Despite very unhappy marital relations she had scrupulously refrained from indulging in any sexual activity except with her husband until shortly after their divorce. Then, for reasons she could not explain, she found herself susceptible to almost any overture, and, in fact, made it all too plain that she was cheaply available. There occurred a series of unrewarding sexual relations with strangers who casually picked her up, with some salesmen who happened to appear at the door, and with acquaintances of long standing (some of whom she considered distinctly unattractive). After some months of this behavior she reoriented herself and has since then been leading her customary conventional life.
Temporary periods of distinctly delinquent behavior are apparently not uncommon even in careers on the whole successful and constructive. More protracted or habitual reactions of this sort result in disordered patterns that approach in varying degrees the pattern of the psychopath.
Confused manifestations of revolt or self-expression are, as everyone knows, more likely to produce unacceptable behavior during childhood and adolescence than in adult life. Sometimes persistent traits and tendencies of this sort and inadequate emotional responses indicate the picture of the psychopath early in his career. Sometimes, however, the child or the adolescent will for a while behave in a way that would seem scarcely possible to anyone but the true psychopath and later change, becoming a normal and useful member of society. Such cases put a serious responsibility on the psychiatrist.
A patient I once saw affords an excellent example. A 15-year-old high school boy, the son of respectable and God-fearing parents, attacked with considerable violence and apparently tried to rape a 9-year-old girl. When interviewed, he showed indifference, despite the fact that the girl’s father had threatened him with death and tried to seize him. He denied actual rape and spoke calmly of the whole affair as if it were a minor matter, such as, for instance, breaking a neighbor’s window. He later tried to excuse himself by inventing a palpably absurd story about being drugged with marijuana given him in the form of cigarettes by a Mephistophelian stranger. This boy’s parents were severely pious and strait-laced. Much of his teaching had apparently implied that a minor oath or any preoccupation with thoughts of sex should be regarded as soul-devouring. He seemed indeed much like a psychopath, but might his conduct not have been the result of an ordinary adolescent drive emerging in a mind relatively without restraining principles partly because of the very fact that absurd trifles had been so magnified by his teaching that he saw all prohibited things at a level of importance and had dismissed all as absurd because so many indeed were? In such a case I feel that the child should be given benefit of the doubt until evidence of a persistent pattern is thoroughly established.
A 16-year-old boy was sent to jail for stealing a valuable watch. Though apparently content and untouched by his situation, after a few questions were asked he began to seem more like a child who feels the unpleasantness of his position. He confessed that he had worried much about masturbation, saying he had been threatened and punished severely for it and told that it would cause him to become “insane.”
He also said no one liked him, that he talked and yelled too much, and that no one would play with him. While speaking of this he seemed to echo a real worry, to reenact a former attitude to a perplexity and trouble that he once felt. At the moment this boy seemed accessible and it was felt his problem might be understood, as many of the behavior problems of children and adolescents can be understood. In the next moment, however, hope faded, and it became apparent that the boy was not now taking seriously what he might once have taken seriously. I could not reach a level of any inward reality. There remained only the mimicry of feeling that, if it ever existed, had now vanished. Of course, it cannot be stated positively that there was no genuine feeling. It cannot be known that a schizophrenic who fails to turn his head when told of a tragedy fails to suffer. We often feel with strong conviction, however, that the schizophrenic does not appreciate such events in the ordinary sense and as people who are not schizophrenic appreciate them. With similar conviction I believe that this boy was no longer aware of serious conflict or suffering or humiliation either about masturbation, about his present status in jail, or about the almost unbelievable series of absurd, shameful, and fruitless acts that had occupied him for years, He was entirely rational in the ordinary sense and of average intellectual capacity.
He admitted having broken into his mother’s jewelry box and stolen a watch valued at $150.00. He calmly related that he exchanged the watch for 15 cents’ worth of ice cream and seemed entirely satisfied with what he had done. He readily admitted that his act was wrong, used the proper words to express his intention to cause no further trouble, and, when asked, said that he would like very much to get out of jail.
He stated that he loved his mother devotedly. “I just kiss her and kiss her ten or twelve times when she comes to see me!” he exclaimed with shallow zeal. These manifestations of affection were so artificial, and, one might even say, unconsciously artificial, that few laymen would be convinced that any significant feeling, in the ordinary sense, lay in them. Nor was his mother convinced.
A few weeks before this boy was sent to jail, he displayed to his mother some rifle cartridges. When asked what he wanted with them, he explained that they would fit the rifle in a nearby closet. “I’ve tried them,” he announced. And in a lively tone added, “Why, I could put them in the gun and shoot you. You would fall right over!” He laughed and his eyes shone with what seemed a small but real impulse.
This might be considered merely childish jest. A normal child might, of course, say such a thing, and in a normal child it would be merely a jest. I believe that this boy also spoke in jest, but I fear that he might carry out the jest, not with bitterness or hate in the ordinary sense but merely because the fancy struck him and because the death of his mother would mean so little to him that it cannot be counted in the ordinary terms of human emotion.
