Studies in Forensic Psychiatry - Bernard Glueck (grave mercy .TXT) 📗
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If one takes into consideration the entire life history of this individual he will have little cause for surprise at the resort to malingering by this man when he found himself under an especially stressful situation. That he malingered every frank psychotic symptom which he manifested is beyond doubt a fact, even though he would not have admitted so much himself. But one would commit a serious error if on this account he would consider the man normal mentally. From childhood on this man has manifested traits of character which are absolutely psychopathic in nature. Among these may be especially emphasized the confirmed truancy and running away from home, the aimless, constantly-changing industrial career, the inability to pursue any line of endeavor towards a definite goal, the early criminalistic tendencies, the repeated commission of military offenses in spite of the frequent punishments, and, lastly, his total inability to adjust himself to the prison régime, resulting in serious mental upsets which necessitated his admission to a hospital for the insane on three different occasions. It is perfectly natural that he should resort to malingering of mental disease in his last attempt at evading a stressful situation. Malingering is frequently the only means of escape for such as he, unable as they are to meet life’s problems squarely in the face.
It is of no particular value to add more cases illustrative of the type of mental make-up which leads to malingering, especially since there exists a more or less complete unanimity of opinion on the subject among present-day psychiatrists.
ConclusionsThe conclusions which may safely be drawn from the study of malingering as it is manifested in criminal departments of hospitals for the insane are as follows:—
1. The detection of malingering in a given case by no means excludes the presence of actual mental disease. The two phenomena are not only not mutually exclusive, but are frequently concomitant manifestations in the same individual.
2. Malingering is a form of mental reaction manifested for the purpose of evading a particularly stressful situation in life, and is resorted to chiefly, if not exclusively, by the mentally abnormal, such as psychopaths, hysterics, and the frankly insane.
3. Malingering and allied traits, viz., lying and deceit, are not always consciously motivated modes of behavior, but are not infrequently determined by motives operative in the subconscious mental life, and accordingly affect to a marked extent the individual’s responsibility for such behavior.
4. The differentiation of the malingered symptoms from the genuine ones is, as a rule, extremely difficult, and great caution is to be exercised in pronouncing a given individual a malingerer.
REFERENCES[1] Brill, A. A.: “Artificial Dreams and Lying,” Journal of Abnormal Psychology, vol. ix, No. 5.
[2] Delbrück, Anton: “Die Pathologische Lüge,” Enke, Stuttgart, 1891.
[3] Ferrari, L.: “Minorenni Delinquenti,” Milano, 1895.
[4] Penta, Pasquale: “La Simulazione della Pazzia,” Napoli, Francesco Perrella, 1905.
[5] Wilmanns: “Ueber Gefängnispsychosen,” Halle, S. 1908.
[6] Bonhoeffer: “Degenerationspsychosen,” Halle, S. 1907.
[7] Knecht: Quoted by Penta.
[8] Vingtrinier: “Des Alienes dans les Prisons,” Annales d’hygiene et de med.-legale, 1852-53.
[9] Jones: Introduction to “Papers on Psycho-analysis.”
[10] Pelman: “Beitrag zur Lehre von der Simulation,” Irrefreund, 1874, and Arch. de Neurolog., 1890.
[11] Birnbaum, K.: “Zur Frage der psychogenen Krankheitsformen,” Zeitsch. f. d. ges. Neur. u. Psych., 1910.
[12] Siemens: “Zur Frage der Simulation von Seelenstörung,” Arch. f. Psych. und Nerv., xiv, 1883.
[13] Melbruch: Quoted by Penta.
[14] Glueck, Bernard: “Catamnestic Study of Juvenile Offender,” Journal of Am. Inst. Crim. Law and Crimin., viii, No. 2.
