Hervey Milton Cleckley (September 7, 1903 – January 28, 1984) was an American psychiatrist and pioneer in the field of psychopathy. His book, The Mask of Sanity, originally published in 1941 and revised in new editions until the 1980s, provided the first clinical description of psychopathy. He defined the term somewhat more broadly than it is understood today, as referring to somebody who behaves in a destructive manner despite lacking overt signs of psychosis or neurosis; this is reflected in the term "mask of sanity", derived from Cleckley's belief that a psychopath can appear normal and even engaging, but that the "mask" conceals a mental disorder. By the time of his death, Cleckley was better remembered for a vivid case study of a female patient, published as a book in 1956 and turned into a movie, The Three Faces of Eve, in 1957. His report of the case (re)popularized the diagnosis of multiple personality disorder in America. The concept of psychopathy continues to be influential through forming parts of the diagnosis of antisocial personality disorder, the Psychopathy Checklist, and public perception.
Life and career Cleckley was born in Augusta, Georgia, in the Southeastern United States.Hervey Cleckley and Corbett Thigpen The Augusta Chronicle, 01/01/2000 His parents were William and Cora Cleckley. His younger sister, Connor Cleckley, was schooled for some time in England (e.g. Headington School, Oxford) and later married and widowed by Aquilla J. Dyess, the only person ever to be granted America's highest awards for both civilian and military heroism (the Carnegie medal and, posthumously after World War II, the Medal of Honor).Featured obituary: Mrs. Connor Cleckley Goodrich By Albert Ross Jr. The Augusta Chronicle, May 2002.
Cleckley graduated from the Academy of Richmond County high school in 1921, then graduated in 1924 summa cum laude with a Bachelor of Science degree in mathematics and science from the University of Georgia (UGA) in Athens, where he was a member of the varsity football and track and field teams. Cleckley won a Rhodes Scholarship to study at Oxford University, England, graduating in 1926 with a Bachelor of Arts.
Cleckley then earned his M.D. from the University of Georgia Medical School (now known as the Medical College of Georgia) in Augusta in 1929. After several years of psychiatric practice in the Veterans Administration, he became professor of psychiatry and neurology at the Medical College of Georgia and, in 1937, the chief of psychiatry and neurology at University Hospital in Augusta. In 1955, Cleckley was appointed clinical professor of psychiatry and neurology at the medical college and became founding chairman of the Department of Psychiatry and Health Behavior. He served as a psychiatric consultant to the Veterans Administration Hospital in Augusta and the US Army Hospital at Camp Gordon. He was a member of the forensic committee of the Group for the Advancement of Psychiatry and a fellow of the American Board of Psychiatry and Neurology and the Society for Biological Psychiatry. He also worked in the private practice of psychiatry along with Corbett Thigpen and later also Benjamin Moss, Jere Chambers, and Seaborn McGarity.Obituary: Benjamin F. Moss Augusta Chronicle, June 12, 2011. His first wife was Louise Martin; after her death, he married Emily Sheftall.Between the Covers Rare Books, Inc.Georgia Regents University | Historical Collections and Archives, Robert B. Greenblatt, MD Library | Hervey M. Cleckley Collection, July 2014
Psychopathy In 1941, Cleckley authored his magnum opus The Mask of Sanity: An Attempt to Clarify Some Issues About the So-Called Psychopathic Personality. This became a landmark in psychiatric case studies and was repeatedly reprinted in subsequent editions. Cleckley revised and expanded the work with each edition published; the second American edition published in 1950 he described as effectively a new book (Cleckley 1988, p.vii).Cleckley, Hervey, M.D. The Mask of Insanity: An Attempt to Clarify Some Issues About the So-Called Psychopathic Personality. 1988, The C. V. Mosby Co, fifth edition, p.vii: "In attempting to revise the book for the second edition (1950), I found it was impossible to do justice to the subject by minor additions, deletions, and modifications. It was necessary to write a new and much larger book."
The Mask of Sanity is distinguished by its central thesis, that the psychopath exhibits normal function according to standard psychiatric criteria, yet privately engages in destructive behavior. The book was intended to assist with the detection and diagnosis of the elusive psychopath for purposes of palliation and offered no cure for the condition itself. The idea of a master deceiver secretly possessed of no moral or ethical restraints, yet behaving in public with excellent function, electrified American society and led to heightened interest in both psychological introspection and the detection of hidden psychopaths in society at large, leading to a refinement of the word itself into what was perceived to be a less stigmatizing term, "sociopath".