This boy’s history showed, over a period of several years, dozens of episodes similar to the present. His misdeeds were apparently without purpose. He gained nothing, took little or no precaution against detection, and seemed to be unmoved by punishment. He is mentioned here because I could not help but wonder if a few years earlier he perhaps did feel shame and insecurity and might have been amenable to teaching. It was difficult to say whether his behavior disorder would tend to improve or be substantially modified by ordinary treatment or whether this was an early stage of the psychopath’s career.
36. A Case Showing Circumscribed Behavior Disorder
When behavior disorder is circumscribed, in a child or in an adult, one may sometimes feel that symptomatically the patient resembles a psychopath but that a different sort of personality lies behind the manifestation. Instead of essential indifference to the pathologic situation, we sometimes see genuine zeal to avoid the faulty and self-damaging acts. It is not rare to find relatively normal attitudes to most aspects of life and sometimes healthy and admirable personality features.
In such patients, unlike psychopaths, it is more often possible to bring out valid responses and to learn about experiences and relations that have been influential over years and that may have played an important part in causing the poorly adapted behavior. Strong indications can sometimes be found that inner and poorly understood emotional confusions and conflicts are provoking repetitive rebellious and ineffective antisocial conduct. A brief discussion of one such patient may be germane:
This young woman in her middle twenties voluntarily sought help front an internist widely known for his interest in personality problems; he referred her for psychiatric treatment. Her spontaneous complaint was of sexual promiscuity which she feared would damage her socially. She expressed the opinion that, aside from what these doings might cause others to think of her, she herself deemed them wrong and highly undesirable.
A virgin until approximately two years earlier, she had since that time had full sexual relations with
over twenty different men. She denied any personal attachment or romantic attitudes toward these partners, to whom she had yielded casually, promptly, and apparently without conflict or indecision. She had obtained pleasant reactions from the physical contact and after the first few ventures began to respond regularly with genital orgasm. She had never entertained illusions to the effect that any of this considerable group of men were enamored of her and said she had no desire to bring out such feelings in them. Her appearance was distinctly attractive and her figure particularly well endowed with anatomic features likely to arouse and enhance erotic interest.
An articulate and apparently a candid girl, she showed little reluctance to discuss either her sexual adventures or any other material. In most respects she showed evidence of better than ordinary maturity and a considerable sophistication without affectedness. Her general intelligence was even better than might have been expected from her good record at college and subsequent success in her work.
In journalism she had made rapid progress as a writer of advertisements and of feature articles on the daily paper in one of the largest cities in her state. She did not, as many newspaperwomen do, write for the society columns or deal chiefly with material considered of special interest to women. She often discussed politics, scientific developments, and economic problems. Nothing in her appearance or manner, however, suggested masculine characteristics, tastes, or attitudes. She dressed in such a way as to make the most of her looks and had interests and hobbies predominantly feminine.
Although the excitement of physical relations seemed to have been genuine and full orgasm occurred and left her without the feeling that anything might be lacking, the experiences reported impressed the examiner, in some important respects, as relatively shallow. She gave as her reason or motive for doing what she regarded as wrong (and as unwise) a mounting sense of tension and a specific desire that she found too strong to resist. It seemed likely that she was really influenced by natural feelings of this sort but not to any unusual degree.
In fact, it was chiefly the matter of relieving a trivial or, at most, a rather moderate need than of being driven by intense passions or allured by breath-taking or exquisite possibilities of fulfillment.
Although she had made her charms fully available to so many men, she usually permitted only a single encounter of this sort. Shortly after the beginning of her promiscuity she had continued with one partner through three dates at intervals of several days, and a few months later she equaled this record with another man. Several other times she had repeated her adventure with the same partner through two sessions.
The rule for many months had, however, been one night with almost anybody but two with none. Considering her physical attributes and personal attractiveness, it is not surprising that those who had been so generously treated, often on the first date, wished to continue. She felt not only an aversion for this but also for seeing or having anything further to do with the partner. She realized that after such full and prompt compliance or cooperation at the beginning it would be difficult indeed to keep matters more or less platonic thereafter.
She was cognizant of the old analogy between getting the first olive out of a bottle and getting the first kiss and of its even greater applicability to what she had offered without even initial delay or any impediment whatsoever.
This did not, however, appear to be the chief factor in her breaking off relations. There was a primary loss of interest in the partner. No evidence emerged of an appreciable sense of shame on her part or of uneasiness about meeting unflattering attitudes and appraisals that might develop toward a girl who lets herself be taken so readily.
Nor did she worry about perhaps drawing out strong feelings in the partner, about his developing a binding attachment that might cause him distress. She was not, so far as she was aware, designing her conduct so as to enjoy the frustration or disappointment of all these men by cutting them off so abruptly from a quite lively pleasure they had reason to hope would remain available.
