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Psychopath

THE MASK OF SANITY

Section 2: The Material

Part 1: The disorder in full clinical manifestations

16. Joe

 

 

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16. Joe

This patient came in the custody of two friends, both state officers in the

American Legion, to apply for admission to the hospital. He had with him commitment

papers showing that he had at his own request been declared incompetent.

Joe was alert and intelligent and conducted himself in a manner that suggested a

person of poise, good judgment, and firm resolution. He was anything but the sort of

figure that might come to mind in thinking of a patient sent for admission to such an

institution.

THE MATERIAL 147

He frankly admitted that he was not "insane" in the ordinary sense of the word

and therefore was-not eligible according to the letter of the law for admission into a

hospital of this sort. He urged, however, that he be accepted, stating that for the last

sixteen or seventeen years he had been drinking to great and foolish excess in periodic

sprees. He seemed to be remarkably frank and straightforward, admitting that he had

made an unholy mess of his life and caused misery untold for his wife, his parents, and

his friends. At times he became much depressed, he said, when ruminating over the

magnitude of his failure. He appeared earnest in his strongly expressed determination

to pull himself together and make a fresh start.

A rather unusual and impressive sincerity seemed to distinguish this man from

some with similar histories of psychopathic drinking and psychopathic failure. He did

not promise to become a new man. He admitted that he knew it would be most

difficult for him to change his ways and seemed to realize that his many collapses in the

past after similar good intentions told against his present chances.

Records which accompanied him gave the information that three years previously

Joe had attempted suicide by severing veins in both arms. Definite scars were visible

four or five inches above the wrists. Since he had not played up this phase of his case,

his statement that he had really tried to kill himself was particularly convincing. Though

such patients, officially not psychotic and considered responsible for their own troubles

and misdeeds, are not technically eligible, it was decided to take this man.

His history of a suicide attempt furnished plausible grounds for calling him an

emergency, and his apparently desperate intention of escaping from the pattern of his

past folly promised that treatment in a mental hospital might give him a chance to gain

insight and forge new resolution which he would need in starting over again.

During the month of psychiatric study and constant observation that preceded

diagnosis before the staff, this man proved to be a model patient. He was cheerful,

convivial, alert, and energetic. He asked for work and at once made himself useful,

checking out laundry, typing various lists, helping psychotic patients, and performing

many other duties. Quick, accurate, and reliable, he seemed to take a real pleasure in all

work that he could get and actually accomplished much more than an average man

could.

He was at all times in perfect contact, reasonable, optimistic, and plainly

intelligent. During examinations he told his story with a remarkable appearance of

frankness and insight.

"I suppose, doctor, I am still a child emotionally," he admitted in explanation of

the fifteen years during which he threw away many valuable positions, lost his wife, and

went repeatedly to sanatoriums which offer

148 THE MASK OF SANITY

whiskey cures and to mental hospitals. He seemed to realize that his conduct was

extremely irrational and without reward, agreeing that he had been quite unhappy nearly

all the time and a source of grief and despair to others.

Drinking, Joe said, was not in his opinion the cause of his trouble but merely a

symptom of some obscure flaw in his makeup. This defect he found it hard to define or

describe, although he spoke very intelligently and almost, it might be said, profoundly.

He distinguished between his own case and the various psychoses, maintaining that he

was entirely sane but admitting that, though sane, he had behaved more foolishly that a

bona fide "lunatic," and for no purpose.

He mentioned the writings of Freud, Jung, Bleuler, and William A. White and

showed unusual familiarity for a layman with psychiatric terminology as well as a

surprisingly good acquaintance with the literature.

"I suppose I must be a constitutional psychopath," he concluded after describing

his many opportunities, his many confident resolutions to adjust, and his inevitable,

quick failures.

As in so many cases of this sort, drink, being a tangible and superficial activity, is

often stressed by the family and the patient as if it were the major source of difficulty.

Being at a loss to account for antisocial and self-damaging acts in terms of real purpose,

it is customary for them to decide that these must have been carried out because some

drinks had been taken. I do not share such a belief. This patient, like a good many

others, was more inclined to discuss drinking than his more essential difficulties, so this

at first was the chief topic.

"But why do you drink?" he was asked. "Why do you let yourself take the first

drink, when you realize by now to what it will lead?" It was hard to say, he admitted. He

felt he had not for many years obtained pleasure from the effects of whiskey. Even if

there had been some extraordinary pleasure in drinking, he felt sure this would not have

been worth even a small part of the price he had paid.

Perhaps habit was a factor, Joe suggested; perhaps he was emotionally

conditioned to repeat this disastrous step, no matter how plainly reason warned him

against it. He spoke of possible forces within his mind that might seek failure,

unconscious tendencies to defeat himself. Desire to escape from the difficulties and

failures of life, he felt, might influence him to seek intoxication. On the other hand, he

believed the failure and difficulties would not occur if he did not drink. He was

confident that drunkenness led to the many disastrous actions he had taken.

Joe emphasized his belief in a vicious cycle of sequences, the drink causing him to

get in grave difficulty, to lose what he most wanted, and

THE MATERIAL 149

then his subsequent disappointments causing him to seek refuge in drink. Though

some causal influence may lie in this, it is apparently secondary and superficial. When in

extremely advantageous positions, in situations he described as ideal, without

provocation or known purpose, he often acted in such a way as to lose all that he said

he found desirable and to make failure inevitable and spectacular.

On being asked if he really found life worth while, if a normal life offered

anything to him, he quickly answered that it did. He appeared frank in affirming that

there was in him a strong and persistent will to succeed, an urge to get at the

satisfactions of existence which most people choose in preference to the sort of career

he had known with its almost fantastic and presumably frustrating reverses and

maladjustments.

As Joe discussed the possibility that impulses unrecognized by him might play a

part in his way of life, he seemed like one with an almost Socratic respect for the depth

and extent of the unknowable. It was entirely possible, he maintained, that he might be

deceiving himself. Perhaps, he admitted, there were tendencies within, whose presence

he did not suspect. As he continued, he spontaneously questioned his essential sincerity

but in such a way as to make him seem even more sincere than heretofore.

This man's apparent insight, freedom from evasiveness, and willingness to admit

himself responsible for his misfortunes are, it might be said, inconsistent with his

history, which is typically that of a psychopath. In my opinion, however, none of these

qualities which appeared to be so highly developed in him are real. It is perhaps more

accurate to say that, whatever reality there may be in these qualities, it is not integrated

into the person's functioning. It does not emerge objectively in the actuality of

behavior.

In time, his insight comes to seem but a mimicry of insight. He uses the words

which one who understood would use, but they do not have a corresponding meaning.

He speaks with every evidence of conviction and sincerity, but when one studies him

over a period of time, it becomes apparent finally that he is merely going through the

motions, that he is not actually living the feelings he describes so well. His evasiveness,

of almost Dostoevskian complexity, consists in an openness which is actually no

openness at all. He freely gives up discrediting information about his weakness and his

failures and appears to take them with ardent seriousness, to understand them, to regret

them to the bottom of his heart, and to intend to learn and profit by them. But all the

while he is, for the most part, merely using the words, the gestures, and the expressions

without entering into the feeling and the understanding. We find ourselves dealing not

so much with a genius at acting but with a person who, in the most important matters,

has no capacity of distinguishing between what is acting and what is not.

150 THE MASK OF SANITY

Joe is not really facing facts now but only acting in charade in which he faces

imitation facts. He says he is responsible for his failures and seems to accept this

responsibility honestly and to have normal regret for the pain he has caused others, but

in studying him it becomes apparent that the regret is something quite different from

what we have presumed he was talking about and that he is able to act as if it were

profound only because he is utterly unaware of what real and serious regret is - because

he does not experience real and serious emotions.

It is difficult to describe this impression without implying that the patient's

reactions are being identified with deliberate fraud or with hypocrisy in its ordinary

meaning. There is, however, a fundamental difference. Psychopaths notoriously

deceive and falsify, with strict awareness of the intention and about any sort of situation.

Voluntary and quite conscious decisions to lie occur and are carried out in

discussing the points on which we attempt to estimate insight and the genuineness of

emotions, desire, grief, remorse, love. In addition to such factors, however, we

encounter misleading reports of another sort.

In all probability, Joe was often accurately describing his reactions insofar as he

could. Something left out of his experience made it impossible for him to see that the

words he used did not refer to such emotional actualities as they would in another. One

might say this constitutes a kind of strange and paradoxical sincerity, something a little

like the report of a color-blind man (without knowledge of his defect) who after

investigation swears conscientiously that the horizon is gray, though it actually blazes

with all the colors of the sunset.

Such a somparison is, however, full of implications that may mislead us. It can

also be said that this particular patient, when it suits his purposes, does not hesitate to falsify

with full deliberation.

