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4 APTO 1 (1960)

handle is hein.journals/ijotcc4 and id is 1 raw text is: RETURN PosTAGE GUARANTEED 9 E. 97, N.Y.C. 29 The Journal of the Association for Psychiatric Treatment of Offenders April, 1960, Vol. 4, No. 1 The Concept of Psychopathy APTO Chapter News JAMES M. TOOLAN, M.D. The Board of Directors announces with pride the formation of a Massachusetts Chapter, under The term psychopathic personality has created the Chairmanship of Donald Hayes Russell, M.D. difficulty since Koch introduced it into psychiatric Brooks S. White, M.D., is the Secretary of the nosology in 1888. It has been employed to describe new Chapter, whose address is: Massachusetts all perverse, antisocial and unacceptable delin- APTO, Quincy Court Clinic, 8 Coddington Street, quent or criminal behavior. More recently, accord- Quincy 69, Massachusetts. ing to the official American Psychiatric Associa- The Charter Members of Massachusetts APTO tion diagnostic manual, the term has been used are: to describe a chronically antisocial individual are- who is always in difficulty, feels no loyalty, and fails to profit from experience. However, any diagnostic entity based primarily upon an in- dividual's attitude to society is on tenuous ground. Similarity in behavior may be exhibited by individuals with markedly different personality structures. It is suggested, therefore, that this entity be considered as but one variety of the character disorders, and that the diagnosis be limited to those showing: 1) no conscious guilt or anxiety. (Depression may be seen as a reaction to stressful situations, e.g. prison.) 2) defective superego or conscience. 3) difficulty in identifying with and relating to other persons. 4) antisocial behavior. The latter is not a necessary feature of the defini- tion, but usually follows from the previous ele- ments. Some psychopaths are able to avoid overt difficulty with society and may even manage to be highly successful in business or politics. If the above criteria are strictly applied, we encounter few true psychopaths even in prisons. Behavioral patterns vary during different periods of the life of an individual. One's personal- ity structure is not static, and noticeable changes are frequently encountered during the transitional years of adolescence. The cases which follow all illustrate the variation which is so often encoun- tered in the individual patients life history. Patient A. was 16 years of age when brought for help by his parents. He had been a well- behaved youngster from a middle-class family. He was sensitive about his small physical stature. Although only an average student, he had enjoyed school and studied diligently. At 15, he began to associate with a delinquent gang and engaged in several gang fights, which he enjoyed. He was eager to be a big shot in the gang and eventually was expelled from school. Short-term psycho- therapy enabled him to recognie that he was attempting to bolster his somewhat weak self- image by identifying with a strong gang. He was able to give up his gang friends, secure employ- ment, and avoid further delinquent behavior. This patient was essentially a normal youngster who during adolescence had attempted to solve his problems by identifying with a delinquent group and as a result exhibited delinquent be- havior. The process was quickly reversed with the aid of psychotherapy. DONALD HAYES RUSSELL, M.D.-Director, Massachusetts Court Clinics Program BROOKS S.- WHITE, M.D.-Director, Quincy Court Clinic EUGENEJ. BALCANOFF, M.D.-Director, Suf- folk Superior Court Clinic SHEPARD C. GINANDES, M.D.-Director, Cambridge Court Clinic THOMAS P. HACKETT, M.D.-Cambridge Court Clinic JOHN W. DONOGHUE, M.D.-Dircctor, Spring- field Court Clinic JOSEPH I. BERNSTEIN, M.D.-Springfleld Court Clinic J. BURNS AMBERSON, M.D.-Springfield Court Clinic EDWARD MASON, M.D.-Director, Worcester Court clinic RICHARD ROSENWALD, M.D.-Director, Framingham Court Clinic EUGENE MITTELMAN, M.D.-Director, Mal- den Court Clinic LAWRENCE CLAMAN, M.D.-Director, Brook- line Court Clinic WILLIAM SHELTON, M.D.-Director, Wal- tham Court Clinic WALTER KAUPE, M.D.-Director, Stoughton Court Clinic The next issue of the APTO Ja-al will be a Massachusetts issue, in honor of our new Chapter. Patient B. had been an anxious child, fearful of the dark and especially dose to an older sister who assisted him in his school work and calmed his fears. He was an excellent student but when his sister married, he lost all interest in school and became delinquent. The Children's Court allowed him to enlist in the Navy but he was often AWOL, insubordinate, and had a poor service record. After leaving the Navy, he was sexually promiscu- ous and perverse, had no feelings for others and wss especially insulting to women. At his work, despite obvious talent, he was always in difficul- ties with his superiors. Cautinerd -n paer 4 A Lawyeis Guide to the Perplexed Psychiatrist NATHAN DECHTER, L.B., Pa.D. With growing frequency police agencies, judges, district attorneys, lawyers, social workers, and institutions are asking psychiatrists for reports on offender-patients. These requests are a challenge and a responsibility, and even the ex- perienced psychiatrist may sometimes find himself at a loss where to begin. However, the task will be much simplified if a systematic approach is adopted. Assuming that the psychintrist has already examined, evaluated, and diagnosed the offender- patient, there are still four important questions to be asked: 1. Who, exactly, has requested the report? 2. Have the necessary releases been sumbitted? 3. What, specifically, does the inquirer want en know? 4. To what use will the information in the report be put? 1. The frst question requires very careful consideration. Police agencies and the district attorney's office are concerned primarily with prosecution and conviction; information will be used in support of these objectives. Defense at- torneys seek exoneration or mitigation of punish- ment. Judges, probation officers and social workers are concerned with final disposition and treat- ment. (Psychiatrists, however, are aware that treatment is sometimes only disguised punish- ment.) Although a psychiatrist may occasionally tend to tailor a report, it is actually a mistake to thus be influenced by the source of the request. Absolute medical objectivity is vital to the fair and proper administration of justice. 2. The problem of medical releases is not within the scope of this brief discussion, but the psychiatrist should be warned that it is essential to possess an appropriately executed release from the offender-patient before forwarding the report Caursrd e pap 4

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