Milt arrived home apparently well pleased with himself. He admitted that he was sorry to leave college, for which he had voluntarily expressed a desire and to which he had never objected. He quickly placed all the blame for his expulsion on others and seemed to feel that nothing more should be said of it. What explanation he gave his parents centered about points of honor and principles which he let them know it was not modest or quite proper to speak of frankly and fully. He meant to promote the belief that he had, out of respect to the stoic traditions of honor in the school, sacrificed himself to protect another. There was not the slightest thread of truth in the skein of lies and false implications he built up about this, but it very naturally appealed to his parents.
Examination at the hospital showed a splendid figure of a young man slightly over 6 feet tall, weighing 180 pounds, and free from any sign of physical illness. Milt was neatly and becomingly dressed, distinguished in manner, alert, and intelligent. Although his politeness was unfailing, it was plain that he thought the psychiatric examination a bore. He confessed that he held it as nothing short of ridiculous for his parents to consider that there was any possibility of his having a personality disorder. He showed no interest in efforts to approach whatever emotional factors might lie behind his maladjustment and apparently was incapable of realizing that he had shown signs of maladjustment. His technical reasoning powers were excellent.
All the information about his past was discussed. Milt made many ingenious excuses, and if too much undeniable evidence was presented for him to persist in them, he dismissed the point. He would, in response to leading questions, state at times that phases of his situation seemed serious, but it was plain that he was not moved. No evidence of any substantial affective relation with his family, with girls, or with friends could be elicited. In discussing his expulsion from college, he maintained that he had been a victim of the military code of honor, allowing himself to be sacrificed instead of denying the report of the other cadets, which he calmly maintained was a falsehood, “It had to be me or those boys. They were seniors, and it would have been harder on them than on me to be sent down.”
A few days before entering the hospital he had been arrested for speeding after taking the family car without permission. He was given a summons but neglected to appear at court the next morning. The police found him and brought him to the barracks, where he telephoned his parents and indignantly demanded that they come at once and have him released. Hoping that the night in jail might be helpful, they refused to do so, carefully explaining their reasons. On being released, he showed plainly that he felt he had been seriously misused but condescendingly offered a cool forgiveness. Milt had no excuse for not answering his summons except to say that he had overslept. He had, however, been on the streets for several hours when the police arrested him at about noon.
This patient showed no sign at all of an ordinary psychosis. He was self-possessed, shrewd, and entirely calm except for a superficially polite impatience to be gone from the hospital.
Milt was told frankly that everything indicated a serious condition and one that demanded his attention and his major efforts. He was bored with all efforts to approach him but agreed to undertake a detailed plan that was worked out. It was plain that he had no idea of doing so. On leaving the hospital, he continued exactly as he had been doing before.
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 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 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 psychi
atrist’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 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:
Whenever he’d get a job he’d steal or just quit … All this began early in life and now 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 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.
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 h
ere.”
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.
The Mask of Sanity Page 25