In time a typical glibness about the major social disasters of his life reveals itself,

and one sees that this man has a sort of pride in the spectacular capers he has cut. He

admits that he is to blame for his wife's having had to divorce him because of

nonsupport, periods of desertion, and gross, repetitive, and almost publicly transacted

acts of infidelity. Even now, while full of expressed intentions to change his ways, he

shows no genuine concern for the fate of this former wife and little or none for his

children. He admits his childishness, his failures in ever undertaking, and his flagrant

lack of consideration for others. He admits some dozen or two arrests in the last year

and a half, for causing disorder in public and for unacceptable conduct while drinking.

But he is very solemn in assuming that he is a man of honor in the most unqualified sense,

despite what he confesses as his faults. He states that he will not break his word and

that he had never

THE MATERIAL 151

committed an act against anyone else for which he should have been arrested. He

admits that the alleged suicide attempt was a pure fraud and that he had made a false

statement about it in order to get into the hospital. He had cut his arms only to frighten

his wife and parents and to create a dramatic scene in order to gain his ends with them.

He describes his exploit in detail, admitting its extreme childishness. He remembers

that he took care to pull over a chair and to fall with a great thud and clatter so that he

would attract sudden attention and become at once the center of an exciting scene.

This, for the sort of man he is known to be, is admitting a great deal. But he at

once insists that he has always been a man of his word, ignoring the many incidents in

his history to the contrary. He leaves out many well-established facts which would not

fit in with the picture he now means to give of himself, as a man who has done many

foolish and unpardonable things but who is still a "gentleman" fundamentally. He

always insists that the many women with whom he has had relations were those who

would obviously excite romantic feelings, though this is by no means true. He says

repeatedly that sexual relations are no pleasure to him unless he gives the woman

pleasure too, but one can see that this is an opinion he has picked up from reading and

that it has nothing to do with the reality of his life. Actually his experiences with

women have been casual, incomplete, and of so little real significance to him that he has

been known to drink himself into a state of impotence rather than continue even the

primary physical exercises of the relationship. Later he says that no woman among the

many with whom he has had intercourse ever afforded anything of serious significance

to him; but he feels that this is rather to his credit as a romantic lover. "I am in love

with love!" he concludes tritely.

Joe speaks of his misadventures with what would pass for admirable humor, and

this would have been real humor had there been a contrasting seriousness in his

understanding to give it meaning. But his light touch in dealing with his own faults and

his own follies loses significance when it becomes apparent that for him there is no

tragic reality against which it is maintained.

Now 38 years of age, he is athletic, well groomed, and rather handsome. The

story of his life as he gives it is in most of the outer facts identical with the story as

given in social service reports and by his friends.

Joe's father was a prominent man in one of the largest cities in Alabama. High

ambitions were entertained for this son, and he was given every educational

opportunity. He feels that his mother had puritanical ideals of life and wished him to

live according to them. He admits that he made no attempt to suppress his natural

inclinations and says that he enjoyed sexual

152 THE MASK OF SANITY

intercourse frequently since he was about 13 years of age. He was unusually bright in

school and made rapid progress despite interruptions caused by pneumonia and typhoid

fever. He was sent to a celebrated preparatory school in the East where he did well in

his studies and achieved athletic prominence in football and tennis.

He then entered the state university but after two years transferred to Virginia

Military Institute. Before graduating, he enlisted in the army. The war ended seven

months later and he was discharged with the rank of corporal. He then entered law

school at the state university and three years later graduated with high distinction, being

named valedictorian for his class.

Joe had already begun to show irresponsibility, often walking out of class

capriciously and ignoring serious duties as well as matters on which his own welfare

depended. He had also on isolated occasions begun to show the tendency to behave

outlandishly when he drank. He was very capable and successful in the practice of law

when he gave his attention to it, but he soon lost interest and neglected his work. His

father was, however, able to cover most of his deficiencies and keep him in an

appearance of success.

He often entertained big ideas but did little to put them into practice. He

constantly made excuses and was full of high-sounding promises, few of which he made

any attempt to fulfill.

The patient himself accounts for his loss of interest in law as resulting from an

idealistic outlook. He states that he entered his profession with the assumption that

actual justice was the criterion of legal decisions; finding this to be far from true, he had

little patience left for the law.

He was at this time settling down to serious drinking, as he expresses it. As a

matter of fact, his essential untrustworthiness and his tendency to squander his

resources and throw his responsibilities upon others stand out in his behavior while not

drinking at all, although in his own account of his career he tends to cloak his more

important aspects of maladjustment under the explanation of alcoholic influence.

Joe became interested in running for city council, threw himself with great energy

into the race, and after a shrewd and active campaign was elected. According to the

social service reports, most of his drinking was done alone, even at this time when he

was in his early twenties. On occasions when he drank in company, he often

misbehaved in most extraordinary and distressing ways.

