Psychopath

THE MASK OF SANITY

Section 2: The Material

Part 1: The disorder in full clinical manifestations

18. Gregory

 

 

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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.

About a month before the fire-setting episodes Gregory was expelled from

school for "stealing and destructiveness." Several months before this he had been in the

juvenile court and confined in the detention center for setting fires, stealing, and for

wandering off from home and staying away sometimes for several days without any

word to his parents. These early acts of fire-setting gave some of the doctors who

examined Gregory at this time the impression that he might be suffering from a

circumscribed form of character disorder or a compulsive disorder, perhaps from the

condition sometimes called pyromania. Such a disorder would drive the patient

specifically to set fires and burn down buildings. His subsequent history does not

confirm this interpretation. Though Gregory continued to carry out various destructive

and antisocial activities, he did not, so far as we can determine, ever set another building

on fire. On the other hand his exploits grew even more versatile.

From Gregory's medical history a few items recorded during this period

168 THE MASK OF SANITY

by parents, doctors, social workers, friends of the family, and relatives

seem worthy of our attention:

During last year caught robbing parking meters…. His sisters say "he's a perfect

gentleman at home." … Now in detention center. … Often stayed away from home for

days. … Recently stole money on several occasions, also a bicycle. … Any remorse shown

by this boy is staged. … Tells lies freely and convincingly…. Seems to have no

understanding of the meaning of his deeds. … Inveterate stealing. … Superficial

expressions of affection to mother but these apparently have little reality. … Mother says

patient was a problem since he began to walk. … Seemed sweet and loving. … Roamed

off. … Now stays away for days at a time. … Mother drives about for hours searching for

him. … Shows no real remorse. … I wish to add that he seems to hurt those who extend

themselves to help him. … I have had to learn to beware of Gregory when he has

brought me gifts.

Unlike some of the other patients we have discussed whose gross maladjustment

was first noticed as alarming during adolescence Gregory presented many problems

even in the very early years of his life. His parents report that he was extremely

uncooperative in toilet training and that soon after he learned to walk adequately,

serious difficulties arose through his "roaming and wandering away." In order to curb

this tendency and his destructiveness he was, on the advice of his pediatrician, a few

times tied to his bed. He circumvented this effort to control him by pleading a need to

go to the bathroom, where he got possession of his father's razor, concealed it, and used

it to cut the restraints when they were reapplied. The account given by his family

includes these items:

At a very early age he dragged a gun into the room in an apparent attempt to shoot me

[his mother] … He pulled the trigger but luckily the bullet didn't get into the firing

chamber. My God, if he had done that he would have had it to live down all his life.

…Hour after hour we would try to discipline him but it was no use. … The boy would

always succeed in getting another chance. … But he has always been so lovable…. He

would set up an atmosphere of peace and goodness and then sneak off… If caught, he

would be appropriately very, very sorry and then everybody would offer him forgiveness

and another chance. … After he began school he kept roaming off and was often gone for

several hours or several days…. He would steal money, buy candy with it, and give the

candy away.

One of the physicians who treated Gregory prior to his adolescence felt that a

hyperkinesic disorder might be playing an important part in his trouble and that he

would probably settle down when 14 or 15 years old and make a normal adjustment.

Another physician felt that his basic disorder

THE MATERIAL 169

might be thalamic epilepsy, chiefly on the basis of an electroencephalogram report

that now in retrospect does not seem definitely indicative (if this or of any other

organic disorder.

A psychoanalytically oriented psychiatrist who worked very hard and long with

Gregory felt convinced that "he does not have a basic psychopathic structure" and that

"his so-called delinquent acts," were related to emotional trauma in very early life. From

the psychiatrist's report let us note these opinions:

He should be seen at this office at least three times a week for psychotherapy and

should also be seen at the _____ Foster Home by a parole officer or counselor four or

five times a day at regular and spaced hours. I do not feel that there is any danger in

releasing this boy from the detention center to the community provided we, step by step,

give him increasing degrees of freedom.

This psychiatrist succeeded in getting Gregory released from the detention center

where he had been placed for repeatedly robbing parking meters and for persistent

truancy. The therapist repeatedly expressed strong confidence that the boy would

respond to treatment and become satisfactorily adjusted. His sponsorship of Gregory

led the school from which he had been expelled to take him back again for another

chance.

In addition to giving prolonged and concentrated psychotherapy, this psychiatrist

took great pains in trying to modify various environment factors. His efforts along this

line included having Gregory come as a guest into his own home to mingle there with

his own children. Gregory at this stage of his life, and also later, could at times give a

remarkably convincing impression of having changed profoundly and of having gained

crucial insight. It is, perhaps, not remarkable that his psychiatrist kept renewing his

hopes of success. He seems truly to have gone beyond the ordinary call of medical duty

in his almost heroic efforts to rehabilitate Gregory. Despite these efforts and those of

many other psychiatrists, psychologists, social workers, teachers, clergymen, and others,

Gregory continued in his destructive, irresponsible, and antisocial patterns of behavior.

