be this other sort of thing loomed as a threat to one's own manhood. The untouchable priestess, once disclosed as an impostor, must be thoroughly defiled. Thus man sometimes seeks protection from confusion through which he himself risks the defilement of personally enshrining one who will make his virility (honor) the laughingstock of the group. Fortified by this enlightenment, Bill partook of Anna's favors soon afterward. All of the boys found a special pleasure in talking together about their achievements. Soon a friend of these three was told about their source of pleasure, then another friend, and still another. At first each boy had gone alone, but as time passed it became more practical for several to visit Anna together. An appointment would be made by one of those interested. Anna, under the pretext of taking a walk or going to visit a friend would, without detection, make her way to a building situated on the other side of the large garden behind her house. Now used as a storehouse and garage, the building was originally a stable, and its former hayloft afforded reasonable privacy. The boys, by coming from another street through a hedge back of the garage, could make their way unnoticed to the rendezvous. Safe opportunities, though fairly frequent, were limited because the chauffeur was sometimes in the garage. There were also days when the yard man worked nearby, or, rarely, Anna's brother might be there exercising with barbells and other gymnastic equipment he kept in another part of the building. This, no doubt, was a factor in the group's choice of coming together, particularly as its membership expanded. Of even more importance, perhaps, was a specific satisfaction found by some in entering upon the venture together. The closely shared experience seemed to enhance the pleasures of club conversation when they gathered later to talk over what happened. After chapel in the morning it was customary for the captain of the baseball team, the chairman of the debating club, and others interested in extracurricular activities occasionally to announce plans for meetings of their various groups. One morning, in response to a dare by other club members, Jack came forward and in a bold voice called out: "At the beginning of lunch hour there'll be a meeting of the Animal Crackers in Room 49." There was a scatter of giggling and some random speculation on the part of a few teachers, but no official inquiry about the club was made and no adult thought of any play on Anna's name or caught improper innuendos. THE MATERIAL 109 The existence of the club and their daughter's undesirable situation was finally brought to the attention of Anna's parents through its effect on another person. Among the older boys who had been attracted by Anna was one who had apparently turned to her in the utmost seriousness. All accessible information indicates that this boy fell in love with Anna not by a trivial attraction but with all the vividness and life shaking stir that the first complete and genuine experience of this sort can bring to an earnest young man almost ready for college. The younger girl, suddenly having become mature in body, loomed like something never seen before upon his awareness. There is reason to believe that he was determined to marry her and resolved to be scrupulously faithful through all the years he must wait for this. There is nothing to suggest he did not seek her with strongly passionate physical desire, but apparently his idealization of her and fear of arousing even further impulses, which it would have been for him a desecration to fulfill under these conditions, caused him to treat her, if not like an untouchable goddess, at least with extraordinary restraint. Anna, it seems, behaved in such a way that he was sure she reciprocated his feelings not only in kind but also in degree. Reports as to how he discovered the relations of Anna with the club are somewhat conflicting. It is almost impossible to believe that fortune was so unkind as to have him blunder upon an actual meeting of this group with the customary activities in progress. So it is said to have happened. At any rate, he received enlightenment in such a convincing way that the impact was sudden and trenchant. In his immediately subsequent state, rumored to be a "nervous breakdown" at the time, his family physician, after considerable difficulty, seems to have obtained some idea of what he had experienced. Being a relative of Anna's mother and a boldly conscientious man, he felt that the situation demanded attention and disclosed something of it to her parents. Insofar as the complicated and seldom obvious attitudes that enter into the administration of parental authority and guidance on such an occasion can be evaluated, it seems that this girl's father and mother avoided the typical mistakes that might have been made. Neither attempted to conceal the humiliation and distress brought upon them by such conduct. After adequate frankness about their reaction to the conduct itself, they tried to avoid rubbing it in by moralizing reiteration. A decision was made for Anna to be sent at once to a fine boarding school in a distant state. Apparently feeling that the daughter could not fail to be critically traumatized by realizations that