Section 2: The Material

Part 1: The disorder in full clinical manifestations

5. Max



Energy Enhancement          Enlightened Texts         Psychopath           The Mask Of Sanity



5. Max

This patient first came to my attention years ago while I was serving my turn as

officer of the day in a Veterans Administration psychiatric institution. His wife

telephoned to the hospital for assistance, stating that Max had slipped away from her

and had begun to make trouble again. With considerable urgency and apparent distress

she explained that she was bringing him to be admitted as a patient and begged that a

car with attendants be sent at once to her aid.

He was found in the custody of the police, against whom he had made some

resistance but much more vocal uproar. The resistance actually was only a show of

resistance consisting for the most part of dramatically aggressive gestures made while he

was too securely held to fight and extravagant boasts of his physical prowess and savage

temper. His general demeanor in this episode suggested the familiar picture of small

boys, held fast by peacemakers, who wax ever more eloquently militant as the

possibilities of actual conflict diminish.

He came quietly with the attendants and on arriving at the admission ward was

alert, self-assured, and boastful. Extolling his own mettle as a prizefighter, as a

salesman, and as general good fellow, he was nevertheless friendly and even flattering

toward the examining physician and the hospital.

He was far from what could be called drunk. In fact, it would be stretching a

point to say he was "under the influence." He had been drinking, it is true, but he knew

well what he was doing, and only by an impracticable flight of fancy could one attribute

his behavior primarily to liquor.

At the admitting ward of the hospital, accompanying papers promptly revealed

that the patient's desire for treatment arose in consequence of some checks which he

had forged in Spartanburg, S.C. He had been arrested and convicted, but an agreement

was reached whereby, instead of being sent to jail, he might come to the hospital for

psychiatric treatment.


His wife, his attorney, and representatives of a veterans' organization pointed out

that he had frequently been in hospitals for the treatment of mental disorder and

maintained that he was not responsible for his misconduct.

He seemed pleased to be at the hospital and was expansive and cordial but a little

haughty despite his well-maintained air of camaraderie. Although a small man, only 5

feet, 6 inches tall, he made a rather striking impression. His glance was fresh and

arresting. His movements were quick, and he had an air of liveliness vaguely suggestive

of a chipmunk. Though preposterously boastful, he did not show any indications of a


The hospital records showed that he had been a patient eight years previously for

a period of two months. During this time of study he showed no evidence of a

psychosis or a psychoneurosis and was discharged with a diagnosis of psychopathic

personality. He was found to have tertiary syphilis, but neurologic examination and

spinal fluid studies showed no evidence of neurosyphilis.

Though at first cooperative and agreeable on this previous admission, he soon

became restless and expressed dissatisfaction with the hospital. He was granted parole,

but on his first pass into town he got into an altercation in which words were more

prominent than blows and was held by the police for disturbing the peace.

After losing parole, he became constantly unruly in petty ways, often insulted the

nurses and attendants, and several times egged on mildly psychotic patients to fight each

other or to resist the personnel on the ward. On being questioned about this conduct

by physicians, he glibly denied all and showed little concern at being accused. Since he

was not considered as suffering from a real nervous or mental disorder and since it was

difficult to keep him on any ward except the closely supervised one among actively

disturbed patients, he had been discharged.

Records show that he sought hospitalization on other occasions after having been

fined a half-dozen or more times for brawling on the streets and for petty frauds. There

is every reason to believe, from the evidence of careful reports by the Red Cross and by

social service workers, that when his troubles with the civil authorities became too

discomforting he sought the shelter of a psychiatric hospital.

Several months previously he had spent six weeks at a Veterans Administration

hospital in Maryland after getting into similar trouble with the police in Wilmington,

Delaware. He complained at the time of having spells during which he lost his temper

and attacked people, often, according to his story, with disastrous results, since, again

according to his story, he had at one time been featherweight boxing champion of



According to the psychiatric history at the Maryland hospital, he had, in

describing these spells, mentioned some points that would suggest epilepsy. As soon as

he came to the hospital and was relieved of responsibility for the trouble he had made,

the so-called spells ceased. His description of them varied. Sometimes, when

particularly expansive, he boasted of superconvulsions lasting as long as ten hours,

during which he made windowpanes rattle and shook slats from the bed. After being in

the hospital for several weeks and apparently beginning to grow bored, his talk of spells

died down and he seemed to lose interest in the subject. He was discharged after the

staff had agreed that the alleged seizures were entirely spurious and the patient himself

had all but admitted it. The diagnosis of psychopathic personality was made.

Between his first visit to the present hospital and his recent return, he had been in

five other psychiatric institutions, each time following conflicts with the law or pressing

difficulties with private persons. In all the records accumulated during these

examinations and investigations, no authentic symptom of an orthodox mental disorder

is noted. True enough, there are statements by wives and other interested parties about

spells and opinions by the laity, such as the following which was quoted by his attorney

on one occasion to shield him from the consequences of theft:

I had occasion to be in Dayton, Ohio, recently and talked to the people running the ...

