The Mask of Sanity
Page 14
There was no indication in him of a reaction such as awakening to an error, or even of surprise accompanying his verbal withdrawal from his fictional heroine. He did not seem to feet any need to revise his attitude as the ordinary man does on finding himself in error. The fact that he had been, as admitted by himself, on the wrong track seemed in no way to stimulate him toward getting on another track. He impressed me as being this way about the most serious and practical matters and no less so than in this small theoretical question. It was not hard to get the feeling that he had never been on any track at all, that he had not really been committed to his first proposition and so he had nothing to withdraw.
This young man’s parents, in his absence, spoke of his having been an unusually loving and demonstrative child until he was about 14 years of age. “We worried,” his mother said, “because he was too considerate and affectionate. He never did anything wrong. He would do so many sweet, attentive little things to show us how he felt. He used to stay at home and seem to want to be with us so much that I thought it might not be good for him.”
After 14 a difference became discernible and finally striking. He gradually changed from being overattentive until, in recent years, he seemed cool and showed little convincing evidence of affection to his parents. He seemed to want to be out all the time. Though the parents felt uneasy about these changes, they reassured themselves. He did not drink and had the reputation of being very moral, “pure-minded,” and proper. He was liked by his friends, did well but not brilliantly in school, and usually took the lead in superficial activities at clubs and social gatherings.
Occasionally incidents arose that briefly alarmed the parents. The boy, when he wanted to have his way about small matters, sometimes seemed utterly unable to see the other side of a question. Once when his mother was physically indisposed and needed to get a number of articles downtown, he refused to help her, saying that he was going to the movies with another boy. His indifference struck her as extreme, and she suffered not only considerable inconvenience and discomfort but also sharp hurt. That night when, as usual, he wanted the family automobile, his father refused him, pointing out that he had not behaved toward his mother in a way to deserve this favor. According to his parents, he reacted as if an arbitrary and vicious injustice had been done him, showing what looked like a quiet indignation, politely controlled in its grosser aspects but consistent with what one might feel who is for no fault provoked and deeply wronged. Both parents felt that they had often given in to him too much.
On another occasion when he had shown unwillingness to put himself out in even the smallest degree for the comfort of his mother, who was then recovering from a serious attack of illness, his father had pointed out to him that his mother might have died and still was in danger. “Well,” he said, “suppose she did. Everybody has to die sometime. I don’t see why you make so much of it.” He seemed honestly surprised at his father’s reaction. In discussing this with me, he still seemed to feel that the most important point in the matter was the factual correctness of his statement about mortality.
Unlike most psychopaths, this patient as yet shows relatively little obvious disturbance in his social situation. There is no trail behind him now of a hundred thefts and forgeries, repeated time after time in clear knowledge of the consequences. He has, in general, avoided outraging his friends and acquaintances by vividly antisocial acts or distasteful and spectacular folly. Many of his contemporaries smoke, swap bawdy jokes with gusto, sometimes get a little drunk, and not a few indulge in illicit sexual intercourse. Not doing these things, by which “goodness” or “badness” in people of his age is often judged by the community, he has acquired a considerable reputation for virtue. He goes to church regularly. All this tends to offset what negative qualities he has shown and makes it hard for his friends to realize things about him they might otherwise grasp. Though far from being truthful, his frank manner and his ability to look one in the eye without shame have so far concealed most of his serious shortcomings, not only from his parents but also from a fair percentage of his acquaintances.
Many of Pete’s contemporaries do not, as a matter of fact, regard him as the excellent character and promising young man he appears in the eyes of his elders. He has no really close friends. Bound by no substantial attachments, he has, one might say, the whole of his time and energy for superficial relations and is able to cultivate many acquaintances with whom he is in a sense popular. He does not get close enough to anyone in true personal relationships to be recognized well in his limitations or to be well understood. What little warmth he possesses is all on the surface and available to one and all. What he offers to the most casual acquaintance is all he could offer to friend, parent, or wife. In general he is accepted as a person representing virtue and manifesting affability. Having no serious interests or aims, he is free to devote more attention than others to social clubs and to young people’s organizations sponsored by school or church for moral purposes. It is easy for him to say the right things and go through the proper motions, for he has no earnest convictions or strong conflicting drives to cause confusion.
Behind an excellent facade of superficial reactions that mimic a normal and socially approved way of living, one can feel in this young man an inner deviation, an emotional emptiness, comparable in degree with what seems to lie at the core of schizophrenia. He lacks, however, all the characteristics by which a diagnosis of schizophrenia is made. Not only are the gross and demonstrable symptoms such as delusions and hallucinations absent, but there is no oddness, no peculiar inwardness and constraint, no abstruse stiffness of manner, or any of the other subtle, sometimes inexpressible, qualities and shadings that can be felt in the patient with simple schizophrenia or in those with schizoid personality. On the contrary, he is glibly sociable, utterly at ease. He mixes readily and tends to lead in his group. There is nothing guarded and shy on the surface of his personality and probably nowhere within the range of his consciousness.