withered them with pain and shame, Anna's mother and father tried, as some people are able to do after losing eyesight or a first child, to 110 THE MASK OF SANITY accept what has happened without evasion but nevertheless to turn with all resolution available to what is ahead and not to stir what is tragic or hideous, but now past and unmodifiable. There does not seem to have been gross error in glossing over what had taken place or minimizing the possible consequences. Both parents tried to support Anna by emphasizing opportunities in the future and by their knowledge that in the process of growing up it is not uncommon for people to make mistakes that in the adult world would be fatal. Anna's apparent reactions were such as to enable all the family to be entirely sincere in showing her their continued confidence, their respect, and their love. In choosing a fine private school with high academic standards, she seemed to be showing her serious intentions about the future. Her keen interest in choosing clothes, her care in getting exactly the right sort of curtains for the dormitory room might have suggested to some almost too easy and quick a recovery from the fell blow she was thought to have suffered, but at the time this seemed instead a fit and appealing veil of insouciance that she bravely, if not almost heroically, pulled about her to conceal with stoic and patrician grace the terrible trauma her spirit had sustained. Even in the short period of time before she left for the East, the outwardly blithe air that Anna displayed when she joked and laughed with friends who came by (her ability to seem blandly preoccupied in getting the new jazz records and those popular dancing slippers that the shop was expecting any day now) provoked fleeting but ominous thoughts in the family that such poise, considering the full circumstances, might be a little excessive. Excellent reports on Anna came for several months from the distant school. She was doing well in her studies and already she had won a place on the swimming team. She seemed also to have found herself almost at once in the warm affection of teachers and students. One teacher, in a letter to her mother, spoke of Anna's "unusual promise in English" and of her Surprising maturity of outlook." Anna's own letters, though few, were warm with expressions of devotion that seemed to follow the inimitable idiom of sincerity. In these letters she sometimes mentioned her conviction that she knew of no way to express her gratitude except to show by her own conduct that she did deserve the trust her mother and father had shown in her and the support of their love and understanding. No happiness could mean more than that she would find in making them feel they could be proud of her again. Such letters were building up in these parents an encouragement they sorely needed and offering (as an anodyne for their anguish and humiliation) THE MATERIAL 111 increasing hope that as parents they had not, perhaps, failed their daughter utterly. Meanwhile, reports began to come from the school which seriously disquieted them. Anna had apparently broken a number of rules, most of them involving minor issues, it is true. She had twice been caught smoking with several other girls; she had four times stayed out considerably beyond hours; she had cut several classes; she had spoken disrespectfully to a teacher. But, after all, such misdemeanors often indicate a healthy sort of growing up and her parents were anxious to avoid forcing Anna into a rigid pharisaical propriety as compensation for her terrible error. When a final decision was reached that Anna could not be kept at school, a good many more serious symptoms had come to light. Several petty thieveries (at first assumed to be absentminded borrowings), flagrant but ingenious cheating in laboratory work, calm lies about matters that were accepted as points of honor-all of this added up to make her expulsion imperative. At the half dozen or more subsequent schools attended by Anna, she often seemed to have changed, and for varying periods her family's hope was high. Her behavior at each place fell into similar but not identical patterns. Like the persisting theme in a complicated work of music, her actions took diverse courses but came always to an identical point, which for her was failure. A Brahms concerto may spread and range, with woodwinds at one phase carrying the movement and, a little later, the violins manifesting something of another sort or the piano (as if in reply to the orchestra) weaving a fresh subject into the manifold skein; so through her history appeared episodes of variety and genuine novelty, all contributing to a design of impressive versatility but leading to an inevitable conclusion. Once or twice Anna completed the entire year, but nearly always each new institution found itself unable to handle her after a few months. Sometimes she worked steadily during the summer and easily completed courses she had missed in her numerous shiftings about. Perhaps on the basis of an excellent performance on the entrance examination, she gained admission to a distinguished college for women and, after being expelled, briefly attended a smaller college and two state universities. On other occasions she undertook training