The Mask of Sanity, by Hervey M. Cleckley, M.D., was the first book to systematically describe the psychopathic personality disorder. It was initially published in 1941, and revised four times over the next 35 years. In 1988, Cleckley’s heir, Emily S. Cleckley, made the book available for non-profit educational use. You can download a PDF for free here:
About half of The Mask of Sanity describes case studies of individuals who were dragged into psychiatric hospitals by their confused and distraught families. Cleckley, who was a clinical professor of psychiatry at the Medical College of Georgia, relates these stories with a mix of old-fashioned propriety and understated, entertaining detail.
The first case study profiles “Max,” who had been convicted of passing bad checks, but preferred a psychiatric hospital — where he’d been committed several times — to jail. Max had married multiple times. His second wife was proprietress of the local brothel, where he had a habit of disrupting business. Cleckley wrote:
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 well might 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.
Max’s unbelievable story continues, followed by 14 more case studies of “the disorder in full clinical manifestations,” including two about women. These people wandered off aimlessly, stole from their families and gave the items to casual acquaintances, committed crimes for no particular reason, engaged in indiscriminate sex and convincingly lied that they didn’t do any of it. “Many of them are plainly unsuited for life in any community,” Cleckley wrote.
Cleckley also included case studies of “incomplete manifestations or suggestions of the disorder” — people who did seem to function in the community, until they didn’t. One man ran his business effectively — except when he got rip-roaring drunk, partying with “vagrants” and “harlots.” Another man made a career of finding women — especially older women — to care for him.
Cleckley noted “the astonishing power that nearly all psychopaths and part-psychopaths have to win and to bind forever the devotion of a woman.” He observed:
The more intimately a large number of such people are studied, the stronger becomes the impression that it is chiefly woman’s impulse to mother that they arouse. Feminine intuition senses that here, concealed beneath an appearance of maturity, is a baby or something very much like a helpless, crying little baby. Her deep instincts to nurse and protect this winsome little darling are unconsciously called out. The superficial relationship of woman to her lover conceals this fundamental urge. She longs to take this defenseless creature, hold him to her breast, guard him, shape him, and let him grow up under her protection. Her feminine intuition, which so accurately divines the presence of the spiritual baby, fails, alas, to understand that it is a baby who will never grow up.
Traits of a psychopath
In the third section of the book, Cleckley outlines what he sees as the traits of a psychopath:
- Superficial charm and good “intelligence”
- Absence of delusions and other signs of irrational thinking
- Absence of “nervousness” or psychoneurotic manifestations
- Untruthfulness and insincerity
- Lack of remorse or shame
- Inadequately motivated antisocial behavior
- Poor judgment and failure to learn by experience
- Pathologic egocentricity and incapacity for love
- General poverty in major affective reactions
- Specific loss of insight
- Unresponsiveness in general interpersonal relations
- Fantastic and uninviting behavior with drink and sometimes without
- Suicide rarely carried out
- Sex life impersonal, trivial, poorly integrated
- Failure to follow any life plan
One theme running throughout The Mask of Sanity is the pointlessness of the psychopath’s deviant behavior. For example, when explaining “inadequately motivated antisocial behavior,” he writes:
Not only is the psychopath undependable, but also in more active ways he cheats, deserts, annoys, brawls, fails, and lies without any apparent compunction. He will commit theft, forgery, adultery, fraud, and other deeds for astonishingly small stakes and under much greater risks of being discovered than will the ordinary scoundrel. He will, in fact, commit such deeds in the absence of any apparent goal at all.
What can be done?
Cleckly never offers a concise definition of psychopathy. The closest he comes is in the preface to the fifth edition of the book, where he writes:
It is not easy to convey this concept, that of a biologic organism outwardly intact, showing excellent peripheral function, but centrally deficient or disabled in such a way that abilities, excellent at the only levels were we can formally test them, cannot be utilized consistently for sane purposes or prevented from regularly working toward self-destructive or other seriously pathologic results.
At the end of The Mask of Sanity, Cleckley asks, “What can be done?” That question remains unanswered. He admits that own efforts to help psychopaths change their behavior failed. He observed other professionals, using multiple therapeutic approaches — they also failed.
In the end, Cleckley had little hope that psychopaths could be rehabilitated. But he was grateful that The Mask of Sanity at least drew attention to what he considered to be a massive problem in our society — psychopaths and the damage that they cause.
Download the PDF for free here: