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The Mask Of Sanity

Written By

Hervey Cleckley

Presented Here By

Bonnie M. Wells

In a sense, it is absurd to maintain that the psychopath's incapacity for object love is absolute, that is, to say he is capable of affection for another ill literally no degree.

He is plainly capable of casual fondness, of likes and dislikes, and of reactions that, one might say, cause others to matter to him. These affective reactions are, however, always strictly limited in degree. In durability they also vary greatly from what is normal in mankind. The term absolute is, I believe, appropriate if we apply it to any affective attitude strong and meaningful enough to be called love, that is, anything that prevails in sufficient degree and over sufficient periods to exert a major influence on behavior.

True enough, psychopaths are sometimes skillful in pretending a love for women or simulating parental devotion to their children. What part of this is not pure (and perhaps in an important sense unconscious) simulation has always impressed this observer as that other type of pseudolove sometimes seen in very self-centered people who are not psychopaths, which consists in concern for the other person only (or primarily) insofar as he enhances or seems to enhance the self. Even this latter imitation of adult affectivity has been seldom seen in the full-blown psychopath, although it is seen frequently in those called here partial psychopaths. In nonpsychopaths a familiar example is that of the parent who lavishes money and attention on a child chiefly to bask in the child's success and consciously or unconsciously to feel what an important person he is because of the child's triumphs. Although it is true that with ordinary people such motives are seldom, if ever, unmixed, and usually some object love and some self-love are integrated into such attitudes, in even the partial psychopath anything that could honestly be called object love approaches the imperceptible.

What positive feelings appear during the psychopath's interpersonal relations give a strong impression of being self-love. Some cynical psychologists and philosophers have, of course, challenged the existence of any love which is not on final analysis selfish, saying that the mother who gives up her own life for her child really does so because it would be more painful to her to see the child perish. Without attempting to take up the cudgels in this interesting dispute, it will suffice to say that whatever normal and highly developed and sincere object love may actually be, it is, whether judged behaviorally or intuitively, something that impresses the ordinary observer as definitely unlike anything found in the psychopath.

The psychopath seldom shows anything that, if the chief facts were known, would pass even in the eyes of lay observers as object love. His absolute indifference to the financial, social, emotional, physical, and other hardships which he brings upon those for whom he professes love confirms the appraisal during psychiatric studies of his true attitude. We must, let it never be forgotten, judge a man by his actions rather than by his words. This old saying is especially significant when it is the man's motivations and real feelings that we are to judge. This lack in the psychopath makes it all but impossible for an adequate emotional rapport to arise in his treatment and may be an important factor in the therapeutic failure that, in my experience, has been universal.

In addition to his incapacity for object love, the psychopath always shows general poverty of affect. Although it is true that he sometimes becomes excited and shouts as if in rage or seems to exult in enthusiasm and again weeps in what appear to be bitter tears or speaks eloquent and mournful words about his misfortunes or his follies, the conviction dawns on those who observe him carefully that here we deal with a readiness of expression rather than a strength of feeling.

Vexation, spite, quick and labile flashes of quasi-affection, peevish resentment, shallow moods of self-pity, puerile attitudes of vanity, and absurd and showy poses of indignation are all within his emotional scale and are freely sounded as the circumstances of life play upon him. But mature, wholehearted anger, true or consistent indignation, honest, solid grief, sustaining pride, deep joy, and genuine despair are reactions not likely to be found within this scale.

Craig said long ago that patients who suffer from hysteria do not react with awe, reverence, wonder, or pity. Often they do not, it might be said, appear capable of achieving in sincerity the major emotions, although their protestations of such emotions are prominent and their show of feeling is sometimes so vigorous that the observer is often misled to believe that they are in tragic grief or remorse. Although such a diminution of emotional range, especially along the deeper notes, may be seen in the patient with hysteria, in the psychopath it is very much more far-reaching, profound, and final. Even in the situations of squalor and misery into which he repeatedly works himself, when confined in jails and what he regards as lunatic asylums, after throwing away fortunes or catching and transferring gonorrhea to his bride - even under these circumstances he does not show anything that could be called woe or despair or serious sorrow. He becomes vexed and rebellious and frets in lively and constant impatience when confined, but he does not grieve as others grieve.

Psychopaths are often witty and sometimes give a superficial impression of that far different and very serious thing, humor. Humor, however, in what may be its full, true sense,* they never have. I have thought that I caught glimpses of it in psychopaths and, despite a typical history, was inclined to question the diagnosis. Further observation of these patients gave convincing evidence that the apparent humor, like the apparent insight, was really an artifact.