in business school, in hospitals (nursing, x-ray technician) and welfare work. She often expressed spontaneously a lively interest in this or that career and worked out her plans with good judgment, but, after widely varying periods during which she applied herself, she regularly ended by quitting voluntarily or being dismissed. When Anna sought some new job with which to occupy herself or to enter some course of training, she seemed to have no hesitation in giving 112 THE MASK OF SANITY as references those who had no choice except to describe her as entirely unreliable and unfit for what she planned. Sometimes the reason for her failures seemed not to lie so much in antisocial or spectacularly improper acts as in other maladaptations. A few excerpts from a letter follow: Mrs. Anna _____ has requested that we write you in regard to her work as a student in our School for Roentgenological Technicians. … Because of her irregularity in attendance she lacked fourteen weeks of the period required in our course…. It was necessary to admonish this student on several occasions because of her poor work. …She repeatedly made mistakes, the seriousness of which seemed not to concern her in the least. …Similar complaints were handed in against her by several instructors. The mistakes were never made through lack of intelligence… but apparently from disregard of consequences or some type of distraction…. She was put on probation, twice for avoidable and grave mistakes, and once for her attendance record…. On being threatened with dismissal because of her apparent disinterest, she, for a while, regularly demonstrated her fine ability. … This student, we are compelled to say, was a definitely dangerous worker to have around Roentgenological apparatus. It became necessary to watch her carefully. She could not be trusted to carry out things on her own responsibility. … When told of her failings, she always showed amazement and disbelief that she could possibly be doing anything wrong. She appeared to be sincere in such reactions.... I find it impossible to recommend this person for work along these lines. … I am convinced that her performance would be detrimental to the profession or to any group for which she might work. … We regret that it is necessary to submit so unfavorable a report... This letter is written in response to her request. Among the almost limitless accumulation of incidents that loom in a retrospective glance at her career, only a few can be given here, and these in the utmost brevity. From one prep school she was dismissed though standing high in her classes after it was proved she had placed a half dozen or more rubber condoms so that these useful items would become unmistakably evident when several couples seated themselves on the two sofas that flanked the fireplace. Here, almost directly under chaperoning eyes, the younger pupils not yet given permission to go out with their boyfriends had circumspect dates on certain evenings. No sudden scurrying of mice could have evoked more hearty squeals or such quick explosive male laughter than the magic-like appearance of these unmistakable objects, some neatly rolled, others generously stuffed. Had only one or perhaps even two of the condoms emerged inconspicuously into view as the soft cushions shifted with the seating of couples, it might have been possible for an alert girl, or perhaps THE MATERIAL 113 even for one of the self-conscious and preoccupied boys, to cover it and hide it away before general attention was aroused. Anna, it seems, had given some thought to this. Perhaps with time and retelling, some exaggeration has colored the event. It is said that an elastic band was set to snap one condom boldly forth and that others were placed so they would slip down from under the knitted antimacassars. At any rate, Anna made certain of a conspicuous display. Struck almost witless by the magic appearance of such an object in her lap (whence it had dropped from the top of the sofa), one girl released the initial squeal. Such uproar ensued automatically that hastening chaperones missed little of the scene. On numerous occasions Anna made difficulties for herself by driving off in cars that belonged to teachers or other school employees. Only once, or possibly twice, during her teens does it appear she had serious intentions of stealing the car for permanent possession. On the other hand, there were periods when she frequently stole underwear, stockings, and ornaments (usually inexpensive costume pieces or club pins) from other students and even from those in authority. While at the university, for a time she fell into the sporadic practice of relieving her dates of small amounts of cash she discovered in their pockets during heavy petting. Under such circumstances she also, but more rarely, took a pocketknife or a bunch of keys. At one finishing school where personal dignity among the faculty was emphasized, she is said to have lost her place as a student by neatly lettering on the door of the office of the sedate Latin instructress a concise advertisement: Hot p____ available here-cheap! After making good grades in a well-known college and having been in no serious trouble for several months, she began lying in bed too late to attend her early classes. Interviews