When I next saw Gregory almost ten years ago (1965) he was 25 years old. He

had been sent from prison by the court for additional psychiatric study and for advice

about what steps should be taken next. The judge apparently shared some of my

bewilderment about this man's career and about what might be done to prevent, or to

minimize, a persistent repetition of what had for so long been going on.

This time Gregory had stolen a police squad car, driven about in it for a while,

with no particular end in view, and, carelessly, run it into a ditch, causing some damage.

In view of his many unpleasant encounters with

170 THE MASK OF SANITY

the police through arrest and his many attempts to escape from them, it seems strange,

indeed, that he should choose this particular automobile to steal, and that he would steal

it through a mere impulse to ride around and while away the time.

In addition to this latest felony the records show that Gregory's maladjustment

and his antisocial activities had continued unabated over the years. Perhaps it is

worthwhile to note a few additional items from his more recent medical records:

when he's almost 25 it still goes on... Stealing cars. … Always makes a good impression

and people trust him but he always betrays the trust... Has been sent to state hospital

many times... Usually they won't keep him but a few weeks... Once state hospital kept

him almost a year... According to Mother, doctors at state hospital say that he is normal,

"nothing wrong with him." … Once he seemed to be doing well for three or four months

but then old troubles began again... Stole sister's auto and impersonated a naval officer...

Gets in fights from time to time... Drinks sometimes but apparently liquor plays little part

in his behavior... Sometimes, when arrested, claims that liquor is responsible (not himself)

and that the man who sold him liquor should be punished, not himself... Cruelly mistreats

younger brother (now 14 years old).

It is remarkable indeed how often this man has been released by prisons and by

psychiatric institutions and gone free to continue in a self-destructive and criminal

career. At times he has worked regularly and apparently adapted himself to the

demands of normal life for several weeks and occasionally for several months. A few

years before I last saw Gregory in connection with his stealing the police car he eloped

from the state hospital where he had been sent as an alternative to prison. He went to

Atlanta where he impressed a stranger so favorably that he was given a job in this man's

filling station. Soon the man and also his wife and children were so charmed by

Gregory and so impressed by his account of his misfortunes that they took him in to

live with them and would not accept any pay for board and lodgings. He worked

regularly at this job and apparently kept out of trouble for several months. Everyone

considered him a trustworthy and delightful person and felt strong inclinations to help

him in any way possible. This episode of Gregory's career was terminated when he stole

several hundred dollars from his benefactors and disappeared. Valuable pieces of the

family silver were also missing. After squandering the money on a lavish weekend in

Miami, he apparently settled down to work in a small Florida town and kept out of

trouble for four or five weeks. Neither

THE MATERIAL 171

his family nor the people in Atlanta who had befriended him knew where he was or

whether he was living or dead, until news came out of his being arrested again in

Florida.

This man has several times made suicidal gestures by lightly cutting the skin at his

wrists. These cuts or scratches were always done with caution and with due concern for

his safety. Such acts were carried out, apparently, to gain some material end, to insure

that he be sent to a psychiatric hospital as mentally ill instead of to prison, or to evade

some other unpleasant consequence.

Once when pursued by the police he climbed on the high catwalk of a bridge

over a tidal river and threatened, if pursuit continued, to throw himself down from a

height of over two hundred feet to a dramatic death. This proved to be an empty

threat.

When the patient was in the hospital in 1965 he described this episode for me

eloquently and in lavish detail. He claimed, however, that he was considering suicide

because of a girl he dearly loved. He spoke of himself as adoring and cherishing this girl

so much that he felt he should kill himself because he had once taken advantage of her

love for him to have sexual relations with her. According to Gregory, in this

spectacularly pious and puritanical vein, he had, in a way, desecrated her according to

the high standards of his spiritual affinity. So, though eager to marry her, he felt he

should heroically redeem himself by death. He represented himself as still engaged to

this girl, as loving her beyond measure, and as looking forward with vivid anticipation to

their marriage.

Within a day or two of this discussion of his romantic love and deathless

devotion he took up with a female patient in the hospital and tried to persuade her to

marry him. He also tried to seduce her despite the close supervision and restrictions of

the hospital. With the appearance of great seriousness, he told me about the very

special feeling he had developed for this new woman and how she had brought him

tremendous, deep insight and a sort of spiritual redemption that would enable him to

avoid all trouble in the future. He said that he now hoped to get parole and move to

Augusta where he could marry this recently encountered girl and work regularly to

support her and take care of her every need. A few days later he expressed quite

different ideas and seemed to have lost all interest in the matrimonial plans so recently

made with the female patient.

Gregory has shown attention to a number of women and, so far as can be

learned, has probably had sexual relations with a good many of them. There is no

indication that he ever developed any personal attachment to any of them, despite many

claims of high and chivalric love, such as those mentioned above.

172 THE MASK OF SANITY

During this last time in the hospital under my care, I was particularly impressed

by several points about his attitude that made me wonder again about the psychopath's

specific lack of insight.

