The Mask of Sanity

by Hervey Cleckley

  “It’s ugly, Carter, it’s all so terrible and useless.”

  “What is?”

  “Everything, Life!”

  Among such groups languidly withdrawn in the name of art or bohemian self-expression from ordinary affairs, it is scarcely remarkable that the bards of pathology, negation, and life perversion find disciples in each new generation.

  If it is true that some creative artists of great renown show both in their conduct and their work indications of serious personality disorder, how shall we class them? Are some of those established by tradition as high priests of truth, beauty, and inspiration really members of the clinical group we call psychopaths? Although some of their works convey reactions and evaluations as inadequate as those of the typical psychopath and as incompatible with even minimum standards of human feeling and behavior, we should not necessarily identify their disorder with that of the patients presented in this book. Sexual deviation with its inevitable frustrations and reversals of response and masked but profound schizoid disorder formulated in disdainful misanthropy and life perversion seem more likely to account for the tastes and viewpoints revealed by these talented people. None of the creative artists thought by Mario Praz to be dominated by sadistic influences, and none of the others mentioned in this chapter, impress me as people who should be classified primarily with the true psychopath.

  In contrast with them, the typical psychopath does not labor consistently to express in art pathologic reactions or distorted appraisals of life. In words the typical psychopath characteristically gives normal evaluations, defines excellent moral standards, enthusiastically claims the accepted goals and aims of civilized man as his own. He is often an articulate spokesman for the good life. If the sort of patient described here should have sufficient talent and industry to produce works accepted as valuable literature or art, I do not think it likely he would in them try to express nihilistic or perverse attitudes. Whatever he might express would probably be as spurious, as little representative of authentic human experience, as his convincing but empty promises, his eloquent protestations of a love he does not feel. His production, however brilliant technically, would be a valid rendering of neither health nor disease but a counterfeit.

  Is it possible that behind the psychopath’s disorder there once lay extraordinary potentialities? I have seen other types of people who in critical periods of development seemed to face problems that arose largely from their own precocity, their own distinctly superior qualities. Such patients sometimes seem, it might be said, to have advanced intellectually and in some respects emotionally, so far ahead of what is average that they encounter problems and pressures which demand greater general maturity than it has been possible for them to acquire, although their general maturity may well excel the average. Patients in such situations have been observed who, it seemed, were being pushed into various patterns of psychiatric illness; pushed toward clinical psychoneurosis or possibly even toward schizophrenia, by factors brought into play more through the indirect effects of their superiority than by any specific personality deficits.

  Although excellent capacity is of value in efforts to work through problems, to avoid dangerous pathologic reactive patterns, it is also, I believe, possible that higher magnitudes of emotional and other functional potentiality may have something to do with the degree of destructiveness when regressive withdrawals and disintegrative forces set the course. A man of unusual integrity and loyalty is likely to be more severely damaged than a man mediocre in these respects if complicated and confusing situations cause him to make grave errors in his business (or in his decision as an officer during combat) that result in disaster for which he holds himself responsible. Abandonment or betrayal by a fiancé or mate is likely to put stress upon persons in direct proportion to the depth of genuineness with which the other is loved. Persons of great dignity and pride may find it necessary to destroy their own lives under circumstances in which those with a shallower scope of feeling can adjust with only moderate emotional damage.

  The possibility that a once great capacity for positive living may have played some part in the development of the psychopath’s negative (destructive) patterns is, I believe, worthy of careful consideration. Certainly these patterns are thorough and uncompromising (no halfway measure) and if they do represent something purposive, though consciously involuntary, their effectiveness suggests an invisible purpose of uncommon force. If the psychopath’s disorder could be shown to arise in some such fashion, it is so subtle and so monumentally effective a job that it is easy to imagine that the potentialities represented here in reverse might deserve the estimate of genius. No real evidence, however, has been presented to support this purely speculative hypothesis.

  39. The Injudicious Hedonist and Some Other Drinkers

  Those who devote their lives unduly to sensual pleasure are popularly regarded by more sober and restrained members of society as wicked or depraved. By his fellows who are especially austere the ways of the careless bon vivant are often attacked with thunderous vigor and even, by certain extremists, held as largely responsible for the ills of mankind.

  It is well known, of course, that a large number of human beings, during their development, pass through a stage of recklessness in which strong drink and casual lovemaking are snatched at injudiciously. These jejune efforts to drink life to the lees sometimes bring embarrassment or misfortune to young people. Having tried out his wings of independence or of revolt and usually having received a fair number of bumps, jolts, or bruises, the average fledgling learns his way about and ceases to lay aside altogether his judgment and common sense when in pursuit of pleasure.

  Ordinary people, young or old, if they contract a venereal disease, become illegitimately pregnant, lose their jobs because of excessive drinking, or suffer some other sharp reverse, observe the sequence of cause and effect and try to adapt themselves so as not to suffer in the same way again. Indeed, even a severe headache or other unpleasant features prominent in the aftermath of late hours and excessive drinking will cause the normal person to avoid waking in the same condition the next day. Sometimes, of course, indiscretion is piled on indiscretion and the bout of dissipation causes prolonged discomfort. The general rule, however, is to learn, even if slowly, by experience.