Whether or not the formal diagnosis of antisocial personality (or psychopath) is established in this case is a question I am willing to leave open. There is much in his conduct that would indicate such a disorder. It is not what he has done that points so strongly in this direction but how he feels and inwardly responds. When one deals with him directly, he offers more of an opportunity than the previous patients to sense at close range some of the attitudes that can often be surmised only at a greater depth beneath the unaccountable conduct and the verbally and logically perfect front of the psychopath.
Almost three decades have passed since the experiences with Pete in his early life that have just been reported. Since then I have not had him under regular observation, but from time to time information reaches me about his career that seems to confirm my fear that he was, and is, a classic psychopath.
In his marriages he has behaved so similarly to other patients described here that there seems little reason to attempt a full and detailed account of the disastrous experiences of his wives.
Let us note, however, that when married to a relatively wealthy and sexually attractive second wife, he spent most of his evenings over a long period with various married women much older than himself. None of these women seemed to tempt him erotically or to answer any intellectual or other understandable emotional need. They were, on the whole, a remarkably unprepossessing lot. His account of these relations makes it very difficult to believe he found anything but mild boredom in them. Apparently this boredom was more acceptable than what he was able to find at home with his good looking young wife.
The married woman with whom he most often spent time was twenty-five or thirty years older than Pete. She was quite plain, often ungrammatical in speech, and to most people devoid of charm. Her husband, a former bootlegger, was at the time engaged in a business involved with illicit gambling schemes that often kept him from home until late at night. Pete seems to have won the confidence of this woman completely for he succeeded in stealing from her a
good deal of valuable jewelry and also securities which he apparently persuaded her to make over to him in the guise of a loan.
Pete, like so many others of his type, seemed to evade the more serious consequences of this episode and of other major antisocial behavior in which he has continued. During fairly recent years he made headlines in the newspapers of a large city by a more than ordinarily ambitious and ingenious exploit. This concerned breaking and entering, and the removal of furniture and other valuable contents from a large residence.
The house, sometimes spoken of as the — mansion, had been the home of a wealthy and distinguished family but for many years had not been occupied. The older generation had died and the several children had married and for a long time been living in distant cities. Very handsome furniture, rugs, pictures, silver and china, and other expensive possessions had been left in the ancestral place. Pete apparently gave a great deal of thought to his plans and worked out the details with care and excellent judgment. On the appointed night he and his confederates moved several trucks and vans up to the house and after breaking in the doors loaded the vehicles with its most valuable contents and calmly drove away. Measures were taken ahead of time to disarm the suspicion of anyone who might happen on the scene and if the necessity should arise to reassure the police that nothing objectionable was going on. According to the report a burglar alarm system had been carefully studied and silenced to facilitate the operation.
The last available information indicates that Pete continues in a versatile fashion the typical career that distinguishes the people described in this volume.
11. Frank
The following letter was received by an influential senator in Washington and referred by him to the hospital.
Dear Sir:
It is with regret that I find it necessary to seek consideration from higher authority but I have been confined in the Veterans Administration Hospital at for two years.
During my period of incarceration here I have tried in every available way to cooperate with the officials, but it seems an impossibility to get any consideration from them toward gaining my freedom.
I was placed here on the recommendation of my sister because she thought I was a drug addict, and she has written some pretty nasty things against me to the officials here.
I can prove to the satisfaction of all concerned that I am not a confirmed drug addict or habitual user of any form of drug sufficiently to warrant continuous confinement. I am not a criminal, nor had I the slightest minor charge of any description against me at the time I came here. The Staff here has rated me less than 10 percent disabled and discontinued all government compensation; therefore, I believe you will agree with me that any man with a less than 10 percent disability could not possess a physical or mental disorder sufficient to prevent his having his freedom and making his own livelihood.
I am not even allowed parole privileges of the grounds as a great many of the patients here are. Some are continually violating institutional rules and still retain their parole privileges undisciplined.
I have two children, who need my support and as long as I am kept incarcerated I can’t assist them in any way for I have no means other than my labor to support them.
I hereby humbly request you to intercede in my behalf and demand these officials here to grant my release in order that I may be able to support my children to the best of my ability as is every man’s duty.
There are quite a few men in these institutions that are nothing short of impositions on the government and taxpayers of the United States. They, the same as myself, are perfectly capable mentally and physically to support themselves and should be forced to do so.
