Herman M. Adler

“ We have had a few cases in which, after a preliminary survey at the Psychopathic Hospital, a course of training has been applied, which has consisted above all in arousing the interests and appealing to the pleasure-loving side of the individual. It is a well known fact, for instance, in dealing with wayward young people that even under the most advantageous circumstances and even with the most favorable and friendly environment, the individuals do not do well. This appears to be due to the fact that the emotional impulses are of short duration and leave no strong impression behind them. ”

“ While it is undoubtedly an encouraging fact that the attitude of the community towards delinquency is rapidly changing and is assuming more the position of sympathetic inquiry into the causes and remedies, it is none the less a fact that the law remains as of old,-sternly searching for the responsible parties. ”

“ We are too apt to blame the law and to exalt science in this connection. As a matter of fact, we are forced to the conviction that the law will be changed the instant that science gives a definite basis for such change. ”

“ In one group of cases, the impulse to go away appears quite without warning. The patient suddenly gets an idea he must go to Trieste, Hamburg, Vienna, Paris, occasionally in connection with some pathological depression or anger. Sometimes the accidental possession of a large sum of money may be the cause of this. As soon as they feel the impulse, they proceed to act. The patients disappear, wander and travel about, here, there and everywhere, according to their whim. ”

“ As soon as the patient has spent himself or has been removed from his environment, composure and clear consciousness rapidly return. As a rule, they are still somewhat irritable, will not eat, give information, but soon they adjust themselves to the situation, and attempt to re-establish their relations with the outer world. The recollection of the incidents is often somewhat unclear. Some patients refuse to believe the details that are told them, they attempt to put their conduct in the best light, place blame on the environment, on the relatives, and so forth. ”

“ It is clear that we are dealing with a group of individuals who are so nearly normal that it is only in the course of years and by the effect of cumulative evidence that they appear in any way different from the average. There are two main factors to be considered. The one is the intelligence of the individual, his ability consciously and logically to direct his conduct. The other is the emotions. Whatever the peculiarities of the individual, whatever his special experiences in the main, these two factors can be distinguished in his activities. ”

“ Thus, as Kraepelin points out, alcohol is an important factor in producing the final downfall. Extravagence, profligacy, sex excesses, bad companionship, and so forth, are the factors which combine to cause the social difficulties. The siggestibility of these individuals," their intelligence and insight, which is usually quite adequate for their needs, can be made use of in acquiring and strengthening the habits which the individual would never be able to gain if left to himself. What is desired, therefore, is a system of mental and emotional exercises for the purpose of habit formation. ”

“ In co-operation of the various tendencies that strengthen the will, those attain unusual power which arise in the general moods and vital desires of the individual as opposed to those guiding and inhibiting impulses which ordinarily control them and which are the result of training and experience. One of the fundamental dispositions which give rise to impulsive tendencies is above all the desire to dominate in a purely external fashion. A direct'result of this is the tendency to boast, to lie, to squander money, in so far as an impression is made thereby. ”

“ If such an individual is to be classified by his delinquency he might find himself at one time a disturber of the peace, at another time a murderer. Furthermore, just as the individual might commit different sorts of crime, so the same crime might be committed by individuals belonging to entirely different types. ”

“ Very striking is often the minor nature of the existing cause which produces these unmeasured excesses. A simple correction, the denial of a small wish, a little gossip, an unwelcome order of the physician in the hospital, the mere taking of a patient to the place of detention, suffices to evoke a paroxism of rage which increases in severity as the forms of expression take on a violent nature. Alcohol is here again often a factor which the patient may have taken previolisly to drown his sorrows or to strengthen his courage. ”

“ Nothing can be gained by endeavoring to increase the intelligence of a mental defective. Nothing can be expected from an attempt to change the personality of the paranoid individual. A great deal can be accomplished, however, in controlling the emotional instability of those whose chief difficulty is the result of such instability, as well as the emotional difficulties of the paranoid and defective group. ”

“ According to the definition contained in the above-mentioned law, a defective delinquent is, first, "an individual who has committed an offense not punishable by death or imprisonment for life, but who ordinarily might be committed to a state prison, a reformatory, jail, or house of correction, to the state farm or the industrial school, a truant school, or to the custody, of the State Board of Charity as mentally defective." ”

“ The defective delinquent in this sense might be termed a burnt child that does not dread the fire: the mere burning with all its unpleasant experiences is not sufficient to create the defense habits which will prevent its recurrence. The thresholds for these reactions must lie at different levels in different individuals. This is a point for analysis in each case. Undoubtedly, there are individuals so far deviated from the average, that practically no amount of experience, even under the most careful guidance, will produce resistance. ”

“ It would seem that by careful training based on an analysis of each individual-especially from the behaviourist's point of view, considering the past life-and career rather than the self-explanatory, subjective statements-it should be possible to influence the future conduct of these individuals. While their fundamental equipment cannot be changed any more than that of the other two groups, these people suffer more from the effects of their conduct than from their subjective attitude towards themselves or their environment. ”