CHAPTER VTHE ANALYSIS OF A CASE OF KLEPTOMANIA
Introduction.—The past two years have been very profitable ones for the science of criminology, as they have brought to light two books on the subject which concretely reflect, on the one hand, the dying out of the old statistical method of studying the criminal, a method which will never tell the whole story, and on the other hand, the birth of a new kind of approach to the study of the criminal, namely—the characterological approach. The study of crime or antisocial human behavior from this newer standpoint at once becomes a study of character, and demands a scientific consideration of the motives and driving forces of human conduct, and since conduct is the resultant of mental life, mental factors at once become for us the most important phase of our study. Both of these books represent epoch-making culminations of years of hard labor and scientific devotion to criminology by two eminent students—Drs. Goring[1] and Healy.[2]
Dr. Goring’s book, “The English Convict, a Statistical Study”, appeared in 1913, and is the result of an intense statistical study of 4000 English male convicts, to which the author devoted about twelve years of his life. Dr. Healy’s book, “The Individual Delinquent”, which appeared in the early part of this year, reflects the results of thoroughgoing scientific studies of about 1000 repeated offenders, during the author’s five years’ experience as Director of the Juvenile Psychopathic Institute in connection with the Juvenile Court of Chicago. Numerous reviews of these two books have appeared in medical and criminologic literature, and we shall only touch very minutely upon the difference in the methods of approach to the subject of these two authors as they concern the subject under consideration in this paper. I can do this no better than by quoting from a critical review of Goring’s book by Dr. White,[3] as it happily touches upon our very subject—namely, stealing. “Take the more limited concept of ‘thief’, for example. One man may steal under the influence of the prodromal stage of paresis who has been previously of high moral character. Another man may steal under the excitement of a hypomanic attack; another may steal as the result of moral delinquency; another as the result of high grade mental defect; another under the influence of alcoholic intoxication, and so forth, and so on, and how by any possibility a grouping of these men together can give us any light upon the general concept of ‘thief’ is beyond my power to comprehend.”
When one remembers that the 4000 units with which this really marvelous statistical machinery has worked for twelve long years had nothing more in common than the fact that they were English male convicts—the force of White’s argument becomes quite apparent. I need not state that this view of Goring’s work is not intended to detract one iota from the full measure of credit which this author deserves. His work will stand forever as one of the monumental accomplishments of the twentieth century.
Our views concerning Healy’s contribution to the science of criminology will be reflected in the course of this chapter, which will indicate, I trust, in a way, his mode of approach to the problem, though he may not agree with me concerning the details of my interpretation of the case I am about to report.
Definition.—Like many another I dislike the term “kleptomania” and would much prefer the term “pathological stealing” to denote the condition under consideration. Pathological stealing is not synonymous with excessive stealing as one would gather from the sensational use of the term in the lay press. Neither is Kraepelin’s dictum that Kleptomania is a form of impulsive insanity, necessarily correct. It is obviously, however, a form of abnormally conditioned conduct. Healy’s criterion of Pathological stealing is the fact that the misconduct is disproportionate to any discernible end in view. In spite of risk, the stealing is indulged in, as it were, for its own sake, and not because the objects in themselves are needed or intrinsically desired. This definition at once excludes all cases of stealing from cupidity, or from development of a habit. It furthermore excludes stealing arising from fetichism, pronounced feeblemindedness and mental disease, such as is for instance illustrated in the automatic stealing of the epileptic.
According to Healy, the vast majority of all instances of pathological stealing are those in which individuals, not determinably insane, give way to an abnormally conditioned impulse to steal.
The Psychoanalytic Study of Anti-Social Behavior.—In introducing the term “Psychoanalysis” into this chapter I am fully conscious of the task I have set before me, of writing clearly and convincingly in a work of this nature on that vast and highly important subject which one at once links with this term. To strip it of its highly technical considerations, psychoanalysis is primarily and essentially a study of motives, intended to bring about a better understanding of human conduct. We shall leave out from consideration the very intricate technique which this method of approach to the study of human behavior employs except to indicate the chief source upon which it relies for its information, namely, the individual’s unconscious, that is, that part of the individual’s personality which is outside of the realm of his moment-consciousness, and which is inaccessible either to himself or to the observer except through special methods of investigation. It would be highly desirable, indeed one would say almost imperative, to give a full discussion of the “unconscious” before a proper and sympathetic understanding of what is to follow can be made possible. This, however, is obviously out of the question in a limited chapter like this. Volumes have been written on the subject. I will only ask my readers to agree with me for the sake of gaining proper orientation with reference to the subject under discussion, in the conclusion which I quote from a masterly paper on the “unconscious” by White.[4] “We come thus to the important conclusion that mental life, the mind, is not equivalent and co-equal with consciousness. That, as a matter of fact, the motivating causes of conduct often lie outside of consciousness, and, as we shall
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