Psychopath

 

Superficial charm and good

"intelligence"

 

More often than not, the typical psychopath will seem particularly agreeable and make a distinctly positive impression when he is first encountered.  Alert and friendly in his attitude, he is easy to talk with and seems to have a good many genuine interests.  There is nothing at all odd or queer about him, and in every respect he tends to embody the concept of a well-adjusted, happy person.  Nor does he, on the other hand, seem to be artificially exerting himself like one who is covering up or who wants to sell you a bill of goods.  He would seldom be confused with the professional backslapper or someone who is trying to ingratiate himself for a concealed purpose.  Signs of affectation or excessive affability are not characteristic.  He looks like the real thing.

Very often indications of good sense and sound reasoning will emerge and one is likely to feel soon after meeting him that this normal and pleasant person is also one with high abilities….  …Although the psychopath's inner emotional deviations and deficiencies may be comparable with the inner status of the masked schizophrenic, he outwardly shows nothing brittle or strange.  Everything about him is likely to suggest desirable and superior human qualities, a robust mental health.

 

Absence of delusions and other signs

of irrational thinking

 

The so-called psychopath is ordinarily free from signs or symptoms traditionally regarded as evidence of a psychosis.  He does not hear voices.  Genuine delusions cannot be demonstrated.  There is no valid depression, consistent pathologic elevation of mood, or irresistible pressure of activity.  Outer perceptual reality is accurately recognized; social values and generally accredited personal standards are accepted verbally.  Excellent logical reasoning is maintained and, in theory, the patient can foresee the consequences of injudicious or antisocial acts, outline acceptable or admirable plans of life, and ably criticize in words his former mistakes.  The results of direct psychiatric examination disclose nothing pathologic - nothing that would indicate incompetency or that would arouse suspicion that such a man could not lead a successful and happy life.

Not only is the psychopath rational and his thinking free of delusions, but he also appears to react with normal emotions.  His ambitions are discussed with what appears to be healthy enthusiasm.  His convictions impress even the skeptical observer as firm and binding.  He seems to respond with adequate feelings to another's interest in him and, as he discusses his wife, his children, or his parents, he is likely to be judged a man of warm human responses, capable of full devotion and loyalty.

 

Absence of "nervousness" or

psychoneurotic manifestations

 

There are usually no symptoms to suggest a psychoneurosis in the clinical sense.  In fact, the psychopath is nearly always free from minor reactions popularly regarded as "neurotic" or as constituting "nervousness."  The chief criteria whereby such diagnoses as hysteria, obsessive-compulsive disorder, anxiety state, or "neurasthenia" might be made do not apply to him.  It is highly typical for him not only to escape the abnormal anxiety and tension fundamentally characteristic of this whole diagnostic group but also to show a relative immunity from such anxiety and worry as might be judged normal or appropriate in disturbing situations.  Regularly we find in him extraordinary poise rather than jitteriness or worry, a smooth sense of physical well-being instead of uneasy preoccupation with bodily functions.  Even under concrete circumstances that would for the ordinary person cause embarrassment, confusion, acute insecurity, or visible agitation, his relative serenity is likely to be noteworthy

It is true he may become vexed and restless when held in jails or psychiatric hospitals.  This impatience seems related to his inability to realize the need or justification for his being restrained.  What tension or uneasiness of this sort he may show seems provoked entirely by external circumstances, never by feelings of guilt, remorse, or intrapersonal insecurity.  Within himself he appears almost as incapable of anxiety as of profound remorse.

 

Unreliability

 

Though the psychopath is likely to give an early impression of being a thoroughly reliable person, it will soon be found that on many occasions he shows no sense of responsibility whatsoever.  No matter how binding the obligation, how urgent the circumstances, or how important the matter, this holds true.  Furthermore, the question of whether or not he is to be confronted with his failure or his disloyalty and called to account for it appears to have little effect on his attitude.