Once when a guest at a formal dance held in a small town fifty miles away from

his home, he threw a large crowd of respectable people into extreme consternation.

After taking some drinks, he walked out on the dance floor, cut in on an attractive

young lady who belonged to one of the best

THE MATERIAL 153

families in town, and joined with the crowd as it gave itself up to pleasant and seemly

strains of a waltz.

Stopping brazenly in a semisecluded corner of the dancing area, Joe drew sudden

attention from the chaperones, from the astonished eyes of a hundred waltzing couples,

and from the musicians. These at first found it difficult to credit their perceptions or to

act as they watched him jerk his partner's dress up over her head, set himself to work

divesting her of her undergarments, and, despite her struggles and screams, commence

on the first steps toward an attempt at sexual intercourse in these inauspicious

surroundings. A tumult ensued. He was snatched from his victim and removed from

the ballroom at once. Only the energetic intervention of his friends saved him from

violence.

A year later he married. The wedding was delayed because Joe, about a month

before the announced date, ran off with another girl, the respectable daughter of a

professor in the university. He hid out with this partner in a cheap hotel to avoid

pursuit by her parents but eventually, after many highly embarrassing and unseemly

episodes, went off into maudlin or uproarious drunkenness and finally stupor, leaving

his partner in illicit love to her own devices.

Joe's marriage was from the first a failure. He neglected his wife, lay out for days

in drinking sprees, wandered off and spent the night in low dives, and availed himself of

every opportunity to have casual intercourse with other women.

He made little pretense now of working, neglecting even his position on the city

council which had cost him some shrewd planning and considerable effort to obtain.

According to the opinion of those who know him, he was not interested in the position

itself, that is to say, in anything he might accomplish thereby, but only in the petty fame

it might bring him. He enjoyed stepping into various roles in which he played the big

shot.

Joe's father, who is a very influential man, some time later got him appointed

judge of a local court. This position paid an excellent salary and required only about an

hour of work daily. This, however, was too much. He would not attend even to the

barest minimum of his duties, refused to go to his office, wandered on

pseudoadventures in distant cities without making any provision for his responsibilities

to be met, often without letting his family know he was going or informing them of his

whereabouts. Despite the zeal of friends and relatives to make good his deficiencies, he

lost this very valuable position.

His father bought him a house, leaving it encumbered with a small mortgage in

order to stimulate the patient to use his funds constructively and free himself from his

obligation. Although receiving an ample income

154 THE MASK OF SANITY

to make these payments, he made no effort to do so but instead, as his father later

discovered, took out another large mortgage and squandered this money as well as his

income.

There seemed little incentive or definite purpose in the actions through which he

destroyed his opportunities and squandered his and his parents' resources. One can

discern no strong recognizable temptation, no formulated course of living, good or evil,

for which be abandoned what others found so desirable.

Although his father supplied his wife and children with money (he has two

daughters) and continued to give him opportunities to make an easy living at law, he

worked little or not at all and spent his time getting in and out of police barracks, going

time after time to hospitals where he remained for a few weeks or a month, only to

return and take up at once his former practices.

After several years of such living he was sent to a federal psychiatric hospital in

Mississippi for study and treatment. Nothing to suggest a psychosis or a

psychoneurosis could be found. He showed himself to be highly Intelligent and

energetic but inclined to be domineering, especially toward his father, whom he would

not allow to come on the ward and visit him. After five weeks he left against medical

advice. He was classed as a case of psychopathic personality.

Three months later Joe set off in his car, sober and apparently enthusiastic about

the prospect of his vacation, to join his wife and children who were spending a few

weeks at a summer resort in the Tennessee mountains. On the way he picked up

another woman, then after they had a few drinks together apparently lost interest in her.

Stopping in a small town in northern Alabama, he left his companion in the car, making

some excuse, and went to a railroad station, throwing away the keys to his car on the

way in a gesture of careless bravado. At the station he stood before a timetable, closed

his eyes, and put down his finger at random. Noting that he had by chance fallen on

Tulsa, he bought a ticket and, bringing along a good supply of whiskey, left without

more ado for that city.

Nothing was heard from him for several weeks. Leading the life of a bum or city

tramp who lives by his wits, he was active at panhandling, petty fraud, and other

schemes and tricks to pick up small sums. He fell more than once into the hands of the

police. Always disarming and impressive, he cleverly talked himself out of the usual

consequences.

At length an acquaintance of Joe's family ran across him in Texas and notified his

father, who sent him funds at once by telegraph so that he could come home. Instead,

he bought more whiskey and continued his rambles, drinking sometimes with chance

acquaintances he found in saloons,

THE MATERIAL 155

occasionally drinking alone, and staggering about uninviting sections of town or out into

the countryside.