“ The second group of psychopathic personality is characterized by the suggestibility of the will which controls the entire life course. The intelligence in most cases is good, in a fewer number it is below the average, or even poor. Some even appear to be above the average. They are usually good observers, have insight into the weakness and peculiarities of their entourage. They know how to display their talents. They have very little perseverance, and no inclination to exert themselves. ”

“ None the less, this must be done, and in every instance, in every disagreement, at every change in the routine of the individual, emphasis must be laid on the fact that it is done from a medical point of view, that is, from a point of view of therapy and help, with kindly feelings toward the patient, and never as a corrective or as a punishment, and above all, never vindictively. ”

“ One sees, however, that the criminology of these patients is brought out by their economic incapacities. The principal delinquency in the case of women is prostitution. Almost as frequent, however, is theft, then again swindling. The influence of alcohol can be recognized in all these instances in addition to the social and economic deterioration. The patients themselves are aware of this gradual demoralization. Occasionally, it is true, they assume the attitude of indifference, make no attempt to pull themselves out of the difficulty. ”

“ The patients feel that they are destined to do great things. They want to do something better than the average. In other cases, however, the mood is depressed or at least more sober. The patients feel that they are unlucky. They have doubts as to their future. They worry about their condition in life, complain that their life is a failure, they have no luck, they are lonely and forsaken. Nothing pleases them, everything appears hard, they have no friends. They frequently threaten suicide and even plan it, rarely, however, find the courage to carry it out. ”

“ On the contrary, they demand comforts and the satisfaction of their often very immodest requirements, and interpret every limitation as an undeserved insult. They are very pleasure-loving. The most severe disturbances, however, are in the region of the will. This shows itself often most markedly when the patient leaves the protection of his home. It resuits, in the first place, in a very apparent lack of perserverence and thoroughness in work. They usually begin to work with great enthusiasm, but soon lose interest, become distracted, and absent-minded, and commit gross errors and negligence. ”

“ Both factors exist in every individual and practically never operate independently. In health, the two are well integrated. The emotional impulses, the temperamental tendencies, or, to use the word of the biologist, the tropisms, exert often opposing tendencies towards each other and towards the guiding intelligence There is therefore a very marked distinction between the action of the tropism and that of the intelligence, namely, that the former exercises an episodic effect, whereas the latter is more or less continuous. ”

“ The male patients show smaller numbers than the females between the 15th and 20th year. After that, however, the number remains larger than that of the women and reaches its maximum 'between the 25th and the 30th year. It shows principally that there are causes at work which even after the full growth has been attained, tend to weaken the will and self control. There is another factor, however, which counteracts the natural maturity and which increases 'the number of those that have gotten into difficulties on account of their instability, namely, alcohol. ”

“ Occasionally, the attempt at suicide succeeds. Many patients suffer seriously from the results of the acts of violence or from excessive use of alcoholics. The attacks of excitement may recur frequently according to the temperament and the social conditions of the patient, but, as a rule, the tendency to these attacks diminishes from the end of the 20's. A third of Kraepelin's psychopathic cases belong to this group of excitable ones. Sixty per cent of these were female. ”

“ THE ANTI-SOCIAL INDIVIDUALS. The anti-social individuals are included in a group that has adequate intelligence, but has a certain dullness of perception in regard in social customs. They are disinclined to work, are lazy, untruthful, irritable, vain, self-satisfied, and most important of all, are incapable of any deep emotion. ”

“ These patients show a remarkably active imagination. They tend- to exaggerate, to embroider their narratives, to picture themselves in ideal situations, to invent stories. They imagine they are wealthy, belong to the nobility and so forth. They buy things on credit at stores under false representations. Often they seem to have no realization of the truth. One patient thought that he hypnotized himself. Of another it was said "he lies even when one is watching him." Many patients show artistic talents. ”

“ The behaviourist psychologist will nof lay too much weight on the results of a single examination by whatever method, but will lay more emphasis upon the history of the case, and the previous experiences of the individual and, above all, upon the reaction of the individual-to certain test situations during a period of observation. This behaviourist method offers the hope of a short cut in dealing with these individuals. An examination of a hundred cases of unemployment made at the Psychopathic Hospital gave the following interesting results. ”

“ When the after effects have disappeared and the patient once more seems normal, he is sent out into the world, in most cases, merely to repeat the offense that brought him under observation in the first place. ”

“ On the contrary, it is external circumstances which are the decisive factors. Furthermore, the patient does not become excited as a result of alcohol, but merely intokicated. An important place in the life of these patients also is sex. These people are usually sexually very active, and under the influence of their emotions, strengthened by alcohol, are guilty of the most shameless excesses. The inability of these patients to resist temptations from without induces the patients to live far beyond their means. ”