They may apply their excellent abilities in business or in study for a week, for months, or even for a year or more and thereby gain potential security, win a scholarship, be acclaimed top salesman or elected president of a social club or perhaps of a school honor society.  Not all checks given by psychopaths bounce; not all promises are uniformly ignored.  They do not necessarily land in jail every day (or every month) or seek to cheat someone else during every transaction.  If so, it would be much simpler to deal with them.  This transiently (but often convincingly) demonstrated ability to succeed in business and in all objective affairs makes failures more disturbing to those about them.

Furthermore, it cannot be predicted how long effective and socially acceptable conduct will prevail or precisely when (or in what manner) dishonest, outlandish, or disastrously irresponsible acts or failures to act will occur.  These seem to have little or no relation to objective stress, to cyclic periods, or to major alterations of mood or outlook…The psychopath's unreliability and his disregard for obligations and for consequences are manifested in both trivial and serious matters, are masked by demonstrations of conforming behavior, and cannot be accounted for by ordinary motives or incentives.  Although it can be confidently predicted that his failures and disloyalties will continue, it is impossible to time them and to take satisfactory precautions against their effect.  Here, it might be said, is not even a consistency in inconsistency but an inconsistency in inconsistency.

 

Untruthfulness and insincerity

 

The psychopath shows a remarkable disregard for truth and is to be trusted no more in his accounts of the past than in his promises for the future or his statement of present intentions.  He gives the impression that he is incapable of ever attaining realistic comprehension of an attitude in other people which causes them to value truth and cherish truthfulness in themselves.

Typically he is at ease and unpretentious in making a serious promise or in (falsely) exculpating himself from accusations, whether grave or trivial.  His simplest statement in such matters carries special powers of conviction.  Overemphasis, obvious glibness, and other traditional signs of the clever liar do not usually show in his words or in his manner.  Whether there is reasonable chance for him to get away with the fraud or whether certain and easily foreseen detection is at hand, he is apparently unperturbed and does the same impressive job.  Candor and trustworthiness seem implicit in him at such times.  During the most solemn perjuries he has no difficulty at all in looking anyone tranquilly in the eyes.  Although he will lie about any matter, under any circumstances, and often for no good reason, he may, on the contrary, sometimes own up to his errors (usually when detection is certain) and appear to be facing the consequences with singular honesty, fortitude, and manliness.

It is indeed difficult to express how thoroughly straightforward some typical psychopaths can appear. 

 

Lack of remorse or shame

 

The psychopath apparently cannot accept substantial blame for the various misfortunes which befall him and which he brings down upon others, usually he denies emphatically all responsibility and directly accuses others as responsible, but often he will go through an idle ritual of saying that much of his trouble is his own fault.  When the latter course is adopted, subsequent events indicate that it is empty of sincerity-a hollow and casual form as little felt as the literal implications of "your humble and obedient servant" are actually felt by a person who closes a letter with such a phrase.  Although his behavior shows reactions of this sort to be perfunctory, this is seldom apparent in his manner.  This is exceedingly deceptive and is very likely to promote confidence and deep trust.  More detailed questioning about just what he blames himself for and why may show that a serious attitude is not only absent but altogether inconceivable to him.  If this fails, his own actions will soon clarify the issue.

Whether judged in the light of his conduct, of his attitude, or of material elicited in psychiatric examination, he shows almost no sense of shame.  His career is always full of exploits, any one of which would wither even the more callous representatives of the ordinary man.  Yet he does not, despite his able protestations, show the slightest evidence of major humiliation or regret.  This is true of matters pertaining to his personal and selfish pride and to esthetic standards that he avows as well as to moral or humanitarian matters.  If Santayana is correct in saying that "perhaps the true dignity of man is his ability to despise himself," the psychopath is without a means to acquire true dignity.

 

Inadequately motivated antisocial

behavior

 

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.

Yet we do not find the regularity and specificity in his behavior that is apparent in what is often called compulsive stealing or other socially destructive actions carried out under extraordinary pressures which the subject, in varying degrees, struggles against.  Such activities, and all disorder distinguished by some as impulse neurosis,14 as we have mentioned, probably have important features in common with the psychopath's disorder.  In contrast, his antisocial and self-defeating deeds are not circumscribed (as, for example, in pyromania and kleptomania), and he shows little or no evidence of the conscious conflict or the subsequent regret that are not regularly absent in these other manifestations.  Again the comparison of a circumscribed dissociation typical of hysteria with the general ego disintegration of schizophrenia may be usefully cited.