One might feel a superficial inclination to credit with humor the patient described under "The Psychopath as Scientist" who, after his lamentable marriage to the very unprepossessing streetwalker, laughed and admitted that the joke was on himself. At first glance such a reply might appear to be the valiant humor of a man who can smile in any adversity. And, indeed, it might be correctly judged as this if the speaker showed any evidence of feeling his adversity or accepting his responsibility. But in this instance the only convincing appraisal is that "he jests at scars who never felt a wound." When the normal man makes a gay or ironic quip on the subject of his own adversity, we may justifiably applaud it as humor. If the quip concerns an adversity which scarcely touches the maker, it is as empty of humor as the empty boldness of a daredevil who wagers his fortune in a dice game where no one is playing for keeps.

such a discussion only personal opinions of what is real humor and what is not real humor can be expressed. Everyone's capacity to appreciate or appraise such a quality varies, no doubt, as widely as one's sense of what is beautiful.

The emotional poverty, the complete lack of strong or tragic feeling universally found in all the psychopaths personally observed, has caused me considerable bewilderment in connection with frequent references in the literature to the powerful instinctual drives and passions said to be manifested in such people.79,128,156 Although weak and even infantile drives displaying themselves theatrically in the absence of ordinary inhibitions may impress the layman as mighty forces, it is hardly to be concluded that wise and deeply experienced psychiatrists would be similarly deceived. Perhaps such descriptions apply to other types of personality than that discussed here. And since, as I have already stressed, the present aim is to present a type of personality disorder well known and believed to be a clinical entity rather than to argue about names, efforts will be limited to describing and trying to interpret the material at hand.

In considering the general shallowness of affect common to all members of this series in connection with their incapacity for object love, there is temptation to wonder about the possible interdependence of these facilities. Is it possible for tragic or transforming emotion to arise in any person without that peculiar and indescribable personal commitment to another? Or, if not to another human being, at least to some abstraction well outside the self?

In a special sense the psychopath lacks insight to a degree seldom, if ever, found in any but the most seriously disturbed psychotic patients. In a superficial sense, in that he can say he is in a psychiatric hospital because of his unacceptable and strange conduct, and by all other such criteria, his insight is intact. His insight is of course not affected at all with the type of impairment seen in the schizophrenic patient, who may not recognize the fact that others regard him as mentally ill but may insist that he is the Grand Lama and now in Tibet. Yet in a very important sense, in the sense of realistic evaluation, the psychopath lacks insight more consistently than some schizophrenic patients. He has absolutely no capacity to see himself as others see him. It is perhaps more accurate to say that he has no ability to know how others feel when they see him or to experience subjectively anything comparable about the situation. All of the values, all of the major affect concerning his status, are unappreciated by him.

This is almost astonishing in view of the psychopath's perfect orientation, his ability and willingness to reason or to go through the forms of reasoning, and his perfect freedom from delusions and other signs of an ordinary psychosis.

Usually, instead of facing facts that would ordinarily lead to insight, he projects, blaming his troubles on others with the flimsiest of pretext but with elaborate and subtle rationalization. Occasionally, however, he will perfunctorily admit himself to blame for everything and analyze his case from what seems to be almost a psychiatric viewpoint, but we can see that his conclusions have little actual significance for him. Some of these patients mentioned spoke fluently of the psychopathic personality, quoted the literature, and suggested this diagnosis for themselves. Soon this apparent insight was seen to be not merely imperfect but a consistent and thorough artifact. Perhaps it was less a voluntary deception than a simulation in which the simulator himself fails to realize his lack of emotional grasp or that he is simulating or what he is simulating. The patient seems to have little or no ability to feel the significance of his situation, to experience the real emotions of regret or shame or determination to improve, or to realize that this is lacking. His clever statements have been hardly more than verbal reflexes; even his facial expressions are without the underlying content they imply. This is not insight but an excellent mimicry of insight. No sincere intention can spring from his conclusions because no affective conviction is there to move him.

Such a deficiency of insight is harder to comprehend than the schizophrenic's deficiency, for it exists in the full presence of what are often assumed to be the qualities by which insight is gained. Yet the psychopath shows not only a deficiency but apparently a total absence of self-appraisal as a real and moving experience. Here is the spectacle of a person who uses all the words that would be used by someone who understands, and who could define all the words but who still is blind to the meaning. Such a clinical picture is more baffling to me than any of the symptoms of schizophrenia, on which attempts have been made to throw some light by psychopathologic theories.79,89,129,269 Here we have a patient who fulfills all the ordinary theoretical criteria of a "sound mind," and yet with this apparently sound mind is more incomprehensible than the psychotic patient.

Mask Of Sanity; page 3

Bonnie M. Wells

Pure Coincidence Books

This page posted: December 2007 // BMW