with the college physician, and eventually with a psychiatrist, followed. After several warnings and probationary measures, and just in time to avoid expulsion, she began to attend all classes again. During an interval in which she had no further trouble with the faculty, Anna alienated and outraged several girls in the dormitory with whom she had been very friendly. After a few bottles of beer which the group had shared, she entered the rooms occupied by two of these friends and, in their absence, urinated on several evening dresses which they highly valued. (After the act she refolded the dresses neatly and put them back, sodden and malodorous, in the drawers.) It was a number of days before evidence emerged that unmistakably connected Anna with this deed. 114 THE MASK OF SANITY Observations which in themselves were highly suggestive but not final proof were for a while withheld by those who could not bring themselves to believe Anna capable of such behavior. She easily denied such a possibility to several who spoke with her separately in the hope of finding facts that would exonerate her. She also fabricated evidence to establish her innocence so calmly and so freely that it carried almost axiomatic conviction. On being confronted with plain proof from several sources, she was able to smile off the affair and dismiss it as a whimsical prank. Some felt it was their responsibility as a group to report this incident, but so much was brought out in Anna's behalf that all finally agreed to let the affair go no further. Merely tabulating these and many other details of Anna's behavior tends to suggest rather easily formulated motivations. With a more complete story these appear less likely. If a good many of the stealing incidents are isolated, some would no doubt be inclined to interpret them as ordinary compulsive reactions. On the other hand, personal contact with her does not give the impression of an underlying anxiety or of any strong drive against which she struggles or which she would like to reject. In addition to taking things for which she has little or no need (and which might symbolize some ordinary unconscious aim), she also steals in response to a real though mild desire to possess or for convenience.* With a more inclusive view of her activities the thefts become more difficult to account for satisfactorily by the specific and familiar theories of compulsion. They, like so many of her other symptoms, seem part of a different and far less circumscribed psychopathology. Concentrating on the long record of her outlandish sexual promiscuity (some of which will soon be given), the most naive observer would perhaps think of "nymphomania" or at least of very powerful erotic drives. Others might surmise that she is and has always been a frigid (or partially frigid) woman who finds stimulation but never orgasm and who is driven more or less consciously to all sorts of indiscretions in a never-ending quest. Neither of these hypotheses seems to account for Anna's behavior when one becomes familiar with more evidence pertaining to her inner experiences. Anyone's real inner experience is, of course, difficult to arrive at even by conjecture and perhaps impossible to establish by proof. In a person so accomplished in devising falsehoods on any subject and in making them so convincing, Anna's own statements can hardly be taken as necessarily true. There seems, indeed, but one way (and this one obviously not permissible) ________________________ * See p. 258 for further discussion of these points, particularly of the contrast between "compulsive" and "impulsive" symptoms. THE MATERIAL 115 to discover directly a lady's physical reactions to intercourse; and even then she can, it is said by some, often be misleading if she so wishes. Despite these difficulties, a rather convincing impression emerges that Anna's sexual problem is very different and far more complicated than anything that has been mentioned. It seems likely that she has frequently experienced the physiologic reactions of orgasm but that these reactions have been a minor factor in her behavior pattern. Sometimes, while having technically satisfactory relations with a husband, she would continue intercourse with other men who, it seems, failed entirely to arouse or to gratify her in the usual sense. As a matter of fact, while living with the husband who, more regularly than any other man she can recall, made her "respond," she initiated and continued relations with several other men. From some of these she neither particularly wanted nor ever received pleasure that could be called sensual or romantic. Although such conclusions are necessarily speculative (as they are, indeed, about any patient) and not scientifically verifiable, it seems most probable that this woman has somewhat less than ordinary conscious sexual motivation and that the most significant feature of her sexual experience is that, despite frequent mechanical responses, it has meant so little to her. The localized sensory reaction has not been greatly valued nor has it seemed to play a dominant role in directing her conduct. Anatomic intimacy with man has never been associated with interpersonal relationships of any consequence or duration. Important as this fact may be (granting