Completion of the sexual act was not followed by remorse or self-recrimination. Relieved and pleased, she had no wish for any sort of personal closeness or intimacy with her companion but, on the other hand, she did not feel strong revulsion. She had not sought personal intimacy in the beginning, and nothing happened, despite rather delightful somatic sensations, that gave incentives in this direction. After satisfaction occurred, she did not react with negative feelings toward sexuality or promiscuity as she might had there been strong conscious conflict between an intensely passionate yearning and the ordinary resistances to such conduct under such conditions. She evaluated her behavior as wrong, dangerous, and puzzling, but this evaluation was steady. Her attitude did not lead to a fierce struggle against the impulses toward such behavior, succumb temporarily to overpowering passions, and then arise to invoke shame and bitter regret.
She did not feel impelled by any special need for variety in changing her partners so promptly and in embracing so many, nor did she have the mistaken idea, so commonly encountered in problems of female promiscuity, that she was proving her charms and sex appeal by the fact that so many men had relations with her. She had been popular with men for a long time before her present habits began, and she realized better than most women that almost any female, even one of distinctly mediocre attractions, would not have trouble in getting seduced by practically any number of males alert for opportunities of free entertainment of this sort.
Though sometimes succumbing with almost unparalleled rapidity as soon as her date began his advances, she often pretended to be reluctant and made him go through a good many overtures, both verbally and with caresses, before cooperating.
She could not, however, recall having even once, since over a year previously, failed in full cooperation on the man’s initial attempt. Although not unresponsive sensually to kisses and caresses, it was not the heightening or prolongation of ecstatic pleasure that prompted her to hold out for a while and allow these preliminaries to run their course.
She expressed, in fact, a preference for “going on, getting to it, and getting it over with.” She distinctly enjoyed observing with skepticism a man’s efforts to pretend he might be taking her seriously, his tactics in going through rituals of deception so common and sometimes rather elaborate, which the predatory male uses to get his way with the ladies. She was not conscious, during early discussion of these matters, of any real hate or contempt but admitted it made her feel that by seeing through these hypocritical ruses and pseudoemotional maneuvers she was getting the better of the man in their encounter.
It had not occurred to her that this would be regarded by most as an almost fantastically inaccurate way of scoring in such a contest, since the adversary never failed to gain all his ends. She admitted awareness that men would be inclined to take her lightly, to say the least, on finding that she could be so casually induced to have intercourse, and by so many. She seemed to regret this and to show some concern about it, but hardly to do so in ordinary or adequate degree.
She admitted that the feeling of satisfaction and superiority she attained through her prompt recognition of the date’s concealed intentions and through inwardly mocking him in the steps he took to work the situation toward seduction while pretending other attitudes was distinctly pleasant to her and that she valued it highly.
The more this was discussed, the larger part she estimated it to have played in her motivations. She did not recognize any deeply derogatory attitude in this but found in it something more like the thrill of a game in which one enjoys outwitting and defeating, according to fair rules of the contest, an opponent who is not disliked or despised because of this. She did not feel tempted to show that she saw through the date’s pretenses by her manner and attitude, by so telling him, or by making him fail to achieve his obvious aims with her.
As about other matters, she entered frankly into the discussion of relations she had previously maintained with an older woman. The patient voluntarily
brought up this subject and did not seem to have had any intention to evade it.
Shortly after moving to the city where she now worked, she had met this woman, who immediately showed warm cordiality and treated her with attention that suggested both affection and admiration. This new friend, although almost fifteen years older than the patient, was youthful in appearance and in spirit, attractive to men, and extremely intelligent. She and her husband also were on the faculty of a local college. This woman, whose knowledge of literature, music, and of many other matters was considerable, seemed to the patient distinctly the most delightful and understanding person encountered in all her life.
A tremendous new interest was aroused in my patient, who found in fiction, poetry, psychological books, and in almost all the activities of life, meaning and delight she had never before discovered or deemed possible.
She felt uniquely understood and really cared for in a way that made everything she had regarded in the past as understanding and love seem perfunctory and trivial. For the first time she felt very close to someone and was thus able, for the first time, to realize that this had heretofore been missing.
The patient had been popular with both girls and boys and had never considered herself as lonely or isolated. Her friendship with other girls had, she now discovered, been relatively superficial. She realized more clearly also how little her popularity with boys had led to any personal intimacy or valuable shared understanding. She learned far more in a short time from this new friend than she had during all the years at college, and what she learned filled life with interest, humor, and all sorts of marvelous pleasures and goals.
She found confirmation of attitudes she had developed toward many of the conventional and uninspiring ideas, demands, limitations, and expectations she had encountered in her family. Achieving what she felt was new and real understanding which she could apply to conflicts and uncertainties that had troubled her as long as she could remember, she now felt secure, independent, and almost triumphantly eager for the future and its opportunities.
The Mask of Sanity Page 39