After going to Minneapolis, he wandered on an odd impulse into the tent where a

celebrated evangelist was exhorting sinners. One of the evangelist's assistants happened

on him and urged him to accept salvation and join the troupe. Although an unbeliever,

he was attracted by the idea and, with a great show of enthusiasm, announced his

intentions of devoting his life to the work.

Professing a lusty rebirth, he attached himself to the evangelist and went on to

Chicago, where he was active and successful in bringing in the penitent and getting them

out on the sawdust trail. He also showed himself extremely able and for a while

industrious in running a mission where vagrants were fed. He told utterly false but

dramatic and convincing stories of his life to the religious workers and seemed like one

remarkably suited to his new calling.

Joe continued at these activities for several weeks, not drinking and enjoying

himself fairly well. He maintains that he never entertained any serious belief in the

doctrine of the evangelist or experienced any sensations of penitence or sanctity. "I just

sold myself somehow on the idea of doing it," he says with a broad smile.

Meeting a red-haired girl, his thoughts inclined in another direction. Leaving the

evangelist's party, he put up with her at a hotel where he briefly enjoyed her charms,

then abandoned her as casually as he had begun the relationship.

For a while now he turned to alcohol, taking no interest in anything and

summoning only enough energy to get the bottle and drink himself back to snoring

oblivion. Shortly afterward he returned home, made a few brief gestures at working, but

chiefly idled and drifted.

He continued in this fashion for a year, keeping his wife in misery and perplexity

and his father active by day and night in efforts to get him out of jail, to bring him in

from low resorts, or to whip up some interest in him to make a new start. Occasionally

he spoke seriously of having obtained a new outlook and worked for a few weeks or a

month, always showing excellent ability and succeeding with ease in all he attempted.

No matter how bright were his prospects, he soon threw them up and went on another

round of idle wanderings, self-defeating and apparently boring antisocial routines, or on

mirthless and unhappy drinking bouts.

Finally Joe's wife divorced him and went to live with his father, who assumed full

obligation for her support and that of the children, treating her with the greatest

kindness and consideration.

Some time later the patient's father sent him to New York for another

156 THE MASK OF SANITY

of his fresh starts. He had for years professed an interest in writing and during his sober

interludes, had turned his hand occasionally to journalism. In New York he worked for

several weeks and evidently was headed for some success, having already had a few

articles accepted, one by a magazine of wide circulation.

Idle drifting among dull and delinquent groups, vagrancy, and sporadic

drunkenness now intervened. He soon ceased all efforts to write and led very much the

sort of life typical of men who have no opportunities left and (lacking an alternative)

exist about large cities, lost to interest and incentive, in states often referred to as being

in the gutter. Sometimes brawls in barrooms and quarrels about cheating in games of

chance brought him into contact with the police. For several months he wandered in

the slums of the city, often being brought in by the police or taken to Bellevue and

other hospitals for brief periods of treatment.

On returning home, Joe's career began all over again at the point on which he

had left off and continued until his present admission to this hospital. Though always

cooperative, he was anxious to go before the staff for diagnosis as soon as possible,

since he would only then become eligible for parole. Tactful and not obviously

demanding, he did not at first press his requests but, after several delays had occurred,

sent the following lines to the physician in charge of his case:

Request is respectfully made

By R_ number 6-7-3-0

That his humble case may be laid

Before a busy medico.

Patient seldom hears the voices,*

Never waxes vitriolic;

Quite discerning in his choices

For a chronic alcoholic.

Quiet and cooperative,

He is no wise sadistic;

Records have it that his native

Instincts are all altruistic

A suicidal tendency

Is foreign to his credo,

Due to the marked ascendancy

Of exhibitionistic ego.

Voluntarily committed,

The patient can stand the gaff

* This reference to hearing voices is, of course,

made in jest. He has never experienced

hallucinations.

If only he were permitted

Presentation to the Staff.

Patient does not wish a discharge

From this psychopathic knoll;

He has no urge to roam at large,

But he would like to have parole.

And so, if it is convenient,

Your call is respectfully urged;

Hoping that you will be lenient

When my rye psychosis is purged.

---

THE MATERIAL 157

There is little need to give in detail the record of his failures to adjust to these

new responsibilities. His behavior' was virtually the same as that already described in

such patients while on parole status in psychiatric institutions in a similar situation. It

was clear to him that freedom would be curtailed if irresponsible or antisocial actions

occurred.