Objective stimuli (value of the object, specific conscious need) are, as in compulsive (or impulsive) stealing, inadequate to account for the psychopath's acts.  Evidence of any vividly felt urge symbolizing a disguised but specifically channelized, instinctive drive is not readily available in the psychopath's wide range of inappropriate and self-defeating behavior.

 

Poor judgment and failure

to learn by experience

 

Despite his excellent rational powers, the psychopath continues to show the most execrable judgment about attaining what one might presume to be his ends.  He throws away excellent opportunities to make money, to achieve a rapprochement with his wife, to be dismissed from the hospital, or to gain other ends that he has sometimes spent considerable effort toward gaining.  It might be said that he cares little about financial success and little about regaining his wife, but it is difficult indeed to say that he is not extremely fain to get out of the psychiatric hospital where he has been locked up for months with other patients whom he regards as "lunatics" and who are, indeed, not desirable associates for the average man or for him.  Be it noted again that the psychopath appears as unwilling to remain in a psychiatric hospital and as impatient to regain his freedom as would be the normal man.  I have not in these patients ever found reliable evidence that unconsciously they seek and enjoy as punishment such confinement.

This exercise of execrable judgment is not particularly modified by experience, however chastening his experiences may be.  Few more impressive examples of this could be offered from the records of humanity than the familiar one of the psychopath who, in full possession of his rational faculties, has gone through the almost indescribably distasteful confinement of many months with delusional and disturbed psychotic patients and, after fretting and counting the days until the time of his release, proceeds at once to get drunk and create disorder which he thoroughly understands will cause him to be returned without delay to the detested wards.  It is my opinion that no punishment is likely to make the psychopath change his ways.  Punishment is not, of course, regarded as an appropriate measure in medical treatment.  It is, however, often considered and administered by legal authorities.  And it must be remembered that at present the law deals with these patients more frequently than physicians deal with them.

Despite the extraordinarily poor judgment demonstrated in behavior, in the actual living of his life, the psychopath characteristically demonstrates unimpaired (sometimes excellent) judgment in appraising theoretical situations.  In complex matters of judgment involving ethical, emotional, and other evaluational factors, in contrast with matters requiring only (or chiefly) intellectual reasoning ability, he also shows no evidence of a defect.  So long as the test is verbal or otherwise abstract, so long as he is not a direct participant, he shows that he knows his way about.  He can offer wise decisions not only for others in life situations but also for himself so long as he is asked what he would do (or should do, or is going to do).  When the test of action comes to him we soon find ample evidence of his deficiency.

 

Pathologic egocentricity and

incapacity for love

 

The psychopath is always distinguished by egocentricity.  This is usually of a degree not seen in ordinary people and often is little short of astonishing.  How obviously this quality will be expressed in vanity or self-esteem will vary with the shrewdness of the subject and with his other complexities.  Deeper probing will always reveal a self-centeredness that is apparently unmodifiable and all but complete.  This can perhaps be best expressed by stating that it is an incapacity for object love and that this incapacity (in my experience with well-marked psychopaths) appears to be absolute.

Terms in use for what we experience as "emotion" contain much ambiguity, and their referential accuracy is limited.  This contributes to confusion and paradox which are difficult to avoid in attempts to convey concepts about such a matter.

In a sense, it is absurd to maintain that the psychopath's incapacity for object love is absolute, that is, to say he is capable of affection for another ill literally no degree.  He is plainly capable of casual fondness, of likes and dislikes, and of reactions that, one might say, cause others to matter to him.  These affective reactions are, however, always strictly limited in degree.  In durability they also vary greatly from what is normal in mankind.  The term absolute is, I believe, appropriate if we apply it to any affective attitude strong and meaningful enough to be called love, that is, anything that prevails in sufficient degree and over sufficient periods to exert a major influence on behavior.