Loan Company at ... Street, having stopped there for about an hour between trains en

route for Chicago. I was informed by these gentlemen that he had wheels in his head.

Statements such as the foregoing, opinions that he is "undoubtedly goofy," that

he does not behave like a man in his proper senses, abound in the ponderous stack of

letters, medical histories, social service reports, records of court trials, and other material

that has accumulated in this man's wake. One who reads his strange and prolix story

and, even more, one who knows the hero personally is only too ready to fall into the

vernacular and agree. Nevertheless, it was equally true on reviewing his record at the

time of his new admission that no symptom impressing a psychiatrist had been

manifested and that many groups of psychiatrists had, after careful study, continued to

find him free of psychosis or psychoneurosis, in other words. sane and responsible for

his conduct and even without the mitigating circumstance of a milder mental illness.

Once during this period he had been sent to prison in a southern state for

forgeries a little more ambitious than his routine practice. At the instigation of his

second and legal wife, who consistently flew to his aid (despite her chagrin at the

patient's having meanwhile consummated two bigamous


marriages), well-meaning officers of a veterans' organization became interested and took

up the cudgels.

Wearying sharply of prison, the patient had for some time been talking on all

occasions about a blow on the head which he had sustained while in service. This

alleged incident, though absent from his military records, had cropped up frequently but

not regularly during his hospitalizations. Sometimes the blow, which he had sustained

accidentally from the butt of a gun that a companion was breaching, had merely left him

dizzy for a moment. Again it had knocked him unconscious for a short period and

necessitated several days' rest in his tent.

Max now became more specific about his wartime injury and explained that he

had suffered a severe concussion, lying out stark and unconscious for some eight or

nine hours. Attorneys pointed out his many periods of treatment in psychiatric

hospitals. The governor soon agreed to parole him into the custody of a federal

hospital in Mississippi.

During his present sojourn in the hospital he was for several weeks happily

adjusted on the admission ward, busy doing small favors for the physician, congenial

with all the personnel, and helpful and kindly toward psychotic patients. He was alert,

quick-witted, nimble with his hands, and entirely free from delusions, hallucinations, or

any of the broader personality changes associated with the ordinary psychoses. He was

by no means "nervous," even in the lay sense, and showed no emotional instability or

signs of ungovernable impulse. Rather than an excess of anxiety, he showed the reverse,

apparently finding little or nothing in his present situation or in all his past difficulties to

cause worry or uneasiness.

As the time passed, however, he began to grow restive. He became somewhat

condescending toward the physician, frequently referring to himself as a man of

superior education and culture and boasting that he had studied for years at Heidelberg.

Shortly before the time set for him to come before the staff, he demanded his

discharge. This was denied. He now became involved in frequent altercations with

attendants and sometimes fought desultorily with other patients. These fights always

started over trifles, and Max's egotism and fractiousness raised the issue. He never

attacked others suddenly or incomprehensibly as might a psychotic person motivated by

delusions or prompted by hallucinations. The causes of his quarrels were readily

understandable and were usually found to be similar to those which move such types as

the familiar schoolboy bully. Usually his adversaries were patients also disposed to

quarrel. No signs of towering rage appeared or even of impulses too strong to be

controlled by a very meager desire to refrain.

He always took care not to challenge an antagonist who might get the


upper hand. During this period he talked much of his past glories as a pugilist,

describing himself as former featherweight champion of all the army camps in the

United States. The desire to show off appeared to be a strong motive behind many of

his fights. As will be brought out later, he was indeed a skillful boxer. These stories

were not delusion but the exaggeration and falsifying, sometimes unconscious or halfconscious,

that are often seen in sane people and sometimes even in those who are able,

intelligent, and highly successful.*

Max was often caught sowing the seeds of discontent among other patients

whom he encouraged to break rules, to oppose attendants, and to demand discharges.

He made small thefts from time to time. This trend culminated in his kicking out an

iron grill during the night and leaving the hospital. He took with him two psychotic

patients, and numerous others testified that he had tried to persuade them to leave also.

The next afternoon he was returned to the hospital by the police after

* Such traits can occasionally be found even in wise and reliable people. A highly regarded and

respected friend of mine, a doctor of philosophy, recently appointed professor of physics in a small but

distinguished college, and the author of several useful and accurate contributions to scientific literature,

is the first who comes to mind.

This distinguished man has often regaled groups of acquaintances, myself among them, with

accounts of working his way through the university by playing professional ice hockey at night, later

setting type on a newspaper for several hours, rising before daylight to stoke tugboats on the

waterfront, riding thirty-four miles to a high school to teach one subject and thirty-four miles back, as

well as keeping house in a three-room apartment shared with six aviators and relieving the janitor of

the building one hour during each twenty-four. All these activities were spoken of as being carried out

simultaneously and along with full-time work at the university. He described in great detail and with

apparent familiarity the duties of these positions. His only studying, he said, was done on the subway

en route to his various duties.

