The mask of sanity

I will be writing about the mask of sanity, and how it affects a person.

When people say someone has a mask of sanity they are saying that under that cool and calm act, is a psychopathic human in disguise. In my case study there will be quotes and evidence from actual interviews Hervey M. Cleckley had with real life psychopaths. I will give as much information as I can on whatever patients I decide to write about. I will also make a list of psychotic traits you may see and a simple description of what they mean. 

What is the mask of sanity and its purpose/concept ?

The mask of sanity is a book written by Hervey M. Cleckley, published in

 1941, describing Cleckley's clinical interviews with psychopaths that were incarcerated. The concept of the book is descriptions of a psychopathic person who is outwardly a mimic of a perfectly normal functioning human being. Them being able to mask their fundamental lack of an internal personality structure and whatever internal chaos happens in their head that no one can see, and that they might not even realize is happening.

What does it mean for someone to be psychopathic ?

Psychopathic means to be a person affected by chronic mental disorder with abnormal or violent social behavior. Behaviors psychopaths usually are associated with are, lack of emotional sensitivity and empathy,  impulsiveness, superficial charm, insensitivity of punishing consequences. According to the national library of medicine, the 4 types of psychotic disorders are narcissistic, borderline, sadistic, and antisocial. 

Traits of a psychopath :

A certain theme that goes throughout the book is the pointless behavior of a psychopath. A few traits that one might have could be,

 good intelligence & charming personality - this may help them drag in their person of interest or a way to get what they want 
Poor judgment and failure to learn by experience - if they were to do anything wrong and happen to no get caught, they'll just keep doing it until they do and even after that they might not stop
Pathologic egocentricity and incapacity for love - without these feelings they may not feel anything for the people they hurt and don't have any regret or anything for something they may have done

What exactly is wrong with these people ?

“Psychopathy is defined as a mental antisocial disorder in which an individual manifests amoral and antisocial behavior, shows lack of ability to love or establish a meaningful personal relationships, express extreme egocentricity and demonstrates a failure to learn from experience and other behaviors associated with the condition” -Alternate Human Behavior by Henry R. Hermann Ph.D. 

The mental health of psychophysiology:

Psychopathy mostly revolves around the behaviors of a person that has the condition but we don't really talk about how that person may actually feel and who it affects. 1% of the people in the psychopathy population is much more prevalent in men than in women, and can after up to 25% of the prison population. Psychopathy is a serious personality disorder, yet it has been hypothesized that it is primarily deficient in fear reactability. Another fear that has a negative effect is the acoustic startle eyeblink reflex while looking at an unsettling picture compared to how they react like they are unsettled by pleasant and normal pictures.  This case is not always true in all psychopathy cases but is proven to be only defected in some types of psychopathy.

Are there different types of psychopaths ?

Narcissistic -  meaning a mental health disorder in which people have an unreasonably high sense of their own importance. They need and seek too  much attention and want people to admire them. People with this disorder may lack the understanding or care for  others feelings.
Borderline - meaning they have impulsive and risky behaviors. Like gambling, reckless driving, unsafe sex, spending sprees, binge eating, drug abuse or self-destructive behaviors such as quitting a good job or relationship. Suicidal threats or behavior or self-injurious actions in fear of separation or rejection.
Sadistic -  meaning they tend to display recurrent aggression and cruel behavior. People with this disorder will most likely use violence and aggression in an attempt to establish dominance. When others refuse to submit their will, they will increase the intensity and violence they use.
Antisocial - those with antisocial personality disorder may begin to show symptoms in childhood, but the condition can't be diagnosed until adulthood. People with the disorder tend to lie, break laws, act impulsively, and lack regard for their own safety or the safety of others. Symptoms may lessen with age.

Is there any treatment or cure ?

Yes, psychopathy is treatable! Doctors will start treatment with lots of approaches at once, including psychotherapy, behavioral skills training, and recognition of important roles of family, school, peers, and the community. They may also incorporate medication too.

Case study #1 -  M a x 

Max was mentally ill and his wife called into the hospital with urgency because he had gotten away and started causing trouble again. He was later found in custody of the police. He was having vocal unproars and dramatically aggressive gestures because he was too securely held to fight. When he got to the ward they promptly found out he had been arrested and convicted but there was an agreement for him to get psychiatric treatment in place of going to jail.  His hospital records also have shown he was a patient previously 8 years ago for 2 months but during his stay he showed no signs of psychosis or psychoneurosis, But was released with the diagnosis of psychopathic personality. Not long before his time to come before the staff, he demanded his discharge. After it was denied he became aggressive towards other patients and attendants. He never attacked because of psychotic delusions or impulses, but the fights and quarrels were readily understandable. After a while Max began to cooperate and do good while in the hospital. He began to request bread everyday and a room to himself in hopes that the activity would  keep him out of trouble, and all his requests were granted. He immediately demanded parole but was denied and they told him to wait a little while after giving him all these things. “He sent messages to the medical director of the hospital, to the supervisor of attendants and the chief nurse, and to many others whom he felt it well to ingratiate that objets d'art awaited them in his studio. He was visited by these people and by various

prominent ladies of the city interested in welfare work and active in helping disabled veterans. To most of these he made presentations as well as moving speeches about his misfortunes, his gifts, and his ambitions. His demands for parole now became more vehement. Many influential citizens begged that he be given this chance to rehabilitate himself. As a matter of fact, he had been reasonably cooperative while at his new work. Eventually Parole was granted.” (Mask of sanity, Hervey Cleckley, M.D.).

Case study #2 -   A r n o l d

"Arnold had recently left the hospital (A.W.O.L.) while out on pass. There were letters written out to a physician at the psychiatric hospital that had taken a special interest in his case. Arnold would come and go from the hospital and this physician would make an exception time and time again for him to get restored parole each time he came back. Once after making an especially convincing plea for freedom and with the possibility of parole within the next few days, he succeeded during the night in obtaining whiskey by lowering on a cord an empty Coca-Cola bottle which he had obtained and which some confederates filled for him. With that and him not realizing that he could possibly have obtained liquor, they feared for a moment that he must have developed an ordinary psychosis. On being approached he cursed, sobbed feebly, and was brought back to bed, passing intestinal gas with frequent, grinning at the nurse who had hurried to him at each detonation." The next morning he confessed only because they found the evidence with the coke bottle. He seemed to have a deep sense of regret and couldn't understand why his parole would be delayed from this incident. This patient, entirely sane by orthodox psychiatric standards, having spent the better part of seven years closely confined among other men who, to him as to any layman, were unmistakable lunatics if otherwise agreeable company, was given another series of chances to win his freedom. His parole was restored time after time. He expressed a clear understanding that he was obligated not to leave the hospital grounds. Each time, in accordance with his past behavior, he would promptly disappear. After a few hours, several days, or perhaps a week, the police would call to say they had him in custody. After his first admission he was carefully examined; social service reports were secured and he was observed day after day. No evidence of any condition known as "psychosis" could be found. He was granted parole privileges once again. But by request of his relatives, he was allowed to go home with them on trial-visit status, where, knowing that a failure to behave himself would mean returning to the confinement he naturally detested, he at once engaged in not one but several activities, each of which made his return to the restrictions of a hospital not only necessary but urgent. Even after returning to the hospital this time he returned another after he was released on parole. Arnold kept going back and forth between parole and being taken back into custody of the hospital for months afterwards. Arnold had an incident while on parole leading him back to where his story started.