True enough, psychopaths are sometimes skillful in pretending a love for women or simulating parental devotion to their children.  What part of this is not pure (and perhaps in an important sense unconscious) simulation has always impressed this observer as that other type of pseudo-love sometimes seen in very self-centered people who are not psychopaths, which consists in concern for the other person only (or primarily) insofar as he enhances or seems to enhance the self.  Even this latter imitation of adult affectivity has been seldom seen in the full-blown psychopath, although it is seen frequently in those called here partial psychopaths.  In non-psychopaths a familiar example is that of the parent who lavishes money and attention on a child chiefly to bask in the child's success and consciously or unconsciously to feel what an important person he is because of the child's triumphs.  Although it is true that with ordinary people such motives are seldom, if ever, unmixed, and usually some object love and some self-love are integrated into such attitudes, in even the partial psychopath anything that could honestly be called object love approaches the imperceptible.

What positive feelings appear during the psychopath's interpersonal relations give a strong impression of being self-love.  Some cynical psychologists and philosophers have, of course, challenged the existence of any love which is not on final analysis selfish, saying that the mother who gives up her own life for her child really does so because it would be more painful to her to see the child perish.  Without attempting to take up the cudgels in this interesting dispute, it will suffice to say that whatever normal and highly developed and sincere object love may actually be, it is, whether judged behaviorally or intuitively, something that impresses the ordinary observer as definitely unlike anything found in the psychopath.

The psychopath seldom shows anything that, if the chief facts were known, would pass even in the eyes of lay observers as object love.  His absolute indifference to the financial, social, emotional, physical, and other hardships which he brings upon those for whom he professes love confirms the appraisal during psychiatric studies of his true attitude.  We must, let it never be forgotten, judge a man by his actions rather than by his words.  This old saying is especially significant when it is the man's motivations and real feelings that we are to judge.  This lack in the psychopath makes it all but impossible for an adequate emotional rapport to arise in his treatment and may be an important factor in the therapeutic failure that, in my experience, has been universal.

 

General poverty in major

affective reactions

 

In addition to his incapacity for object love, the psychopath always shows general poverty of affect.  Although it is true that be sometimes becomes excited and shouts as if in rage or seems to exult in enthusiasm and again weeps in what appear to be bitter tears or speaks eloquent and mournful words about his misfortunes or his follies, the conviction dawns on those who observe him carefully that here we deal with a readiness of expression rather than a strength of feeling.

Vexation, spite, quick and labile flashes of quasi-affection, peevish resentment, shallow moods of self-pity, puerile attitudes of vanity, and absurd and showy poses of indignation are all within his emotional scale and are freely sounded as the circumstances of life play upon him.  But mature, wholehearted anger, true or consistent indignation, honest, solid grief, sustaining pride, deep joy, and genuine despair are reactions not likely to be found within this scale.

 

Specific loss of insight

 

In a special sense the psychopath lacks insight to a degree seldom, if ever, found in any but the most seriously disturbed psychotic patients.  In a superficial sense, in that he can say he is in a psychiatric hospital because of his unacceptable and strange conduct, and by all other such criteria, his insight is intact.  His insight is of course not affected at all with the type of impairment seen in the schizophrenic patient, who may not recognize the fact that others regard him as mentally ill but may insist that he is the Grand Lama and now in Tibet.  Yet in a very important sense, in the sense of realistic evaluation, the psychopath lacks insight more consistently than some schizophrenic patients.  He has absolutely no capacity to see himself as others see him.  It is perhaps more accurate to say that he has no ability to know how others feel when they see him or to experience subjectively anything comparable about the situation.  All of the values, all of the major affect concerning his status, are unappreciated by him.

This is almost astonishing in view of the psychopath's perfect orientation, his ability and willingness to reason or to go through the forms of reasoning, and his perfect freedom from delusions and other signs of an ordinary psychosis.

Usually, instead of facing facts that would ordinarily lead to insight, he projects, blaming his troubles on others with the flimsiest of pretext but with elaborate and subtle rationalization.  Occasionally, however, he will perfunctorily admit himself to blame for everything and analyze his case from what seems to be almost a psychiatric viewpoint, but we can see that his conclusions have little actual significance for him.