The same friend once came up from behind while another man and I were commenting on the

height of a cliff on which we stood. The hazards of a dive from the position were being idly discussed.

The newcomer at once estimated, probably with commendable accuracy, the height, the angle of

landing, and all the technicalities of such a dive. He then launched into an astonishing description of a

dive he had made in early youth from a bridge 167 feet above the Guadalquiver.

One of the students to whom this excellent scholar lectures stated that it is the custom for each

succeeding class to tabulate his adventures and their duration in these pseudoreminiscences and

therefrom compute his age. The top figure so far is 169 years. Several classes have bettered 150. The

students have great respect for him and confidence in him, as a teacher and as a man. They are

particularly devoted to him.

Let it be clearly understood that the person discussed in this footnote is not being brought forward

as illustrative of the subject of this study. He is no part of a psychopath. He is, in fact, a character

whose essential traits lie at the opposite extreme. The reminiscences here ascribed to him are not told

boastfully or for the purpose of shielding himself or of gaining any material end. He is strikingly free of

arrogance, kind to a remarkable degree, and altogether worthy of his strong reputation as a good and

reliable man. His word in any practical matter is to be respected.


being arrested in the midst of a brawl that he had caused by cheating at a game of

chance in a low dive. He had taken a few beers but was shrewd, alert, and well in

command of his body and his faculties.

He now insisted on his discharge from the hospital against advice and was

brought before the medical staff. The diagnosis of psychopathic personality was again

made. In his demands to be released, he arrogantly maintained that he had been

pardoned outright by the governor of the state which had imprisoned him, pointed out

vehemently that he was sound in mind and body, and expressed strong indignation at

being confined unjustly in what he referred to as a "nut house." It was then pointed out

to him that he was not pardoned but merely paroled, and he was told that if discharged

at present he would be returned to the penitentiary.

Here his wrath began to subside at once and marvelously. Hastily, but with some

subtlety, his tone changed, and he began to find points in common with the advice he

had been receiving from the staff. He left the room in a cordial frame of mind, tossing

friendly and fairly clever quips back at the physicians, nearly all of whom he had known

during some of his many admissions to various hospitals.

About ten days later he was pardoned outright by the governor and almost

immediately took legal action which got him discharged against medical advice. Many

similar adventures had occupied his time prior to the recent admission. Some of these

had resulted in his being sent, as in the episode just cited, to psychiatric hospitals from

which he promptly obtained his release by legal action. Others had led him to jail and

to the police barracks dozens of times for charges not sufficiently serious for him to

utilize the expedient of psychiatric hospitalization as a means of escape.

A series of troubles had led to his reaching the hospital on this last occasion. As

mentioned previously, he had many years ago divorced his first wife and remarried. The

second legal spouse continued to play an important part in his career. As the

proprietress or madame of a local brothel generally conceded to be the most orderly

and, perhaps in a limited sense, the most respectable institution of its sort in the city, she

was constantly embarrassed by the actions of her husband. Though enjoying a good

part of the revenue from this ever-lucrative business, Max troubled himself little to

maintain the dignity of the house.

In fact, it seemed that he went out of his way to complicate matters for his wife.

If not through his daily and nightly brawls or uproars in various low grogshops,

dancehalls, or "juke joints," then by putting slugs into slot machines or serving as fence

in some petty thieving racket, he brought the police in search of him down on the

"house of joy" which maintained him.


Though satisfactory understandings were said to exist between this institution

and the law, policemen suddenly appearing at the door and trooping through the

hallways proved anything but conducive to that sense of security and dignity Mrs. - had

long and justly boasted for her house.

Especially after a few drinks, Max also liked to go about the house bragging to

clients and to entertainers alike of his prowess in various lines, intruding on parties still

at the "downstairs stage" of the night's activities, minding everybody's business, and

inevitably turning the conversation to his superiorities. Most of the time he was quite

amiable in this role-a cordial, but an all too cordial, host under circumstances in which

people are

usually concerned more with definite and perhaps pressing aims of their own

than with the glowing reminiscences of another. Occasionally when crossed, he became

threatening even with clients and, though open strife was usually avoided, hot, wild

words and strenuous scenes sometimes followed, with Max exulting in the aftermath by

pacing up and down the corridors of the house, shadowboxing, cursing, crying out his

pugilistic titles and victories, and challenging all comers.

No one realized better than his wife, a woman of experience and good judgment

in such matters, what an unhappy effect these antics had on her clientele quietly seeking

pleasure behind doors before which Max roared and paraded. Naturally she sought to

silence him and to lead him off to the quarters they shared. Usually, however, her

appearance served merely as a focus for his ire, and the tumult she sought to quell

redoubled through her efforts. More than once under such circumstances he pursued

her into her room, the wrangle having moved on to open violence, and there beat her to

his heart's content. Mrs. _____, a tall and heavy person, gave a casual impression of

being twice as large as Max. Furthermore, she was a woman of considerable strength.

