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In the early 1950s, I interviewed a 20-year-old man on the prison ward at Bellevue Psychiatric Hospital who had planned, conspired, and helped commit a double murder with ruthless disregard for the consequences of his actions.7 In a very businesslike way he had persuaded a companion, a schizophrenic who was an only son of two physicians, to poison them by having them both drink champagne, which the instigator had filled with arsenic, on the parents’ wedding anniversary night at a “celebration” by this foursome. The police listed their deaths as a double suicide for more than a year. Meanwhile, a life insurance policy of $150,000 was shared by the two youths. The reason for their eventual arrest was my patient's need to impress his girlfriend by constantly boasting of his role in killing his friend's parents; she eventually informed the police about the crime. As a result, both young men were placed on the prison ward for examination and observation. The couple's son was diagnosed as a schizophrenic and my patient as a “psychopathic personality.”
During my psychiatric interviews with him, he neither showed consciously remorse, guilt, shame, nor anxiety, nor did he admit feeling any of these emotions. He admitted readily to his part in the murder, which he said was, to him, an experience similar to Oscar Wilde's “In Search of a New Experience.” He did not have any remorse about his actions, except for the regret he felt about being apprehended and imprisoned. He admitted seeing nothing wrong with murder, stealing, or any other immoral or amoral actions, provided he or anyone else could “get away with it.” He showed no psychotic illness or symptoms.
I demonstrated that his unconscious, idealized image of perfectionistic behavior, with its unrelenting “shoulds” of absolute moralistic standards and unconscious guilt and anxiety, was so burdensome to him that he felt that the only way to relieve himself of this powerful pressure was to externalize his problems and overthrow