Monday, Mar. 31, 1941
Semi-Suicides
X came of a good family, fairly well-to-do. He had two older brothers, both successful and normal. In school, X showed himself fairly bright, but lost interest in his studies, took to playing hookey, running away from home. He seemed indifferent to reproaches and punishment. As he grew older, he started to drink--not with friends, but in low dives or, more frequently, alone in the woods and fields. His father got him a job in a store. For three days all went well. On the fourtli day X showed up glassy-eyed, leeringly insulted several customers, swept a shelf of goods to the floor and stomped out. When his father refused to give him money for liquor, he began cadging from family friends. One of his brothers died. X showed up at the funeral staggering drunk, vomited spectacularly in the church aisle.
In despair, his father put X in a mental hospital. He was diagnosed as a psychopathic personality, but found technically quite sane. So in a few weeks he was released, and instantly the series of wild and apparently aimless folly began again.
X never existed, but he might have. His career is a selection of typical incidents from 15 psychopathic case histories vividly presented in The Mask of Sanity (C. V. Mosby Co., St. Louis; $3) by Dr. Hervey Milton Cleckley, professor of neuropsychiatry at the University of Georgia School of Medicine. His case histories read like snatches of William Faulkner rewritten by a less talented hand.
The word "psychopathic" has been kicked around a good deal by the learned doctors. In The Mask of Sanity, Dr. Cleckley tried to show a class of psychopaths which differs clearly from neurotic alcoholics, psychoneurotics, criminal sex offenders, ordinary criminals, differs also from obvious psychotics or lunatics. The mark of his class is an apparently aimless search for disaster, a sort of continual social and spiritual suicide. These semi-suicides are often, but not always, heavy drinkers. But whereas the neurotic drinker --the classic alcoholic--drinks to avoid reality, to escape feelings of failure, humiliation or inferiority, the disaster-seeking psychopath drinks simply to get himself in trouble.
For this curious disorder, Dr. Cleckley has coined a fancy name: semantic dementia--meaning inability to grasp the ordinary meaning of life as lived by human beings. It is as though, behind the mask of sanity, the emotional mechanism had collapsed, leaving these semi-suicides incapable of love, joy, sorrow, aspiration, regret. When examined in hospitals, they are often alert, bright, cheerful, amiable, sometimes haughty and aloof; but they usually think very highly of themselves, are always wholly callous to the distress they cause others. To the knowing psychiatrist, their eloquent admissions of error and promises to reform are catchwords which have no meaning to the patient but which he has learned will impress others.
Whereas people with other types of mental disorder try to sink to an infantile level, or to an animal or vegetative level, the semantic dementia cases try to find utter disintegration, nonlife. But, not recognizing their deep urge to self-destruction, they practically never commit forthright suicide.
Dr. Cleckley, who has observed hundreds of cases himself, believes the number of semantic psychopaths in the U. S. must nearly equal the number of obvious lunatics (more than 500,000). What to do about them? Dr. Cleckley recommends that they be confined in special hospitals of their own. But he is not very hopeful about curing them.
Some of Dr. Cleckley's case histories show people who have only partly developed semantic dementia, who are able to keep out of serious trouble and even succeed in a profession--one a doctor, another a psychiatrist.
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