No matter how often he was brought in by police or hospital attendants or

confined at the barracks for unacceptable behavior, always, in requesting restoration of

parole, he seemed to have complete confidence in himself and to feel sure that others

would feel likewise. His superficial charm, plausible explanations, and apparent sincerity

enlisted the support of all who met him.

During his various periods on parole he met many women, some of whom he

convinced he was being treated with incredible injustice at the hospital. Several

intelligent and attractive women, persuaded that he was not understood, began to visit

the hospital and intercede with authorities there whenever restriction of his privileges

became necessary.

Even female employees of the hospital were not immune to his charm and found

it difficult to believe he was anything but a wonderful and trustworthy fellow whose

only difficulties arose from poor judgment or unfair attitudes on the part of his family

or the physicians. Some of the nurses whose past experience with similar problems and

direct observation of this subject would, one might think, make it impossible for them

not to recognize his serious disorder seemed for a while inclined to believe that such an

impressive man as this simply could not continue in failures so futile.*

At the weekly dances held for patients he intrigued and delighted large numbers

of feminine visitors. Some of these devoted themselves to his cause, quickly convinced

that sufficient sympathy and full demonstration of faith in his inherent manliness would

resolve his difficulties.

At Joe's suggestion some of these admirers wrote to officials of veterans

organizations and even to congressmen in Washington, insisting on special intervention

in the case. On many occasions the patient violated the terms of his parole, returning

several hours late from passes after being with some of these kind and zealous ladies

who had become increasingly determined to mother him or perhaps to save him by

more frankly exciting methods.

Despite all these efforts in his behalf, his behavior became worse, and

_________________________________________

* One of the most attractive and intelligent nurses in the hospital had, several years previously, married a patient whose

disorder was diagnosed as psyhchopathic personality and who was much more obviously a poor marital risk than our

present subject. The story of her experiences with him could not be adequately given without devoting our entire

volume to it.

158 THE MASK OF SANITY

consequently his periods of parole briefer and less frequent. He soon demanded his

discharge. His family emphasized the great and needless difficulties that would result

and urged, in the name of common sense, that he not be released. Since the

commitment furnished legal authorization, the medical staff kept him despite his

protests.

At the suggestion of the chief of staff, who had consistently reacted to his failures

with extraordinary patience, steps were taken that would lead to his soon regaining

parole privileges. Just before these steps were completed, communications arrived from

Washington citing bitter complaints about the hospital, quoting vicious and startling

accusations against this patient's particular advocate, the chief of staff, who, in the

opinion of many, had often gone too far in trying to meet his demands.

The patient had written to government officials, employing his cleverness,

learning, and ingenuity in such a way as to make some people in high authority suspect

that the most fantastic and implausible injustice had been done him. He had,

furthermore, so used his father's standing in his home community and so manipulated

the great respect in which his father was held that he evoked an extraordinary reaction.

Some in Washington were so stirred and misled by his tactics that they apparently acted

under the impression that the father's testimony supported that of the son.

When questioned about this surprising attack directed chiefly against the most

lenient of all his physicians, Joe was supercilious and a little arrogant, insisted on

skipping these subterfuges and getting down to brass tacks about the restoration of his

parole. There seemed to be no sense of shame or dismay in this role or at having

nothing at all to back up the serious charges he had made.

After being granted parole again, he so conducted himself that the police put him

behind bars and notified the hospital of this fact. Shortly afterward he attempted to

escape. The attempt was made soon after he had given his word, with all describable

aspects of sincerity and with a clear demonstration that he fully understood his

commitments and agreed to abide by them.

He became more and more difficult to deal with by the rules and procedures of a

hospital set up for the ordinary type of psychotic patient. After a trying period for

himself and his physicians, he called in an attorney. By legal procedures that followed

the approved technicalities, he obtained his wishes.

Less than a week after Joe's departure from the hospital he returned in such a

state that anyone could tell he needed shelter and assistance. At the outer gate of the

hospital grounds he demanded that he be admitted. The physician on duty interviewed

him and explained that legal steps had been taken which made it impossible for the

hospital to readmit him. He begged

THE MATERIAL 159

and argued and brought forth the most cogent and practical and pertinent of reasons

why he should be under supervision and treatment. The physician who talked with him

agreed with all he said. But despite this agreement and common understanding, there

was no means by which he could be taken back.