She often fought back vigorously and, though she seldom succeeded in landing a telling

blow that would discourage her marital opponent, her resistance made the fight much

more lively and greatly augmented the uproar of thuds, slaps, crashes, oaths, grunts, and

honest yells of pain.

Over several years this connubial life had been interrupted frequently by Max's

departure, which he usually took in heat after quarrels such as those just described.

Often he left voluntarily with obscene curses at his wife on his lips. Sometimes she

called the police after he had covered her with minor bruises and abrasions from his

practiced fists and had him forcibly ousted. Over the years he spent perhaps two-thirds

of his time away, going from city to city and living by his wits, which are sharp indeed.

When caught in his minor frauds, which he practiced not only on the public but also on

those associated with him in his ventures, he quickly


left town. Or, if retreat was not quick enough, he spent a few days in jail, from which

he soon obtained release by telling of his imaginary head injury, of his "spells," or of

anything else that occurred to his fertile mind as a means to make people believe he was

incompetent because of "shell shock." When his situation turned out to be more

serious, he telegraphed or telephoned to his wife, who at once flew to his aid, usually

with some little money at her disposal.

He covered the entire eastern seaboard on these trips and made several

expeditions into the Midwest. For a few weeks in Texas he lived well off of money he

milked from slot machines by some ingenious device or contraption or maneuver. His

inventions of this type are numerous and highly practical. He could, perhaps, make an

excellent living indefinitely off such takings if he did not, when drinking, and often

when sober, boast too widely of his cleverness or otherwise bring himself to the

attention of the police.

It has been mentioned that earlier in his career, but after his second marriage, he

had been wedded to other women bigamously. His wife learned of these episodes and

legal action was taken by the deceived women.

From these minor troubles he was extricated by his shrewdness, the aid of his

wife, and the power of his familiar tactics of claiming incompetency and irresponsibility.

This gambit of moves seems to have gained rather than lost effectiveness by repetition.

It has become virtually a joker in the deck, or rather up the sleeve, and it has never

failed him yet. One cannot but wonder if the juries, the courts, and other authorities are

not overwhelmed by precedent and, seeing that his grounds for impunity have been

upheld so often in the past, fail to challenge them adequately. Precedent is, of course,

freely admitted to weigh heavily in law. On the other hand, these nonmedical observers

seem to weigh seriously the plain facts of the patient's conduct when they decide that he

is not a normal man, whatever term psychiatrists may use to designate him.

The immediate cause of Max's return to the hospital on this occasion was

indirectly connected with a third bigamous marriage which he recently made while off

on one of his tours from connubial security. With his new partner he tried his hand

again at forgery on a somewhat larger scale than usual. He prospered for a while and,

flushed with prosperity and bravado, brought his new bigamous partner home with him

on a visit to the brothel where his legal wife was struggling to restore standards which

had suffered during his presence.

As might well be imagined, quarreling broke out at once between the two wives.

Max, still in character, did nothing to pour oil on these sorely troubled waters. In fact,

his every move seemed designed to whip up the


already lively doings to a crescendo. The dispute culminated in a vigorous and

vociferous set-to during which both ladies were pretty thoroughly mauled, furniture was

broken, and the brothel all but wrecked. Max's most important personal contribution to

the fray was a broken jaw for his legal wife, the madame of the house.

It is interesting here to note that, despite his continual brawling with both men

and women over so many years while drinking or while quite sober and despite his

ferocious threats of violence and his pretty genuine ability as a pugilist, no serious bodily

harm had before this come to anyone at his hands. I believe that the substantial injury

was unintentional, an act of thoughtless exuberance committed in the heat of a situation

eminently and subtly designed to bring out high enthusiasm in such a man as our hero.

Having succeeded in bringing off a scene that even in his career stands out as a

little masterpiece, he took the bigamous partner and fled back to the nearby city where

his forgeries were in progress. Almost on his arrival detection met him, and hard on its

heels came prosecution from home in consequence of the jaw breaking. To these

difficulties charges for his latest bigamy were added. As such disasters began to

accumulate about Max, his legal wife, finally aroused, decided for the moment to lend

her influence to the punitive forces.

In the court action that followed, the present and third bigamous wife received an

adequate sentence to the state penitentiary, and for a while Max's own fortune seemed

none too bright. Wrought upon by his protestations, however, and perhaps influenced

as well by the disappearance of her rival from the scene, his old protector, the legal wife,

was won over and began to work with her husband. Soon matters were arranged for

him to escape the ordinary consequences of his deeds and be sent again to a psychiatric

hospital. His last admission, with which this account began, was the result.