He repeatedly emphasized the point that he needed help and had turned to us at

the hospital to join him in his effort to get to the bottom of his trouble and straighten

himself out. His repetition of this plea about how much he needed help brought a

comment from one of the attendants in the hospital to whom he had repeatedly boasted

of the many clever deeds by which he had gained his own ends illegally.

The attendant said, "He keeps talking about how he needs help but I don't think

he needed all that help to do the things that brought him here."

Gregory had never sought psychiatric help except when it seemed that it might

facilitate his escaping prison, enable him to avoid some other penalty, or to achieve

some selfishly desired aim.

During our interviews Gregory repeatedly expressed the strong conviction that it

would be shockingly inappropriate for him to be sent to the state prison and forced to

serve his term there.

"Why, that place is full of criminals, people hardened in crime," he said, as if in a

spectacular unawareness that he, himself, had committed more crimes than most of the

inmates now held there. "That's not the proper place for me. … No telling what might

happen to me there among people of that sort."

His repeated and emphatic statements about how he needed help and how

earnestly he sought this help seemed ever more plainly to indicate that he called out for

psychiatric intervention only because he looked on it as something to keep him out of

the state prison. Over and over during various discussions he returned to the subject of

the state prison and emphasized with great conviction, "That's certainly not the right

place for me."

Gregory's utter lack of understanding (or should one say his refusal to recognize?)

why it might be considered just and appropriate for him to go to the state prison for

committing crimes similar to those committed by others confined there well illustrates a

major point that I think often distinguishes the psychopath from other people who

carry out criminal acts. Other criminals do not, of course, want to go to prison, and

often protest against it. But they do not seem to have this strange conviction that they

are, or should be, somehow exempt from prisons that were made to control people who

commit the very crimes of which they themselves have been convicted.

Recently I saw a 19-year-old boy who had served time at several youth detention

centers and later at a typical penal institution. He had been convicted again of a major

offense and there was every reason to believe that

THE MATERIAL 173

he was due to go back to the prison. Blandly and confidently, he expressed the

conviction that he should instead be paroled and allowed to go back to college and get a

degree. When the question of his being sent back to prison was raised he scornfully

dismissed the idea in these words:

"Why that wouldn't do any good. I've already been there and you see what

happened later. Anybody ought to realize that's not the place for me. It wouldn't help a

bit."

I am not likely soon to forget the all but sublime insouciance with which this

young man bypassed all considerations of personal responsibility for having continued

in crime after serving time in prison. The only fault that he seemed to feel really

deserved critical appraisal was that the institution had failed to keep him from carrying

out his own deliberate felonies after he was released from its control. Though he did

not actually suggest that legal action be taken against the penal institution or the court

that had sent him to it, he seemed to feel vindicated in a strange way, to feel that the

blame or shortcoming had all been satisfactorily allocated to other people or to

institutions that had unreasonably interfered with his natural rights.

This 19-year-old boy seen such a short time ago seemed to echo Gregory,

himself, perfectly in this respect, to reflect Gregory's precise attitude and the attitude of

other psychopaths who have impressed me as showing this astonishing and specific lack

of insight.

Gregory, according to my last news of him, has continued in the old familiar

patterns. Perhaps the repeated evasion of ordinary penalties through commitment to

psychiatric hospitals or through intervention by his family contributed to the

assumption in Gregory, and in so many others like him, that he deserves an immunity or

a relative immunity from the law. I think, however, that the roots of this attitude lie

deeper, probably in the core of the psychopath's essential abnormality - perhaps in a

lack of emotional components essential to real understanding.

In my report to the psychiatrist through whom the court referred Gregory to me

I find these conclusions:

hundreds of pages. His repeated antisocial acts and the triviality of his apparent motivation as

well as his inability to learn by experience to make a better adjustment and avoid serious

trouble that can be readily foreseen, all make me feel that he is a classic example of

psychopathic personality. I think it very likely that he will continue to behave as he has

behaved in the past, and I do not know of any psychiatric treatment that is likely to influence

this behavior appreciably or to help him make a better adjustment.

Gregory, like all psychopaths whom I have seen, apparently knows in a verbal sense the

distinctions between right and wrong, and he can

174 THE MASK OF SANITY

express convincingly good intention for the future and formulate excellent plans for a wise,

happy, and socially acceptable life. I do not, however, believe that this indicates at all that he

will follow such plans and alter his past pattern of maladjustment.

As you know, I am very much interested in patients of this sort and feel that they are the

least understood of all psychiatric patients. I also feet that unlike other psychiatric patients

there is no specific provision made by society for handling them adequately or dealing logically

with the problems they create.

I appreciate so very much your letting me see him and am sorry I cannot be more hopeful

about his prognosis.

 

Next: Section 2: The Material , Part 1: The disorder in full clinical manifestations, 19. Stanley

 

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Section 2, Part 1

 

 

 

 

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