The Mask Of Sanity: An Attempt To Clarify Some ...

The first edition was published in 1941, with the subtitle then being 'An attempt to re-interpret' rather than as later 'to clarify'. Cleckley says in the preface that the book "grew out of an old conviction which increased during several years while I sat at staff meetings in a large neuropsychiatric hospital". He added that after commencing full-time teaching duties he found similar patients to be as prevalent in a general hospital, outpatient clinic and the community. In later editions he explains that the basic concepts presented in 1941 were based primarily on "adult male psychopaths hospitalized in a closed institution" for several years. Cleckley had worked for a number of years at a United States Veterans (military) Administration hospital, before taking up full-time teaching responsibilities at the University of Georgia School of Medicine.

The Mask of Sanity: An Attempt to Clarify Some ...

Cleckley then considers how schizophrenia is different from psychopathy, having a defect in theoretical reasoning. He notes that schizoid disorders may appear more similar, and might be more accurately called "masked schizophrenia", which he notes can sometimes be difficult to differentiate from psychopathy. He also notes other 'disguises' of severe personality disorder, such as "cryptic depression" or "pseudoneurotic schizophrenia" or "pseudopsychopathic schizophrenia". He finds the diagnosis of "psychosis with psychopathic personality" unnecessarily confusing. He declares, "There is little point in devoting space to detailed accounts of paranoid or cyclothymic personalities."

In the final chapter, I turn to the question of how psychopaths should be treated in the criminal law. I begin by sketching the distinctive problem that psychopathy presents for the criminal law, and some broad observations on how it is dealt with currently. I engage first with an argument by Paul Litton which states that the criminal law is an expression of democratic norms, and therefore that any attempt to excuse psychopaths based on their psychopathy should be rejected because it would not command the respect of the public. I then turn to the question of whether psychopaths deserve punishment. I review the various ways in which judgments of criminal responsibility are instantiated in legal tests, and the conditions of responsibility that are implicit in these. Ultimately, I conclude that psychopaths lack capacities which ought to be considered a condition of criminal responsibility, essentially the ability to respond to moral reasons, and not just the ability to know that their actions are legally proscribed.

Defendant's conduct after the killing also points away from premeditation. He did not attempt as did the defendant in People v. Eggers, 30 Cal. 2d 676 [185 P.2d 1], to hide the body or to mutilate it to prevent identification. Defendant claimed that he chased an intruder down the alley, and there is evidence of hallucinations in his medical history. Furthermore, defendant did not attempt to hide himself. Instead, he went almost immediately to his brother's house, where his only intelligible words were, "We have got to get over to the house." His brother, as well as the police officers who arrested him, testified that defendant was irrational and incoherent at this time. The police officers took him to the hospital rather than to jail. Dr. Loewenberg, who visited defendant at the hospital some 13 hours after the crime, testified that defendant was then in a clouded state, and that, in his opinion, he was in a clouded state at the time of the killing. It was thus a very close question of fact whether or not the People had proved beyond a reasonable doubt that the killing was "willful, deliberate, and premeditated." It was, therefore, vital that the jury be properly instructed in clear and unambiguous terms. It was error for the court to instruct the jury that on the trial of the issue of not guilty, defendant was conclusively presumed to be of "sound mind." The effect of such an instruction [42 Cal. 2d 571] was to tell the jury that it could not consider defendant's moronity and the effect on his mental faculties of many years' suffering from epilepsy in determining his defense based on lack of capacity to premeditate and deliberate. 041b061a72