that our estimate is in some measure correct), it still does not offer a circumscribed area in which a final explanation for Anna's career can be readily drawn. In every other aspect of social experience also this woman has similarly failed to develop any sort of relationship with another human being that seemed to have much meaning for her or, to put it another way, that could influence her to any consistent, obviously purposive behavior. It is true indeed that this casual or "cheap" use of physical sexuality often appears to be a confused sort of vengeful or self-destructive response to hurt and rejection or to misleading essential concepts of "male" and "female."164 The pattern followed sometimes suggests that such behavior may represent (with varying degrees of awareness in the subject) a "throwing of oneself away." It may at the same time seem to return a hurt and symbolize a protest too profound and too complicated for words.* Anna's sexual behavior and her generalized self-destructiveness (at social and personal levels) might be interpreted on such a basis. Let us remember, however, that such ____________ * See Chapter 36. 116 THE MASK OF SANITY an interpretation is speculative. Let us refrain from projecting items of psychiatric theory into Anna's unconscious and from assuming that they constitute evidence of emotional reactions in infancy that have shaped her subsequent course and by which we can confidently explain her career. Perhaps, some might say, serious and subtle traumatic events unknown to herself and others, even during the first year of her life or later, planted the seeds of a profound (unconscious) conflict which she has been forced to act out in this malignant pattern. No real evidence of this, however, has emerged in the study of her case. We may also consider the possibility that such a person as Anna might be born with a subtle and specific biologic defect. Perhaps, despite a high capacity for intelligence and charm, something necessary for wisdom or for sincere and major human feelings was left out or incomplete in her development. Capacities very different and much simpler are incomplete in the person born with color blindness or with a spastic deficiency in the motor system. Such biologic deficiencies are not necessarily hereditary. Let us assume that a defect in development may leave such a person as Anna without the capacity to attain deep loyalty or genuine love or to adequately recognize and react to the major goals and values of human life. The lack of major satisfactions and aspirations and the freedom from serious scruples or remorse might leave such a person free to act out any whim of folly or rebellion and offer some explanation for such a career as Anna's. At 40 years of age, during our first interview, Anna absentmindedly checked the preliminary information blank to indicate her status as divorced. She spontaneously changed the pencil mark to show that she was married. As a matter of fact, Anna's current marriage had lasted a good many years. It is true her husband was such in name only, but he served a practical purpose. The couple had not seen each other or otherwise communicated since shortly after the nuptials, but the legal existence of this union deterred Anna in one aspect of her behavior that had formerly given considerable trouble to her family and their attorneys. Before her last wedding and over a long period, she had fallen into the habit of marrying on an impulse apparently as trivial as what might lead another woman to buy a new hat. With one man after another she casually completed the legal ceremonies and entered into this monumental contract, the groom being now an adventurous taxi driver, now an opportunistic bar companion, or, again, a delinquent idler she encountered in her welfare work. The succession of divorces and the repeated financial settlements demanded by vagrants and petty rascals she had on several occasions espoused threatened the family resources. Gratifying (and in contrast with some other THE MATERIAL 117 cases of similar illness), Anna's marriage series was halted by the prospect of legal bigamy. The husbands of this series were not (or certainly not usually) men who took the bride very seriously. This cannot be said of her earlier husbands, two of whom were distinguished and wealthy men and, according to the evidence, genuinely and deeply in love with Anna. With one of these, an architect of international repute, she lived for a while in England. To him and almost simultaneously to his wayward brother Anna is said to have given gonorrhea which, as the first year of marriage drew to a close, she inadvertently picked up from a sycophantic interior decorator, a person, according to report, more active homosexually than otherwise. I entertain some skepticism about the details of this episode. Such an extravagant and perfectly timed series of events scarcely seems possible. Though usually ready to deny anything inconsistent with chaste and honorable behavior, this patient has in other moods seemed to relish adding fanciful touches to the already spectacular reality. Her promiscuity has, however, been so lavish that coincidences almost impossible in a hundred other lives combined hardly seem unlikely in hers. There is little doubt