 

Unresponsiveness in general

interpersonal relations

 

The psychopath cannot be depended upon to show the ordinary responsiveness to special consideration or kindness or trust.  No matter how well he is treated, no matter how long-suffering his family, his friends, the police, hospital attendants, and others may be, he shows no consistent reaction of appreciation except superficial and transparent protestations. Such gestures are exhibited most frequently when he feels they will facilitate some personal aim.  The ordinary axiom of human existence that one good turn deserves another, a principle sometimes honored by cannibals and uncommonly callous assassins, has only superficial validity for him although he can cite it with eloquent casuistry when trying to obtain parole, discharge from the hospital, or some other end.

As in attempting to delineate other aspects of the psychopath, we find ourselves again confronting paradox.  Although he can be counted on not to be appreciably swayed in major issues by these basic rules, we often find him attentive in small courtesies and favors, perhaps even habitually generous or quasi-generous when the cost is not decisive.  Occasionally his actions may suggest profound generosity in that large sums are involved or something presumably of real value is sacrificed.  Usually, however, these appearances are deceiving.

…In relatively small matters psychopaths sometimes behave so as to appear very considerate, responsive, and obliging.  Acquaintances who meet them on grounds where minor issues prevail may find it difficult to believe that they are not highly endowed with gratitude and eager to serve others.  Such reactions and intentions, although sometimes ready or even spectacularly facile, do not ever accumulate sufficient force to play a determining part in really important issues...

…Outward social graces come easy to most psychopaths, and many continue, throughout careers disastrous to themselves and for others, to conduct themselves in superficial relations, in handling the trivia of existence, so as to gain admiration and gratitude.  In these surface aspects of functioning, the typical psychopath (unlike the classic hypocrite) often seems to act with undesigning spontaneity and to be prompted by motives of excellent quality though of marvelously attenuated substance.

 

Fantastic and uninviting behavior

with drink and sometimes without

 

Although some psychopaths do not drink at all and others drink rarely, considerable overindulgence in alcohol is very often prominent in the life story.  Delirium tremens and other temporary psychoses directly due to alcohol were not commonly found in the hundreds of patients observed by me.

The view of some professional moralists to the effect that demon rum is the fundamental cause of disaster such as that of the psychopath appears to have little claim to validity.  It has been pointed out already that an irreconcilable difference in primary aim appears to exist between the ordinary person who drinks too much and the psychopath.  This may be restated briefly as follows: The ordinary drinker gets into trouble by drifting with enthusiasm into the opinion that if two or six or eight drinks have made him feel so good, another (or two more or perhaps five more) will make him feel just so much better.  Such rationalizations may assist the normal drinker, especially if he has serious fundamental conflicts, in a progress toward becoming a neurotic drinker or toward an alcoholic breakdown.

I cannot say that it is impossible in certain persons for a state of mental disorder identical with that described here as psychopathic personality to be reached eventually in this way.  Often, however, these neurotic drinkers, in sharp contrast with the psychopath, worry about their state when sober, are capable of making an earnest effort to get well under psychiatric treatment, and lack most of the deeper personality features of the psychopath.  Even in the neurotic drinker it is more often an independent and preexisting personality maladjustment rather than the alcohol which is primarily causal.  Many psychiatric observers make this vividly clear and no less convincing.

…A major point about the psychopath and his relation to alcohol can be found in the shocking, fantastic, uninviting, or relatively inexplicable behavior which emerges when he drinks - sometimes when he drinks only a little.  It is very likely that the effects of alcohol facilitate such acts and other manifestations of the disorder. This does not mean, however, that alcohol is fundamentally causal.  Good criteria for differentiation between psychopaths and others who drink, moderately or excessively, can be found in what tendencies emerge after similar amounts have been consumed.