Military application In the same year as he published The Mask of Sanity during World War II, Cleckley wrote an address warning: "In our present efforts to prepare for national defense no problem which confronts the examining boards for selective service is more pressing or more subtle than that of the so-called psychopathic personality". He argued such soldiers were likely to fail, be disorganized, and be a drain on time and resources. He recommended routinely checking for past encounters with law enforcement or drinking alcohol until incapacitated.International Handbook on Psychopathic Disorders and the Law Alan Felthous, Henning Sass. 14 May 2012. Chapter 7: The Management of Fitness for Duty in the United States Military, Page 120 In The Mask of Sanity, under a subsection entitled "Not as single spies but in battalions", and further detailed in the appendix, Cleckley describes a survey he and others conducted between 1937 and 1939 at a large federal Veterans Administration (VA) hospital on the southeastern seaboard, where he worked as one of the psychiatrists for the ex-servicemen who were mainly veterans of World War I. Cleckley critiques the "benign policy" of the VA of not diagnosing more psychopathic personalities due to giving the benefit of the doubt to issues such as neurasthenia, hysteria, psychasthenia, posttraumatic neuroses, or cerebral trauma from skull injuries and concussions. He concludes that psychopathic personalities have "records of the utmost folly and misery and idleness over many years" and if considering also the number in every community who are protected by relatives, "the prevalence of this disorder is seen to be appalling."
Semantic theory Cleckley consistently described the hypothesized central deficit in psychopathy as "semantic" (the 'meaning' of things), early on referring to it as a "semantic dementia" or "dysergasia" (a term of Adolf Meyer's, implying a physiological basis) and later "disorder". He explained that this did not refer to the meaning of life in an abstract sense but to the emotional substrate from which the purposes and loyalties of everyday life are formed and experienced. In using the term semantic in this broad psychosocial sense, he referred to Alfred Korzybski's theory of general semantics. As earlier read at the Second American Congress on General Semantics, University of Denver, Denver, Colo., August 1 and 2, 1941. Also a version published in Time magazine? March 30, 1941 However Cleckley also separately employed an analogy to a language disorder called "semantic aphasia" in explaining the distinction between the appearance of correct functioning on the surface despite an underlying deficit in meaning. This has repeatedly led to the belief that he had suggested the core abnormality is in the use of language, which he has said is a misinterpretation. Today the term semantic dementia refers to a specific neurodegenerative disorder involving loss of semantic memory, while semantic disorder commonly refers to semantic pragmatic disorder associated with autism.
Contributors Cleckley states in The Mask Of Sanity that "Dr. Corbett H. Thigpen, my medical associate of many years, has played a major part in the development and the revision of this work". He also credits his and Thigpen's wives, both called "Louise", as well as the "constant encouragement, generous help, and the major inspiration that have come from Dr. Sydenstricker to the Department of Neuropsychiatry." Cleckley also mentions taking inspiration for the structure of his book from a work called The Psychology of Insanity by Bernard Hart, an English physician who also published a case study of a multiple personality.
Further development Based on Cleckley's work, but with fundamental changes, from the 1970s the psychologist Robert D. Hare devised an influential "psychopathy checklist" to assess psychopathy primarily in the criminal justice system. The concept of psychopathy evolved substantially with the development of this checklist, and the descriptions of the 15 psychopaths discussed in The Mask of Sanity were thus recently reassessed according to more modern understandings of what psychopathy constitutes. The authors note that "the Cleckley psychopaths were often bold and fearless, as well as exploitative, charming, dishonest, self-centered, remorseless, and shallow. They exhibited a wide range of criminal behavior, albeit inadequately motivated (i.e., petty and poorly planned), consistent with their poor judgment, and inadequate life plan. They were not particularly cruel, callous, or physically aggressive, inconsistent perhaps with current and/or media presentations of the prototypic psychopath." Hence, the modern understanding of psychopathy has placed substantially more emphasis on cruelty and physical aggression, compared to what Cleckley envisioned originally.
Vitamins Virgil P. Sydenstricker was a professor of medicine and an internationally recognized specialist in hematology and nutrition. Articles published with Cleckley were among the first to describe an atypical form of pellagra (now known as "niacin deficiency") which was then endemic in southern states. In 1939 and 1941 they published on the use of nicotinic acid (niacin or vitamin B3) as a treatment for abnormal mental states and psychiatric disorders. The studies have been erroneously used to justify the use of megavitamin therapy in psychiatric disorders such as schizophrenia.
Coma shock therapy Cleckley practiced the now out-dated "coma therapy", where psychiatric patients would be repeatedly put into comas over several weeks through overdoses of insulin, metrazol or other drugs. In the wake of sometimes fatal complications, Cleckley published in 1939 and 1941 advising on theoretical grounds the prophylactic administration of various vitamins, salts and hormones. In 1951, he also co-published case study research suggesting the use of electronarcosis for various conditions, a form of deep sleep therapy initiated by passing an electric current through the brain, without causing seizures as in electroconvulsive therapy which he also used.Thigpen C. H. and Cleckley, H. M. "A Modern Properly Administered Electroconvulsive Treatment, 1979. Presented at the American Psychiatric Association Convention, San Francisco, CA, May 1980.
Criminal responsibility