The Mask of Sanity: An Attempt to Clarify Some Issues About the So-Called Psychopathic Personality is a book written by American psychiatrist Hervey M. Cleckley, first published in 1941, describing Cleckley’s clinical interviews with patients in a locked institution. The text is considered to be a seminal work and the most influential clinical description of psychopathy in the twentieth century. The basic elements of psychopathy outlined by Cleckley are still relevant today. The title refers to the normal “mask” that conceals the mental disorder of the psychopathic person in Cleckley’s conceptualization.
Cleckley describes the psychopathic person as outwardly a perfect mimic of a normally functioning person, able to mask or disguise the fundamental lack of internal personality structure, an internal chaos that results in repeatedly purposeful destructive behavior, often more self-destructive than destructive to others. Despite the seemingly sincere, intelligent, even charming external presentation, internally the psychopathic person does not have the ability to experience genuine emotions. Cleckley questions whether this mask of sanity is voluntarily assumed to intentionally hide the lack of internal structure, but concludes it hides a serious, but yet imprecisely unidentified, semantic neuropsychiatric defect. Six editions of the book were produced in total, the final shortly after his death. An expanded fifth edition of the book had been published in 1976 and was re-released by his heirs in 1988 for non-profit educational use.
The Mask of Sanity
Ever more people today have the means to live, but no meaning to live for. —Victor Frankl
In Man’s Search for Meaning, the neurologist and psychiatrist Victor Frankl (1905–1997) wrote about his experience as a concentration camp inmate during the Second World War. He observed that those who survived longest in concentration camps were not those who were physically strong, but those who retained a sense of control over theirenvironment.
We who lived in concentration camps can remember the men who walked through the huts comforting others, giving away their last piece of bread. They may have been few in number, but they offer sufficient proof that everything can be taken from a man but one thing: the last of human freedoms—to choose one’s own attitude in any given set of circumstances—to choose one’s own way.
Frankl’s message is ultimately one of hope: even in the most absurd, painful, and dehumanizing situation, life can be given a meaning, and so too can suffering. His experience as a concentration camp inmate taught him that our main drive or motivation in life is neither pleasure (as Freud had thought) nor power (as Adler had thought), butmeaning. After his release Frankl founded the school of logotherapy, which is sometimes referred to as the ‘Third Viennese School of psychotherapy’ because it came after those of Freud and Adler. The goal of logotherapy (from the Ancient Greek logos, in this context meaning ‘reason’ or ‘principle’) is to carry out an existential analysis of the person and, in so doing, to help him discover meaning for his life. According to Frankl, meaning can be found through:
- Creativity or giving something to the world through self- expression,
- Experiencing the world by interacting authentically with our environment and with others, and
- Changing our attitude when we are faced with a situation or circumstance that we cannot change.
Frankl is credited with coining the term ‘Sunday neurosis’ to refer to the dejection that is felt at the end of the working week when a person realizes just how empty and meaningless his life is. This existential vacuum may lead him to all sorts of excesses and compensatory behaviours such as neurotic
anxiety, avoidance, bingeing on food and drink, overworking, and overspending. In the short-term these excesses and compensatory behaviours carpet over the existential vacuum, but in the longer term they prevent action from being taken and meaning from being found. For Frankl,depression
can result when the gap between what a person is and what he ought to be becomes so large that it can no longer be carpeted over. The person’s goals seem far out of reach and he can no longer envisage a future. As in Psalm 41, abyssus abyssum invocat—
‘hell brings forth hell’ or, in an alternative translation, ‘the deep calls onto the deep’.