After describing the futile cycle of psychopaths going to prison, to a mental health hospital, and back into society, Cleckley describes the clueless nature of those trying to address those with psychopathic personalities:-
Turning now to penal facilities, now to psychiatric [hospitals], relatives, friends, doctors, lawyers, the community at large, all find they are trying to measure areas in kilowatts or color in inches. Since the fire extinguisher did not particularly help the child’s fever, which has become alarming, we gravely apply a plaster cast.
[The psychopath] not only reproduces consistently good specimens of human reasoning but also appropriate simulations of human emotion in response to all the varied stimuli of human life. So perfect is this reproduction of a whole and normal man that no one who examines him can point out in scientific or objective terms why he is not real. And yet one knows or feels he knows that reality, in the sense of a full healthy experiencing of life, is not there.
I am not sure there was ever much more need for “psychosis with psychopathic personality” than for “psychosis with red hair” or “neurosis with a Ph.D. degree.” The new nomenclature appears better designed to avoid unnecessary confusions of this sort.
Cleckley spends a great deal of The Mask of Sanity attempting to provide a useful framework for studying the psychopath (this is perhaps his main goal).
When speaking of the previous attempts to classify the disorder, Cleckley notes the following:-
A good analogy would arise if someone set out to establish and list scores of inconsequential differences between Buicks, Oldsmobiles, Plymouths, Cadillacs, Lincolns… etc., by studying assiduously a general material in which automobiles, ox-carts, demolished freight cars, jet planes, rural woodsheds, and the village pump were undistinguished, embraced under a single term, and treated through such concepts as can be formed in such an approach.
In the middle of Cleckley’s The Mask of Sanity he takes some time to describe psychopaths from different lifestyles and professions, based upon his many observations and interviews. While writing about the psychopath as psychiatrist, he notes the following:-
Let us first direct our attention to him many years ago when, as an author of some papers on psychiatric subjects he attracted the interest of several inexperienced young physicians then at the beginning of their careers. The articles, it is true, were marred by grammatical errors and vulgarities in English a little disillusioning in view of the suave and pretentious style attempted by the author. At the time, however, they impressed this little group of naive admirers as having all the originality that the author so willingly allowed others to impute to them, and , as a matter of fact, implied not too subtly himself in every line of his work.
The Mask of Sanity
The pompous scholar discussing the pompous psychopath; another reason to love Cleckley.
Many [psychopaths] are plainly unsuited for life in any community; some are as thoroughly incapacitated in my opinion, as most unmistakable cases of schizophrenia. Whether this is to be regarded as a more or less willful contrariness or as a sickness like schizophrenia, in which the patient is to be protected and looked after, may for the moment be put aside.
Mask of Sanity
This view of Cleckley sums up the argument still had today, but the question has changed. Instead of ‘willful contrariness’, because of a demonstrated absence of empathy, we now see the argument as is psychopathy an adaptation (behaviors enhancing reproductive success and the passage of ‘psychopathy’ into the next generation), or a disorder? In my opinion, the latter is true as a see no valid selection pressure against the non-psychopathic.