Safe in the familiar harbor of a psychiatric hospital, he was for a week or more

friendly, cooperative, and apparently content. He was at all times shrewd, somewhat

witty on low levels of humor, and entirely free from ideas or behavior suggesting any

recognized psychosis.

He became very friendly with me during this period and talked entertainingly and

with enthusiasm about his many adventures. He denied all misconduct on his part but

admitted that he had often been in trouble because of his wife and others. It was not

the denial of a man who is eager to show himself innocent but the casual tossing aside

of matters considered irrelevant or bothersome to discuss. After briefly laughing off all

his accusations, he at once shifted the subject to his many triumphs and attainments.


Telling of his early life in Vienna, his birthplace, he spoke of his excellent

scholarship in the schools, of his preeminence at sports, and of the splendid figure in

general he had cut as a youth in that gay and urbane city. In none of these statements

did he lay in details such as might be expected of a man developing a delusional trend.

No psychiatrist, and few laymen for that matter, would have had the least difficulty in

recognizing all this as "tall talk" designed to deceive the listener and to put the talker in a

good light. All the patient's reactions showed that he himself was far from being taken


His birth and upbringing in Vienna coincide with the facts as obtained from his

army records. His alleged experiences at Heidelberg are recorded many times on his

own testimony. He described himself as a distinguished student in that honorable

university, referring to Kant and Schopenhauer and several of the Greek philosophers

as special subjects of his study. He spoke also of a deep interest in Shakespeare during

his student days and sought to give the idea that he was celebrated among his fellows

for his knowledge of the Bard.

The shrewdness and agility of his mind were prettily demonstrated in these

references to the picturesque and traditional gaieties of student life, and to the works of

the philosophers and poets. No less vividly and convincingly did he reveal an utter lack

of real acquaintance with any of the subjects in which he boasted himself learned.

He knew the names of a half-dozen Shakespearean plays, several catchpenny lines

familiar to the man on the streets, a scattering of great names among the philosophers.

He was totally ignorant not only of the systems of thought for which his philosophers

are famous but also even of superficial and general facts about their lives and times that

any person, however unintellectual, could not fail to remember if he ever had the

interest to read of such matters. Of Shakespeare he knew practically nothing beyond

the titles that rolled eloquently from his tongue and a few vague and jumbled

conceptions that have crept into the ideologies of bootblacks, peasants, and street

gamins the world over. Furthermore, he had no interest, as contrasted with knowledge,

in any matter that could be called philosophic or poetic. He liked to rattle off his little

round of fragmentary quotations, the connections and the connotations of which he

realized only in the most superficial sense, to contribute a few pat and shallow saws of

his own believed by him to be highly original, iconoclastic, and profound, to boast

generally of his wisdom, and then to go on to descriptions of his other attainments and


To my surprise, he was several times taken by psychiatrists who studied him

briefly and by social service workers as a man of some intellectual


stature. His story of study at Heidelberg, though usually discounted, was, if the

implication of the psychiatric histories is correctly read, sometimes taken as true or

probably true.

Although my actual contact with Heidelberg is superficial enough, I had no

difficulty in demonstrating in the patient a plain lack of acquaintance with the ways of

life there. The general plan of study and the physical setup of the university, matters

that would be familiar to anyone who had been an undergraduate there, however briefly

and disinterestedly, were unknown to Max. He showed that he might have passed

through the town and that he had heard and still clearly remembered gossip and legend

from the streets of Vienna about the university and its customs, but he had no more real

understanding of it than a shrewd but unlettered cockney would have of Cambridge.

This phase of his examination provided, in my opinion, a striking example of the

ambiguity inherent in our world intelligence. Here was a man of exceptional acumen.

His versatile devices of defraud, his mechanical inventions to overcome safeguards

which ordinarily protect slot machines, and other depositories of cash, and his shrewd

practical reasoning in the many difficulties of his career demonstrate beyond question

the accuracy, quickness, and subtlety of his practical thinking. His memory is unusually

sound; his cleverness at manipulating bits of information so as to appear learned is

exceptional. He is not a man to be taken in by the scheming of others, though he

himself takes in many. One can truthfully say about him that he is "bright as a dollar ...

.. smart as a whip," that "his mind is like a steel trap."

His ability to plan and execute schemes to provide money for himself, to escape

legal consequences, and to give, when desirable, the impression that he is, in the

ordinary sense, mentally deranged, could be matched by few, if any, people whom I

have known. In such thinking he not only shows objective ingenuity but also

remarkable knowledge of other people and their reactions (of psychology in the popular

sense) at certain levels or, rather in certain modes of personality reaction. He stands out

for the swiftness and accuracy of his thinking at solving puzzles and at playing checkers.

At any sort of contest based on a matching of wits, he is unlikely to come off second


To consider his intelligence (or should one say wisdom?) from another viewpoint,

from that of the ordinary man's idea of what is good sense about working out a

successful plan of life on a long-term basis, only the story of his career can speak

adequately. Be it noted that the result of his conduct brings trouble not only to others

but almost as regularly to himself.