A peculiar sort of vulgarity, domineering rudeness, petty bickering or buffoonish quasi-maulings of wife, mistress, or children, and quick shifts between maudlin and vainglorious moods, although sometimes found in ordinary alcoholics with other serious patterns of disorder, are pathognomonic of the psychopath and in him alone reach full and precocious flower.  Even in the first stages of a spree, perhaps after taking only two or three highballs, he may show signs of petty truculence or sullenness but seldom of real gaiety or conviviality.  Evidence of any pleasurable reaction is characteristically minimal, as are indications that he is seeking relief from anxiety, despair, worry, responsibility, or tension.

Alcohol, as a sort of catalyst, sometimes contributes a good deal to the long and varied series of outlandish pranks and inanely coarse scenes with which nearly every drinking psychopath's story is starred.  Free from alcohol, such a patient would scarcely sit under a house all night idly striking matches, or, concealing himself behind book stacks, urinate from the window of a public library on passersby in the street below.  Nor would he, like the psychopathic son of a prominent family, suddenly, as a prank, decide to climb into a tree at a busy street corner, where he deliberately undressed, shouting wildly and puerilely to draw public attention.  This man could not be persuaded to withdraw until the local fire department was called to remove him.  The alcohol probably does not of itself create such behavior.  Alcohol is not likely to bring out any impulse that is not already potential in a personality, nor is it likely to cast behavior into patterns for which there is not already significant subsurface predilection.  The alcohol merely facilitates expression by narcotizing inhibitory processes.136 In cases of this sort very little narcotizing may be needed.  The oil which lubricates the engine of an automobile neither furnishes the energy for its progress nor directs it.

Psychopaths often indulge in these strange performances after drinking relatively little.  They know perfectly well what they have done before when drinking and, with these facts squarely before their altogether clear and rational awareness, decide to drink again.  It is difficult indeed for me to see any substantial grounds for placing the responsibility for the drinking psychopath's deeds primarily on alcohol instead of on the disorder which, in ways no less serious even if less spectacular, he shows also when entirely sober.

 

Suicide rarely carried out

 

Despite the deep behavioral pattern of throwing away or destroying the opportunities of life that underlies the psychopath's superficial self-content, ease, charm, and often brilliance, we do not find him prone to take a final determining step of this sort in literal suicide.  Suicidal tendencies have been stressed by some observers as prevalent.  This opinion, in all likelihood, must have come from the observation of patients fundamentally different from our
group, but who, as we have mentioned, were traditionally classified under the same term.  It was only after a good many years of experience with actual psychopaths that I encountered my first authentic instance of suicide in a patient who could be called typical.

Instead of a predilection for ending their own lives, psychopaths, on the contrary, show much more evidence of a specific and characteristic immunity from such an act.  This immunity, it must be granted, is, like most other immunities, relative.

Although suicide, then, cannot be named an impossibility among this group, its unlikelihood still merits strong emphasis.  Since most psychopaths do not remain hospitalized or under other protective supervision, the rarity of this act becomes more significant.  Also worth noting is the fact that most real psychopaths, not once or a few times but habitually, work themselves into situations that might strongly prompt the normal man to end his own life.  Since suicidal threats, like promises and well-formulated plans to adopt a new course, are so frequently offered by these patients, there is good reason to keep in mind the fact that they are nearly always empty.  Many bogus attempts are made, sometimes with remarkable cleverness, premeditation, and histrionics.

 

Sex life impersonal, trivial, and

poorly integrated

 

The psychopath's sex life invariably shows peculiarities.  The opinion has already been expressed that homosexuality and the other specific deviations, though of course occurring in psychopaths, are not sufficiently common to be regarded as characteristic.  Evidence of consistent, well-formulated deviation was extremely rare in a large group of male psychopaths personally observed in a closed psychiatric institution.  Among male and female subjects seen as outpatients and in general hospitals, such complications, though more frequent, do not seem to be a distinguishing feature.  If we take another viewpoint and consider the group who come or are sent to the physician primarily for sexual deviation, we find again some patients with behavior patterns resembling in various degrees that of the real psychopath.  These patients are probably not typical of the deviate group as a whole, whose members much more frequently show different fundamental patterns of adjustment and maladjustment.