  A significant difference then between the man popularly regarded as a dissipated person and the psychopath is that the former, even though he breaks over into indiscretion from time to time on occasions of excitement, tends to be guided by painful consequences.289 More important still, the ordinary hard drinker or high liver appears plainly to be motivated by pleasure principles which we can all understand.

  What difference will one more drink make? What spoilsport insists on leaving? Words and ideas come to him. The occasion grows more festive and he more sparkling. Perhaps he is putting his best foot forward before some attainable or unattainable lady or merely embracing in good fellowship and understanding some group which he finds, in the general merriment, better able to know and value him. Someone breaks into song, snatches of poetry are quoted, each man gives tongue to his special enthusiasm or his special dislike. There is laughter, merriment, play, the dance. The general effort is toward life, toward a more full and active living.

  Sometimes these activities in the relatively make-believe world of synthetic freedom, these pursuits of joy that is often not quite joy itself, make real living, or one’s ordinary capacity to live, seem drab or feeble by comparison. Sometimes it seems desirable to shirk the harder, soberer transactions of the day and exist chiefly for the escape into another world which is not quite one’s own. In varying degree, depending on how sound is one’s integration and how obdurate one’s insight, persons profit by experience and limit these indulgences in accordance with the hard and inescapable facts of self and of the objective world.

  In the wide range of the accepted normal, various degrees of responsibility, various ethical and esthetic standards, various demands of ambition, and various exi
gencies of the next day or of the next decade must be reckoned with before one even comes to the question of whether drinking and conduct under the influence of alcoholic drink constitute a psychiatric illness. Even when a person arrives at the point where a definite illness or maladjustment unquestionably exists, many psychopathologic pictures must be considered and discarded before segregating the particular picture which we will, lacking a better name, call the psychopath.

  For the Methodist pastor in Paris, Ala., to drink at all would indicate some maladaptation of the man to his way of life. Yet the Anglican vicar in Stoke Poges or the priest in Amalfi may take his port or his Vino Orvieto Bianco Secco without arousing our suspicion. The middle-aged bachelor whose only tasks are to clip coupons and squire admiring dowagers about his gardens may regularly sip whiskey and soda for hours past midnight without invoking the significant consequences which such doings would bring to a surgeon called on for major emergencies several nights a week or to a young and ambitious businessman who must face a hard day’s work each morning at 8 o’clock.

  Several young doctors of philosophy might gather on Saturday night and hurl loud argumentative words about until dawn, consuming no mean quantities of whiskey while the structure of the hypothalamus, the prose of James Joyce, the sexuality of Sappho, and the ideas of Norber Wiener or of Arnold Toynbee are discussed, challenged, and defended. A couple of friendly mill workers whose wives are out of town might settle down some evening before a holiday in a barroom and drink through stages of shouting conviviality, loud song, blustering amorousness with prostitutes, to snoring stupefaction. Such activities might be defended as human by some critics, assailed as wicked by others, and interpreted, perhaps, as efforts to escape the routine of the classroom or of home and factory by still others.

  Two lovers who cannot for economic or legal reasons have each other freely under the same roof may on every available occasion lie in each other’s arms until 3 A.M. in a parked automobile, having sexual intercourse as frequently as their abilities will permit. They may drink enough whiskey to blur recognition of the inevitable morrow, pouring out their feeling and fantasy to each other in a transient delirium of bliss. Each may suffer definite impairment of effectiveness at work, fatigue, headache, nausea, and many other discomforts day after day from deficient sleep and superfluous alcohol. They may be condemned as unconventional, sinful, or foolish by other people of various viewpoints. But their conduct has little in common with that of the psychopath. They feel that the game is worth the candle and they mean to play it.

  A man whose desire for his wife has palled may at every party he attends drink too much, sway a little as he goes from group to group, try to make minor overtures to nearly every woman he encounters, and, with the slightest encouragement, attempt seduction. Such a man, most people would perhaps agree, is maladjusted in the sense that he is far from happy in his life situation. His efforts to gain happiness may incur social disapproval of varying degree, be they adroit or ludicrous. Whatever of his other life plans or his ideologies he is ignoring, he is still moved by a fundamentally normal drive, that it, to accomplish sexual relations with a woman who appeals to him.

  Another man may successfully avoid drinking to excess but also seek every opportunity to seduce female acquaintances, whether or not they are wives or sisters or sweethearts or daughters of his friends. He may try to induce the lady he seeks to drink to excess and so facilitate his purpose. This man might be called a sorry fellow by some, a fiend by others, or a latent homosexual by still others. Again he might be explained as one whose unconscious sense of inferiority or whose unrecognized sexual immaturity demands compensation for his inadequacy, or his regular failure to achieve mature fulfillment with each love object. Still another observer might regard him as a shrewd, cynical person who merely knows how to get what he wants and is above ordinary compunction. In some patients represented by the last example I have observed attitudes, personality mechanisms, and efforts at adjustment which have considerable resemblance to those of the psychopath. In the psychopath, however, is found a far greater regression, a failure to follow out consistently any aim that could be understood by the normal man, and a general disorganization of the whole life plan. The spite reaction may be fundamental in the complete psychopath, but it is directed less consistently toward bringing about an actual sexual union than in untranslatable activities. It is also less obvious and more deeply concealed, not only from the patient but also from the observer. He may start on his spree with such an objective consciously before him, but he will occasionally pour into himself not stimulating but emetic or soporific doses of alcohol and end by vomiting in the bed or falling limp on the floor long before any other aim is achieved.