To take still another point of view and consider him on a basis of those


values somewhat vaguely implied by "intellectuality," "culture," or, in everyday speech,

by "depth of mind," we find an appalling deficiency. These concepts in which meaning

or emotional significance are considered along with the mechanically rational, if applied

to this man, measure him as very small, or very defective. He appears not only ignorant

in such modes of function but stupid as well. He is unfamiliar with the primary facts or

data of what might be called personal values and is altogether incapable of

understanding such matters. It is impossible for him to take even a slight interest in the

tragedy or joy or the striving of humanity as presented in serious literature or art. He is

also indifferent to all these matters in life itself. Beauty and ugliness, except in a very

superficial sense, goodness, evil, love, horror, and humor have no actual meaning, no

power to move him.

He is, furthermore, lacking in the ability to see that others are moved. It is as

though he were colorblind, despite his sharp intelligence, to this aspect of human

existence. It cannot be explained to him because there is nothing in his orbit of

awareness that can bridge the gap with comparison. He can repeat the words and say

glibly that he understands, and there is no way for him to realize that he does not


I believe that this man has sufficient intelligence, in the ordinary sense, to acquire

what often passes for learning in such fields as literature and philosophy. If he had

more stability and persistence he could easily earn a Ph.D. or an M.D. degree from the

average university in this country. If he had this stability and became a doctor of

philosophy in literature, the plays of Shakespeare, the novels of Joseph Conrad or of

Thomas Hardy would still have no power to move him. He would remember facts and

he could learn to manipulate facts and even to devise rationalizations in such a field with

skill comparable to that with which he now outthinks an opponent at checkers. If, for

the sake of theory and speculation, such changes were granted to him, my contention

that he would still be without this sort of understanding is, of course, impossible to

prove. It is maintained, however, that this would be clear to all observers who have real

interest in such aspects of life, however diverse might be their own formulated opinions

on what is good, bad, true, or beautiful about art or about living.

But let us abandon speculation and return to the patient's conduct. He talked at

length of his ability as a fencer, maintaining that he was the best swordsman, or one of

the best, at Heidelberg during his student days and was also well known and feared in

Vienna. He spoke of the championship he had won at boxing while in the army,

boasting often of a belt which he still possessed symbolizing this achievement. On

hearing that I had had a slight experience in amateur boxing, he offered to demonstrate

his skill and to teach me some points. Ostentatiously he insisted that I stand up and,


pulling his punches, went through a number of sequences. He did this several times,

always choosing a place on the ward where he could be observed by a large group of

patients and attendants. He gave every indication of being a practiced boxer. This is

borne out also by army records which indicate that he won some small prize as

champion of his battalion or regiment.

Even before his presentation at the staff meeting, he again became dissatisfied,

making complaints against the nurses and attendants, demanding special foods and

privileges, bullying other patients, and inciting them to make trouble. At staff meeting

the diagnosis of psychopathic personality was reaffirmed.

On failing to get his discharge at once, he became even more fretful and unruly

and threatened to break out of the hospital. It became difficult to care for him on the

ward for well-adjusted patients in which he had been placed, so he was transferred to

the closely supervised ward, where he found himself surrounded by actively disturbed

and egregiously psychotic companions.

He complained at once of this to his wife, who came to the hospital authorities in

tears and with angry protestations, saying that it was an outrage to put her husband with

all those crazy men who were violent and combative and who might hurt him. Earlier

on the ward she made the same protest to an attendant, who saltily remarked on the

inconsistency of such worries about a husband so well known for his boasts of might

and ferocity and pugilistic skill. She made the matter so sharp an issue that Max, after

promising to cooperate, was moved to a quieter ward.

Now, for a short while, he was more agreeably disposed. Boastfully he told me

that he was, in addition to all his other parts, an artist of remarkable ability. He asked to

be given a loaf of bread, stating that he would mold from it creations of great beauty

and worth. On getting the bread, he broke off a large chunk, placed it in his mouth, and

began to chew it assiduously, apparently relishing the confusion of his observers. After

proceeding for a length of time and with thoroughness that once would have met with

favor from advocates of the now almost forgotten cult of Fletcherism, he at last

disgorged the mess from his mouth and with considerable dexterity set about modeling

it into the figure of a cross. Soon a human form was added in the customary

representation. Rosettes, intertwining leaves, garlands, and an elaborate pedestal

followed. The mixture of saliva and chewed bread rapidly hardened.

He now requested a pass to go into town, saying that he must obtain shellac and

appropriate paints to complete his creation. He made it plain that he was molding this

statuette for me, and it was clear that he regarded


it as a most flattering favor. Since it was judged unwise to send him out alone, he was

allowed to go in company of an attendant. He returned with his materials but also with

the strong odor of whiskey on his breath.