Unmistakable psychopaths who do not show evidence of strong or consistent deviated impulses but who nevertheless occasionally carry out abnormal sexual acts have been seen much more often than those in whom the two fundamental patterns seem to overlap.  This is not surprising in view of the psychopath's notable tendencies to hit upon unsatisfactory conduct in all fields and his apparent inability to take seriously what would to others be repugnant and regrettable.  The real homosexual seeking an outlet for his own impulses often finds it possible to engage the psychopath in deviated activities, sometimes for petty rewards, sometimes for what might best be called just the hell of it.

It has been said that some people whose sexual activities are normal under ordinary circumstances may, in the absence of normal opportunities, resort to immature or abnormal practices as a substitutive measure.  It is not hard to believe that a man of orthodox sexuality, if stranded and alone for years on an uninhabited island, might develop impulses toward masturbation.  Some studies of prisoners give the impression that mutual masturbation and far more abnormal relations occur in persons who, when not confined, sought only heterosexual intercourse.184,296  Surely every psychiatrist has seen people whose sexual aims are usually directed toward the other sex but whose orientation is so confused, and whose evaluation of sexual experience is so trivial, that they sometimes also engage in homosexual and other types of abnormal relations.

In psychopaths and in many other people who cannot be correctly placed with the well-defined homosexual group, there are varying degrees of susceptibility or inclination to immature or deviated sex practices.  In contrast with others, the psychopath requires impulses of scarcely more than whimlike intensity to bring about unacceptable behavior in the sexual field or in any other.  Even the faintest or most fleeting notion or inclination to forge a check, to steal his uncle's watch, to see if he can seduce his best friend's wife, or to have a little fling at fellatio, is by no means unlikely to emerge as the deed.  The sort of repugnance or other inhibiting force that would prevent any or all such impulses from being followed (or perhaps from even becoming conscious impulses) in another person is not a factor that can be counted on to play much part in the psychopath's decisions.

As might be expected, in view of their incapacity for object love, the sexual aims of psychopaths do not seem to include any important personality relations or any recognizable desire or ability to explore or possess or significantly ravish the partner in a shared experience.  Their positive activities are consistently and parsimoniously limited to literal physical contact and relatively free of the enormous emotional concomitants and the complex potentialities that make adult love relations an experience so thrilling and indescribable.  Consequently they seem to regard sexual activity very casually, sometimes apparently finding it less shocking and enthralling than a sensitive normal man would find even the glance of his beloved.

 

Failure to follow any life plan

 

The psychopath shows a striking inability to follow any sort of life plan consistently, whether it be one regarded as good or evil.  He does not maintain an effort toward any far goal at all. This is entirely applicable to the full psychopath.  On the contrary, he seems to go out of his way to make a failure of life.  By some incomprehensible and untempting piece of folly or buffoonery, he eventually cuts short any activity in which he is succeeding, no matter whether it is crime or honest endeavor.  At the behest of trivial impulses he repeatedly addresses himself directly to folly.  In the more seriously affected examples, it is impossible for wealthy, influential, and devoted relatives to place the psychopath in any position, however ingeniously it may be chosen, where he will not succeed eventually in failing with spectacular and bizarre splendor.  Considering a longitudinal section of his life, his behavior gives such an impression of gratuitous folly and nonsensical activity in such massive accumulation that it is hard to avoid the conclusion that here is the product of true madness - of madness in a sense quite as real as that conveyed to the imaginative layman by the terrible word lunatic.  With the further consideration that all this skein of apparent madness has been woven by a person of (technically) unimpaired and superior intellectual powers and universally regarded as sane, the surmise intrudes that we are confronted by a serious and unusual type of genuine abnormality.  Not merely a surmise but a strong conviction may arise that this apparent sanity is, in some important respects, a sanity in name only.  When we consider his actual performance, evidence of mental competency is sorely lacking.  We find instead a spectacle that suggests madness in excelsis, despite the absence of all those symptoms that enable us, in some degree, to account for irrational conduct in the psychotic.

Hervey Cleckley, M.D., The Mask of Sanity~An Attempt to Clarify Some Issues About the So-Called Psychopathic Personality, first published 1941, this edition 1988. (Available to download from www.cassiopaea.org/)