Hervey M. Cleckley (1903–1984)

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.[1] The title refers to the normal "mask" that conceals the mental disorder of the psychopathic person in Cleckley's conceptualization.[2]

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.[3] 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.… (más)

First published in 1941 and revised numerous times, I read the 5th edition published in 1975.

Whilst updated as time passed, the 5th edition still included the now known to be incorrect hypothesis that homosexuality is a mental disorder. Asides for this the book, although written academically, and as such quite dry, is up to par with the theories of today.

I encoutered mention of this work in Robert D Hare's Without Conscience which noted it was one of the pivotal and first works on psychopathology.

It is an interesting book, yet I found the manner in which it is written made the 596 pages feel more like 1,000. I wouldn't recommend it for recreational reading, however if you have an interest in the topic it is quite the seminal work and worthwhile to see where theories and practice came from.… (más)

This book surprised me. It was a detailed description of a woman who seeks help for debilitating headaches and troubling bouts of amnesia and who discovers, with the help of two psychiatrists, she is battling a rare disorder. Her story is told in a non-clinical narrative format that worked for me. I can see how some might not rate this very high because it is an intrinsically difficult subject. Unlike some earlier reviewers, I loved the literary references scattered throughout the text as well as the fairly rigorous medical description of her case. Most of the difficult "inside psychiatry" data have been pushed to the end as appendixes, and - this is what surprised me - I was able to follow along with the fairly complicated analyses found here after having read the main text. Some reviewers seemed confused by the Freudian references cited by the authors which, ironically, the authors dutifully submitted as data while explicitly disavowing the Freudian diagnosis; in other words, some reviewers wrongly critiqued the book, their criticism being right in line with the same sceptical viewpoint as expressed by the authors. Finally, I found the denouement to be quite fascinating and powerfully described. I won't forget it (or will I?).… (más)