 

Next: Section 2: The Material , Part 1: The disorder in full clinical manifestations, 17. Milt

 

Energy Enhancement          Enlightened Texts         Psychopath           The Mask Of Sanity

 

 

Section 2, Part 1

 

  • Psychopath Hervey Cleckley THE MASK OF SANITY, Section 2: The Material , Part 1: The disorder in full clinical manifestations, 5. Max
    Psychopath Hervey Cleckley THE MASK OF SANITY, Section 2: The Material , Part 1: The disorder in full clinical manifestations, 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 at energyenhancement.org

  • Psychopath Hervey Cleckley THE MASK OF SANITY, Section 2: The Material , Part 1: The disorder in full clinical manifestations, 6. Roberta
    Psychopath Hervey Cleckley THE MASK OF SANITY, Section 2: The Material , Part 1: The disorder in full clinical manifestations, 6. Roberta, This young woman, sitting now for the first time in my office, gave an impression that vaguely suggested-immaturity? The word is not entirely accurate for the impression. Immaturity might imply the guarded, withdrawn attitude often shown by children in the doctor's office. It was another, in fact, almost an opposite feeling that she gave. Something less than the average of self-consciousness, a sort of easy security that does not arise from effort or from pretense-some qualities of this nature seemed to enter into the impression at energyenhancement.org

  • Psychopath Hervey Cleckley THE MASK OF SANITY, Section 2: The Material , Part 1: The disorder in full clinical manifestations, 7. Arnold
    Psychopath Hervey Cleckley THE MASK OF SANITY, Section 2: The Material , Part 1: The disorder in full clinical manifestations, 7. Arnold, This patient had recently left the hospital (A.W.O.L.) while out on pass. The following letters arrived from him after a few days: Baltimore, April 4th, 19-- Saturday, 2 P.M at energyenhancement.org

  • Psychopath Hervey Cleckley THE MASK OF SANITY, Section 2: The Material , Part 1: The disorder in full clinical manifestations, 8. Tom
    Psychopath Hervey Cleckley THE MASK OF SANITY, Section 2: The Material , Part 1: The disorder in full clinical manifestations, 8. Tom, This young man, 21 years of age, does not look at all like a criminal type or a shifty delinquent. In fact, he stands out in remarkable contrast to the kind of patient suggested by such a term as constitutional inferiority. He does not fit satisfactorily into the sort of picture that emerges from early descriptions of people generally inadequate and often showing physical 'stigmata of degeneracy' or ordinary defectiveness at energyenhancement.org

  • Psychopath Hervey Cleckley THE MASK OF SANITY, Section 2: The Material , Part 1: The disorder in full clinical manifestations, 9. George
    Psychopath Hervey Cleckley THE MASK OF SANITY, Section 2: The Material , Part 1: The disorder in full clinical manifestations, 9. George, This man was 33 years of age at the time I first saw him and admitted him to a psychiatric hospital. He stated that his trouble was 'nervousness' but could give no definite idea of what he meant by this word. He was remarkably sell-composed, showed no indication of restlessness or anxiety, and could not mention anything that he worried about. He went on to state that his alleged nervousness was caused by 'shell shock' during the war. He then proceeded to elaborate on this in an outlandish story describing himself as being cast twenty feet into the air by a shell, landing in his descent at energyenhancement.org

  • Psychopath Hervey Cleckley THE MASK OF SANITY, Section 2: The Material , Part 1: The disorder in full clinical manifestations, 10. Pierre
    Psychopath Hervey Cleckley THE MASK OF SANITY, Section 2: The Material , Part 1: The disorder in full clinical manifestations, 10. Pierre, Some of the patients who have been presented give concrete and abundant evidence in their behavior of a serious maladjustment and one of long duration at energyenhancement.org

  • Psychopath Hervey Cleckley THE MASK OF SANITY, Section 2: The Material , Part 1: The disorder in full clinical manifestations, 11. Frank
    Psychopath Hervey Cleckley THE MASK OF SANITY, Section 2: The Material , Part 1: The disorder in full clinical manifestations, 11. Frank, The following letter was received by an influential senator in Washington and referred by him to the hospital at energyenhancement.org

  • Psychopath Hervey Cleckley THE MASK OF SANITY, Section 2: The Material , Part 1: The disorder in full clinical manifestations, 12. Anna
    Psychopath Hervey Cleckley THE MASK OF SANITY, Section 2: The Material , Part 1: The disorder in full clinical manifestations, 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 at energyenhancement.org

  • Psychopath Hervey Cleckley THE MASK OF SANITY, Section 2: The Material , Part 1: The disorder in full clinical manifestations, 13. Jack
    Psychopath Hervey Cleckley THE MASK OF SANITY, Section 2: The Material , Part 1: The disorder in full clinical manifestations, 13. Jack, My prolonged acquaintance with our next subject began on the occasion of his return for a fourth period of hospitalization. He was accompanied by the sheriff who had brought him from jail in Winston-Salem, N.C. He was affable and courteous, entirely rational in his conversation. Though rather carelessly dressed, he made an imposing figure of a man; he was 6 feet, 3 inches tall, weighed 210 pounds, had red hair, blue eyes, a quick, humorous glance, and a disarming smile. Though 45 years of age, he appeared to be in the early thirties. His body retained good athletic lines, and he sat or stood with an easy poise at energyenhancement.org