I have begged for parole, trial visit, or any other means to prove myself self-sustaining, but the authorities here seem to take my plea as a joke and make a lot of promises that they have no intention of putting into action.
I will gladly submit to any physical or mental examination you may deem necessary to assist you in obtaining my release from this place. I pray that you will give my earnest request your immediate consideration.
Please be assured that I hold no malice toward any of the officials here or elsewhere but my only objective in writing you is to gain my freedom and support my children.
Please let me hear from you personally,
Yours very respectfully,
Frank ______
The writer of this letter has behind him a formidable record of misadventure.
Detailed knowledge of Frank’s early life is not available beyond the following facts. The son of a rustic blacksmith, he was raised in a small hamlet near the mountains of north Georgia. So far as can be learned, no members of his family suffered from nervous or mental disease or made themselves objectionable in the community. He completed the fifth grade in school, where he was considered by no means a dull boy, though often truant. Many of the hours he was supposed to have spent in school or working at some necessary chore for his family he is reported to have idled away in loitering about a local millpond drowning goats and doing other senseless or uninviting deeds of mischief.
Before the United States entered World War I, Frank had forged his father’s name to a false statement about his age and enlisted in the National Guard. He was given vocational training by the government after his discharge from the army. He was tried at several courses but made no serious effort to complete any of them. In his community he soon made himself a problem, sometimes drinking to excess, often behaving in a rowdy and threatening manner, contracting to buy small businesses, filling stations, farms, but never living up to his agreements.
Local ex–service men, believing that he took morphine and that treatment might help his maladjustment (commonly referred to as “nervousness”), had him sent to a psychiatric hospital. He remained for a month, then returned to continue in his old ways.
Now began a series of hospitalizations which extends to the present time. He would be sent first to one place, then to another. He has been treated in state hospitals, in federal hospitals, and in private institutions at the expense of the government. All told, he has been admitted no less than nineteen times to strictly mental hospitals maintained for the purpose of treating psychotic people. Sometimes he remained only three or four weeks and sometimes six or even eighteen months. Over the years his periods of hospitalization have grown slightly longer and his intervals outside shorter. He has never, during the past fifteen years, been free longer than a few months. While not under the care of psychiatrists he has received considerable attention from the police. His jail sentences number seven at the present reading, including a term of nine months in the Leavenworth Penitentiary (where he was sent for forging a prescription for morphine) but not counting a score or more of overnight or weekend stops in police barracks.
Despite these preoccupations Frank has found time to marry and have four children and to become ordained as a minister in a small religious sect noted for vigorous evangelical fervor. His marital relations have been most unsatisfactory during the interludes when he was free to be with the family. His wife reports that he curses her and fights with her, and it is well established that he seizes any money that is available, hires automobiles, and drives aimlessly about the countryside, often drinking to excess and, according to some reports, occasionally taking morphine.
At times he has seemed proud of his ecclesiastical title, referring to himself as a pastor and assuming unctuous and haughty airs. He has not, however, occupied himself with whatever ministerial duties he was supposed to fulfill any more consistently than with other work.
His friends, especially those interested in the American Legion and other service organizations, have obtained many positions for him. He is shrewd, neat in appearance, and an excellent talker. He makes a good impression at first but always shirks his responsibility to such an extent that it is impossible to retain him.
A few years ago he was given a place at a filling station and seemed, surprisingly, to show considerable i
nterest in his work for several days. It was then discovered that he had been drawing off all the gasoline he could and taking it to a nearby town where he sold it and bought morphine from dope peddlers, most of which he, in turn, sold at a tremendous profit to local addicts.
He has been consistently arrogant and aggressive toward his neighbors and acquaintances, usually over trifling matters. After taking a few drinks, he has often threatened others, claimed things that were not his own, and made such a nuisance of himself that local police would be called to deal with him.
He is boastful and histrionic, more eloquently and aggressively so with a few highballs, and much given to temper tantrums. He frequently threatens to kill himself over some petty vexation and once offered a pistol to his wife, urging her grandiloquently to shoot him. He has never made an attempt, however, to harm himself, though his opportunities have been unlimited.
He has been reported as having convulsive seizures. These developed when he was refused special attention by physicians and seemed, according to their descriptions, plainly and consciously designed toward obtaining various ends. This manifestation has also been noted when he was confined to jail and wanted to be sent to a mental hospital in order to escape charges that had been brought against him. These so-called seizures have been observed several times in this hospital by competent psychiatrists. They did not in any way suggest epilepsy nor were they convincing as possible reactions of true hysteria. The patient is unquestionably conscious and shows that he is behaving intentionally in this way to gain a recognized end. Unlike a conversion phenomenon, the purpose does not appear to be concealed from his conscious awareness.63,76