The whiskey had been obtained in this manner: Pleading a call of nature which,

judging by his frantic tone and impressive grimaces, the attendant deemed urgent, he

hurriedly sequestered himself in a toilet. After waiting for what seemed like a most

liberal interval, the attendant went to inquire into the delay. On receiving no response,

he forced the door only to find that Max had made his escape through a small window

near the top of the room, a feat which would have been extremely difficult for an

ordinary man.

Guided by a happy instinct, the attendant hurried to a nearby dive where bootleg

whiskey was sold and surprised our hero in the midst of his second or third potation.

He was drinking to his own cleverness at outwitting the attendant and in loud,

imperious tones commanded all present to drink with him and at his expense.

The attendant found him insolent and intractable at first but, with strong moral

support from the proprietor and others, led him out after settling charges for drinks to

all, which Max had grandly assumed without a cent in his pockets.

For the rest of the day he was surly and idle except for his efforts to promote

quarrels, but on the morrow, extolling again his virtuosity as a sculptor, he settled down

and finished his gift to me. It was indeed an uncommon production. The chewed

bread had become as hard as baked clay. The whole piece was very skillfully and

ingeniously shaped, dry, firm, and as neatly finished as if done by a machine. It was,

furthermore, one of the most extravagant, florid, and unprepossessing articles that has

ever met my glance. Max presented it with mixed pride and condescension, with an air

of triumph and expectancy that seemed to demand expressions of wonder and gratitude

beyond reach of the ordinary man. I did my best but felt none too satisfied with my


Max now asked for daily bread and for a room to be set apart as an atelier where

he proposed to work regularly and without distracting influences. In the hope that this

activity would keep him out of trouble, all his requests were granted. He immediately

demanded full parole also but, when it was not obtained, agreed to wait a short while for


For a week he worked steadily, his mouth crammed with the doughy mass, his

jaws chewing deliberately, his hands nimbly shaping spewed-out hunks of the mess into

various neatly finished and exact, but always garish, forms. His coloring of the flowers

and garlands and imitation jewels, vivid red, pale purple, sickly pink, always struck a high

level of the tawdry


blended with the pretentious. The most gaudy atrocities of the dime store must give

ground before such art.

He sent messages to the medical director of the hospital, to the supervisor of

attendants and the chief nurse, and to many others whom he felt it well to ingratiate that

objets d'art awaited them in his studio. He was visited by these people and by various

prominent ladies of the city interested in welfare work and active in helping disabled

veterans. To most of these he made presentations as well as moving speeches about his

misfortunes, his gifts, and his ambitions. His demands for parole now became more

vehement. Many influential citizens begged that he be given this chance to rehabilitate

himself. As a matter of fact, he had been reasonably cooperative while at his new work.

Parole was granted.

The police brought him back after a few hours. His left hand showed a painful

laceration, the result of a severe bite inflicted in retreat by a barroom opponent who had

resorted to this vaguely Parthian maneuver after finding Max's pugilistic skill too great

to cope with in the ordinary manner.

He showed some evidence of drink but was by no means sodden. Nor did he in

any way give the impression of a man sufficiently influenced by liquor to have his

judgment appreciably altered or any violent and extraordinary impulses released. In

contrast with some of the other patients discussed here, Max, though a ready drinker,

never or very rarely drank to the point of confusion. There is no record in all the saga

of his being brought in senseless from the highways or fields. At the worst he could

scarcely be classed as more than a moderate drinker.

He made no excuses for violating his parole but blamed others in full for the

trouble he had started and felt grossly misused by the man he had attacked, by the

police, and by the hospital which revoked his parole.

His wife at once pled for restoration of his parole, and a number of other

influences supported her. Max reiterated the familiar argument: why deny liberty to a

man classed as sane? Parole was restored after a week. Surprisingly, Max got through

two days without difficulty, but on the third, burst into the office of the supervisor of

attendants and vehemently demanded that a former attendant, dismissed for

incompetence, be reinstated at once. He had brought this man with him into the office.

Inspired by a couple of highballs but by no means drunk, he thundered and swaggered,

threatening to use political influences to have the supervisor discharged if all his

demands were not met forthwith. He named various political powers which he boasted

that he could command. These influences, he very truly pointed out, had lent

themselves to his efforts to get out of jail and out of hospitals in the past. He insisted,

furthermore, that certain other attendants


whom he disliked be discharged. Storming and cursing and threatening, he was

removed to a closed ward.

Somewhat disgruntled, he ceased his modeling in postprandial bread and sulked,

irritable and aggressive, among his psychotic companions. Soon, however, he became

more agreeable and after a few days came swaggering into my office to display a new

product of his ingenuity. Borrowing a dollar bill and a pair of scissors, he cut out five

rectangles of plain paper identical in size and shape with the bill and poised himself with

a faintly prestidigitatorial air. "Watch this," he boasted.