  • Psychopath Hervey Cleckley THE MASK OF SANITY, Section 2: The Material , Part 1: The disorder in full clinical manifestations, 14. Chester
    Psychopath Hervey Cleckley THE MASK OF SANITY, Section 2: The Material , Part 1: The disorder in full clinical manifestations, 14. Chester, In his first admission to the closed ward of a psychiatric hospital, Chester W., 24 years of age, was friendly and alert. His freedom from anything that would suggest an ordinary psychosis was immediately noticeable. He explained to the examiner that he did not suffer from any nervous or mental disorder and emphasized the statement that no question of such a condition had ever come up in his case. He said that he came to the hospital for further examination of a serious injury to his ankle which he sustained while in the army and for which he hoped to get a pension at energyenhancement.org

  • Psychopath Hervey Cleckley THE MASK OF SANITY, Section 2: The Material , Part 1: The disorder in full clinical manifestations, 15. Walter
    Psychopath Hervey Cleckley THE MASK OF SANITY, Section 2: The Material , Part 1: The disorder in full clinical manifestations, 15. Walter, Walter is an only child. In the old South Carolina city where he spent his early years, he is remembered by his first playmates as having been not only normal but also a particularly desirable friend. During his grammar school days he was a good but not an exceptionally bright pupil. He was happily at ease with boys his own age, being generally looked to as a leader, though never aloof or dictatorial. He was somewhat less inclined than usual to the more destructive forms of mischief so dear to the typical young male, yet no child could have been more secure from the taunts often evoked by primness or piety in the schoolboy. It is nothing short of incredible to imagine the term sissy, withering and still unhackneyed stigma of those times, ever having been applied to Walter by anyone. That term, in fact, could not have been defined better by those who used it than as his direct opposite at energyenhancement.org

  • Psychopath Hervey Cleckley THE MASK OF SANITY, Section 2: The Material , Part 1: The disorder in full clinical manifestations, 16. Joe
    Psychopath Hervey Cleckley THE MASK OF SANITY, Section 2: The Material , Part 1: The disorder in full clinical manifestations, 16. Joe, This patient came in the custody of two friends, both state officers in the American Legion, to apply for admission to the hospital. He had with him commitment papers showing that he had at his own request been declared incompetent. Joe was alert and intelligent and conducted himself in a manner that suggested a person of poise, good judgment, and firm resolution. He was anything but the sort of figure that might come to mind in thinking of a patient sent for admission to such an institution at energyenhancement.org

  • Psychopath Hervey Cleckley THE MASK OF SANITY, Section 2: The Material , Part 1: The disorder in full clinical manifestations, 17. Milt
    Psychopath Hervey Cleckley THE MASK OF SANITY, Section 2: The Material , Part 1: The disorder in full clinical manifestations, 17. Milt, An incomplete account of this patient will be offered. His behavior and his apparent subjective reactions differ little from those of the patients already presented at energyenhancement.org

  • Psychopath Hervey Cleckley THE MASK OF SANITY, Section 2: The Material , Part 1: The disorder in full clinical manifestations, 18. Gregory
    Psychopath Hervey Cleckley THE MASK OF SANITY, Section 2: The Material , Part 1: The disorder in full clinical manifestations, 18. Gregory, I first saw this patient when he was 13 years old. He was referred for study and treatment by a psychiatrist who had already tried to deal with his problems for several years and who had shown great personal interest in his complicated situation. Gregory came to me from the detention center in a large southern city where he had been confined after setting fire to the local cathedral. Though he did not succeed in causing serious damage to the cathedral, the exploit was considered daring and precocious for a boy of his age. Before he was controlled by confinement in the detention center he set another fire in a large apartment building that caused substantial damage at energyenhancement.org

  • Psychopath Hervey Cleckley THE MASK OF SANITY, Section 2: The Material , Part 1: The disorder in full clinical manifestations, 19. Stanley
    Psychopath Hervey Cleckley THE MASK OF SANITY, Section 2: The Material , Part 1: The disorder in full clinical manifestations, 19. Stanley, During the summer of 1972 a small item of news appeared in many of our daily newspapers over the country. It was an item that immediately engaged my attention at energyenhancement.org

 

 

 
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