that she was sufficiently unfaithful for this or something equally bizarre to have befallen the husband. On being detected in activities that would produce fear, shame, or consternation in others, this patient often showed simple insouciance. Once at college she did so well for so long that hope returned to her family. Apparently she had found herself at last. After a succession of excellent reports, one showing failures in four subjects appeared. Anna was called on long-distance telephone by her father, who wanted to lose no time in trying to find some remedy for the trouble. Her easy, happy laughter relieved him deeply, even before she bad time to go on and explain the mistake that had been made in the dean's office. She had just heard of it but had not realized the rather comical error had been transmitted to any report that reached him and her mother. Actually she had not realized it was quite time for these reports to be mailed out. She had been, you see, pretty busy-but "mighty happy," too. Warmed within and deeply reassured, he left the telephone completely at ease. Within a few days, sure enough, there came official acknowledgment of the mistake. The grades of another girl had been confused with those of his daughter. The true report was even better than those excellent ones that had been coming regularly now for months. The dean's signed name and the official school paper and forms would have dispelled any suspicions of fraud had suspicions arisen. Anna's tone and manner when she spoke over the telephone were such, however, that no doubt at all seemed justified. 118 THE MASK OF SANITY Soon truly disturbing information came from the school. Not only was Anna failing dismally in all studies, but serious misconduct had brought the question of her expulsion to a crucial point. Wiring his daughter that he was taking the first train, the father also instructed her to make appointments for him with the college authorities. On arriving he found that no appointments had been made. He was entirely unexpected. He was surprised, furthermore, to find that Anna had left for the weekend, after convincing the house mother that she had parental permission to visit an imaginary aunt. Apparently she typed letters and forged signatures to bring off this deception with cleverness comparable to that employed in getting the school stationery and report forms and successfully utilizing these to send back the false reports to her family. On her return after the weekend she seemed surprised to find her father still there and at first expressed vexation with him. He never learned just what misadventures befell his daughter, who had apparently roamed about in a large city nearby. She took all the discussion of her recent acts with equanimity, apologized for her mistakes, and admitted that it was quite inexpedient to bring off such deceptions when it was apparent to her they would certainly and promptly be discovered. She said she did not know precisely why she had acted in such a plainly injudicious way, but she never seemed curious or really concerned about the possibility of discovering a reason for the behavior. What would have happened to this patient had it not been for the extraordinarily ample estate of her family and for their persistent care? One can only speculate. We need not here estimate how many times she was released from jails in widely scattered cities by their efforts, how many times she was hospitalized, how many beginnings with psychotherapy were made by various experts. It is interesting to note that Anna, unlike so many whose conduct closely resembles hers in other respects, seems never to have committed a major felony or tried to do serious physical injury to another. It is true that she was badly beaten up in some sort of night spot brawl in St. Louis. On this occasion several of her ribs were fractured, and a lung was punctured; her brother, who flew to her aid from Baltimore, thought at first her injuries would prove fatal. Though occasionally, when drinking, she has taken an active part in slapping or hair-pulling incidents, she has shown little inclination to attack. In similar episodes she rarely initiated gross vocal disputes or was vulgarly aggressive with words. Calmness seemed more characteristic of her than high temper, although it is recorded that in her teens she was expelled from one academy for publicly telling off a school authority in a speech vehemently and versatilely obscene and closing with references anything but flattering to the state of his "third leg." THE MATERIAL 119 Many of these incidents which in isolation appear spectacular occurred while Anna passed in the community as a reliable, conforming, and extraordinarily attractive woman. Much of the time she seemed poised, polite, and a paragon of happy behavior. For a while during her early twenties she taught a Sunday school class. Her teachings were ethically admirable and she gave a strong impression of sincerity. She often worked for a month or more at a time, efficiently and with what seemed pleasure, at the Red Cross and in other welfare activities. Most who knew her casually in these endeavors would have been genuinely astonished to learn that she had any serious personality problem. Once while hospitalized for a week