  There are scores of patterns in which superficially hedonistic behavior can be seen to represent an escape from or a compensatory reaction to some emotional problem that the person has not solved. The man so attached to his mother that his mature sex aims are distorted may over years maintain a reputation for heavy and boisterous drinking, for being a great man about town with the women.

  Deep marital unhappiness may lead one or both of a married couple to dull the edges of frustration by drinking regularly to excess or by whooping it up at parties in a relatively vain pursuit of excitement and fulfillment. I have known successful businessmen and professional men who, over the years, have each day consumed astonishing amounts of alcohol. Among these are persons who, sober or under considerable influence, remain reliable, pleasantly sociable, and quite themselves. In such cases it must be granted that the excessive drinking, whatever its value as an anodyne, usually constitutes a problem in itself. It is not uncommon to find persons who continue to make a successful adjustment in general, despite the fact that they drink considerably more than many psychopaths. The distinguishing point is that gross changes from a normal attitude and from normal behavior do not occur and a whole life plan is not demolished.

  There are people who may drink regularly to excess to enliven a career that has fallen into boredom or relative idleness but who find a level of intake at which they make an adjustment. Here the drinking is perhaps hit upon to kill time or as a substitute for the diversity and activity lacking in their daily routine. Although persons of this sort may lose control of the situation and become alcoholics in the clinical sense, many continue to maintain themselves without help. Drinking in such cases may be thought of as a handicapping factor but, since there are few responsibilities or vivid interests to demand full activity, the subject remains able to carry on his attenuated career.

  Specifically disturbed emotional and social relations may result not only in alcoholism as a distinct illness but also in excessive indulgence over years or decades without progressive loss of control. Persons with varying components of latent homosexuality often find a partial and disguised outlet for their impulses in frequent and injudicious alcoholic sessions with such groups. Mildly schizoid personalities shut off from close personal contacts and lacking in occupations or preoccupations may solitarily consume alcohol in excess but avoid any spectacular behavior attributable to drink.

  Other types who use alcohol as a partial anesthetic include such figures as O’Malley in Donn Byrne’s story,37 who closes his career as a broken man, wandering from tavern to tavern drinking steadily to excess. A brilliant, able, and charming person in his ordinary life, he submits to this transformation when life holds nothing more for him. His love object, whom he lost because of her being driven to an Anglican nunnery by religious or pseudoreligious manifestations, had come to play so important a part in his life that she could not be replaced. Without her it was a relief for him to avoid full awareness, which he did by drink. He is pictured as a man old before his time, shabby, aimless, slightly intoxicated nearly always, and looking forward to nothing particularly except perhaps death. This, too, is drinking unlike drinking to be happy. It is, however, far from the bellowing, vociferous episodes and the lyings-out of the psychopath. In O’Malley’s case the cau
se of his drinking is readily visible, and his choice of a means to an end is not without logic and purpose. There is no effort on O’Malley’s part to make himself objectionable to others or to create shocking and fantastic situations. He quietly becomes a drunkard to dull his sorrow and only seeks to be let alone.

  The psychopath, then, in my opinion, is something very much more than the ordinarily dissipated or profligate person, even though the latter happens to be extremely injudicious. An important mark of distinction is that the profligate is usually after what everyone can see is a kind of pleasure or is seeking simple relief from pain we can conceive, whereas the psychopath seldom drives at anything that looks very much like pleasure or necessary analgesia.

  Another type of behavior sometimes confused with the psychopath’s life pattern might be represented by the fairly common case of the married man, well established in business and fond of his children, who throws away his security and his respectable position to seek love with some trivial woman who cares nothing for him and on whom he soon throws away what he has. It might be said that such a man is rash or even foolish and some may call him depraved. But the appeal which drives him to his folly is one that most normal people have no difficulty in understanding. Love is well known for its power to make even sages give all, and some commitments between man and woman are all but impossible to explain. Such a man gives up all the fruits of his life to fulfill a definite erotic impulse. But the psychopath’s impulse is not the result of fatal infatuation, nor is it so well formulated and comprehensible as the desire of a man for a woman’s body.

  The wrecked career of the psychopath is sometimes used by reformers and prohibitionists who crusade against alcohol and vice in general as an example of what dissipation will do to those who essay the primrose path. Well-meant though such warnings may be, they are based on a premise of doubtful validity. What drives the psychopath on in his career is not in any ordinary sense the love of wine or song or women. Whiskey is sometimes one of his means to an end, and certainly it aids him in his spectacular exploits, but it is not a primary cause in his life scheme. Though many may come to grief in such pursuit, they are scarcely more likely to become psychopaths than they are to become schizophrenics.