As he cut up his models of the bank note and manipulated the pieces, he called

for paste to be brought. Then, after a shrewd and tricky rearrangement he pasted

together his fragments. "Count them," he ordered in the grand manner. Not five but

six paper models lay on the table, all plainly patched, but all defying the ordinary eye to

detect any appreciable loss of substance.

Within a week his wife, after haunting the hospital and begging for his parole,

insisting that she needed him at home, that she was in want, succeeded in taking him

out in her custody. Late that night local policemen brought him back. After giving his

wife what might be called an average beating, he had caused considerable uproar at the

bawdy house and fled to another dive where, after trying to get loans from a few idlers,

he boasted and quarreled until the police intervened.

He remained then on a closed ward for about a week. After this time, legal

charges against him having been dropped, he demanded release against medical advice.

Since he was sane and competent in the eyes of law and science, he was discharged.

Two months later local newspapers carried small headlines calling attention to his

being taken by federal agents after a protracted investigation in Texas. For weeks

patched-up five-, ten-, and twenty-dollar bills circulated in several Texas cities, and Max,

decked in flashy finery, drove about in his own car and splurged lavishly on food, drink,

and women. The surprising volume of mutilated notes at last caused comment and

finally suspicion. After skillful and persistent efforts, the federal agents finally worked

out the puzzle and brought it to Max's feet.

My colleagues and I felt that perhaps our acquaintance with Max had ended.

Federal justice is widely regarded as less relenting and less distractible than municipal

and state justice. For most lawbreakers this may, indeed, be true. Max's old play,

however, had not lost its charm. Some months later he was in a psychiatric hospital and

shortly afterward at large.

His career continued. The records show that once, while under a fiveTHE


year sentence to a state penitentiary, he stressed his former syphilitic infection and

boasted so vehemently in his old style that a physician who saw him in prison made a

diagnosis of dementia paralytica. No neurologic or serologic findings supported this

opinion, which was offered by a general practitioner after one interview. This was

enough to start the familiar cycle of prison-to-hospital-to-freedom.

Once again, when anxious for shelter, he boasted that he could communicate

with ancestors who had died thousands of years ago. His wife joined in and claimed

that he had seen monkeys and baboons chasing him. At a general hospital a tentative

diagnosis of schizophrenia was offered. Back at another psychiatric hospital he showed

no evidence of an orthodox psychosis and after a short time got his discharge.

Again when pressed by a court verdict, he claimed amnesia for a period of two

years, during which he had been active at defrauding. A suspicion of hysteria was

expressed by some physicians. At the psychiatric hospital he stuck for a while to this

story of amnesia, but, his vanity being aroused, he recalled in detail all his experiences.

It was plain from his manner that he had not suffered from any true amnesia, and he no

longer took pains to make anyone believe that he had.

A few years later he was again brought to the hospital. This time his wife insisted

that his beatings were too much to bear and stated that he had threatened to kill her

with an axe, explaining that he could do so with impunity since he was a mentally

disabled veteran and that, as she well knew, he had always succeeded in escaping the

consequences of any crime. She soon recovered from her fears and asked for his parole.

At the insistence of both man and wife, he was discharged after a few weeks.

Be it noted that despite his vigorous threats such as the one just mentioned, Max

seldom, if ever, tried with deliberate intention to do anyone serious physical injury. This

fact has especial weight in view of his boasted and pretty satisfactorily demonstrated

immunity from penal consequences. In important respects he appears to differ

fundamentally from those who are regularly or often inclined toward major violence, or

toward murder. In his innumerable conflicts with the law he has appeared usually in the

role of petty bully, perpetrator of frauds, sharper, con-man, swindler, thief, and peacedisturbing


Some months later I, with other psychiatrists, testified at court when efforts were

being made to have Max committed by law as "insane." Several citizens whom he had

defrauded and seriously troubled in other ways, finding that he was not vulnerable to

fines or sentences in the municipal courts, hoped to obtain relief and protection by

getting him into a psychiatric hospital.


The psychiatrists could not avoid admitting that he showed no evidence of

anything that is officially classed as a psychosis. Despite some sort of misgivings I had

to agree. Yet it seemed plain that this man, though free from all technical signs of

psychosis, was far less capable of leading a sane, or satisfactory, or acceptable life, less

safe or suitable to be at large in any civilized community, than many, perhaps than most,

in whom psychosis can be readily demonstrated and universally accepted as

unquestionable. Was there any means I could suggest by which he might through

existing laws and institutions be more adequately controlled and kept from destructive

folly? Or by which the community might be better protected from his persistent

antisocial activities? As I groped without avail for an answer the sense of futility became

truly oppressive. Max, neat and well groomed, insouciant, witty, alert, and splendidly

rational, rose, beaming, to hear again the verdict of freedom.


Next: Section 2: The Material , Part 1: The disorder in full clinical manifestations, 6. Roberta


Energy Enhancement          Enlightened Texts         Psychopath           The Mask Of Sanity



Section 2, Part 1


  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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

  • 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





Search Search web