or ten days, she left the almost universal impression of being a delightful patient. Courteous, composed, undemanding, and cheerful, she took discomforts and minor pains in a way that elicited admiration. During this brief period, in which a benign nodule was surgically removed from her breast, she casually accepted cunnilingual attentions from a female attendant (apparently a true lesbian) and also sought to entice an intern. In these enticements she went so far as to get the fly of his trousers open before accepting his determination to refrain. Occasionally during her early thirties, but also a few times since, Anna had engaged in a pastime known in some circles as gangbanging. There were minor variations of procedure. Usually drinks with five or six men, whom she might pick up in one of the less inviting honky-tonks or frolic spots about town, constituted the first phase. Later the group rode out into the country and all her companions had sexual relations with her, each taking his turn. On such an exploit, argument once arose about whether or not she had stolen a cigarette lighter belonging to an escort, and the group, uniting against her, threw Anna in a creek and then drove off, leaving her to walk home. This patient spent a good deal of time reading. In contrast to many psychopaths who readily claim all sorts of entirely imaginary learning, she showed considerable familiarity with literature of many sorts. She seemed to read Shakespearean plays, the major Russian novels, pulp magazines, and comic books with about the same degree of interest. Her factual knowledge about what she had read seemed good, though it must be admitted she often falsified with assurance when questions led her into unknown areas. She played complicated music on the piano with fine technical skill and spent a good deal of time doing so. She had an accurate acquaintance with current scales of intellectual and esthetic fashion and could probably have avoided offense even to the most snide of editors of the most avant-garde of little magazines. How she reacted to such matters in the innermost and final chamber of her being can only be surmised. My impression is that King Lear 120 THE MASK OF SANITY and Amazing Confessions elicited responses in no fundamental way different. There is little I can offer in explanation for the biologic enigma I trust is apparent. Despite abundant time to approach the patient directly, unusually rich detail furnished by others, and even the rare chance of treating psychiatrically more than one other upon whose life her own had impinged traumatically (and, so it would almost seem, of seeing her through more than one set of eyes), despite all this, I cannot reveal the forces that patterned her. I have opinions, but opinions are not facts. Without claiming there is anything demonstrable or profoundly explanatory in such an appraisal, I would give these impressions. It is unlikely that she experienced (in what can reasonably be called ordinary awareness) much of the emotion that we associate with the various deeds she has carried out. In both quantity and quality her emotions, I believe, have regularly fallen short of the affect we almost automatically assume must prompt, accompany, or follow such actions as hers. Though appearances of emotion were sometimes impressive in Anna, it seems probable that these were chiefly facsimiles of actual feeling, an automatic and undesigned mimicry. Though she had vexations and minor satisfactions and though she could at times get mad and could be a little fond of people, Anna never really seems to have meant much harm to others or to herself. One of the physicians who had often treated her expressed his bewilderment about how real seemed her disregard of what was obvious, how strangely she escaped the subjective consequences of her experiences. Taking a phrase from the Russian novel about prostitution, Yama, to embody his reaction, he said, "All the horror is in just this-that there is no horror."176 A thoughtful and now elderly member of her family whose advice her parents and one of her early husbands had often sought was particularly impressed with what he described as an unbelievable but somehow authentic innocence that Anna never seemed to lose. Experiences which would harden an ordinary person conspicuously or ensure a conscious cynicism, mordant and profound, seem to fall lightly on her spirit, to leave her surprisingly serene. The person just mentioned, after more than two decades of concern with her problems, finds even more surprising than all the unfortunate acts combined, Anna's thoughtless assumption that she is to be trusted in all matters, that her behavior has been essentially honorable and ladylike, and the fact that her selfrespect is apparently bright and unblemished. Seeking to give his impression of this strange equanimity, of these paradoxical attributes of innocence, he once quoted: THE MATERIAL 121 She hath wasted with fire thine high places, She hath hidden and marred and made sad The fair limbs of the Loves, the fair faces Of gods that were goodly and glad. She slays, and her hands are not bloody; She moves as a moon in the wane, White-robed, and thy raiment is ruddy, Our Lady of Pain. A. C. 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