FIDDLER OF THE TRUTH
A brief look at pathological lying
by Mark D. Griffiths Ph.D.
Writings relating to pathological lying first appeared in
the psychiatric literature over 100 years ago and have been
given names such as ‘pseudologia fantastica’ and
‘mythomania’ and often used interchangeably.
There is some consensus that Dr. Anton Delbruck,
a German physician was the first person to describe the
concept of pathological lying in 1891 after publishing an
account of five of his patients. Despite the long
history of research, pathological lying is not included
in either the American Psychiatric Association’s Diagnostic
and Statistical Manual (DSM-5) or the World
Health Organization’s International Classification of
Diseases (ICD-10). The only mention of
pathological lying in the DSM is in association with
FactitiousDisorder (discussed below), However, many
psychologists and psychiatrists claim that it is a distinct
psychiatric disorder as highlighted in the many papers
that have been published
on the topic over the last two decades.
At a very simplistic level, pathological lying refers to
a person that incessantly tells lies. However, Dr. Charles Dike
and his colleagues in a 2005 issue of the Journal of the
American Academy of Psychiatry and Law define it as
"falsification entirely disproportionate to any discernible
end in view, may be extensive and very complicated, and
may manifest over a period of years or even a lifetime, in
the absence of definite insanity, feeble-mindedness or epilepsy”. However, there are other psychiatric conditions (such as
people with Manipulative Personality) that may also
engage in pathological lying as part of a wider set of behaviours
and symptoms. In fact, there is a lot of debate as to
whether the behaviour is really a discrete
and unique entity or whether it typically manifests itself
as an adjunct to other recognized psychological and/or
psychiatric conditions. Dr. Dike and colleagues note that:
“Pathological liars can believe their lies to the extent that,
at least to others, the belief may appear to be delusional;
they generally have sound judgment in other matters; it
is questionable whether pathological lying is always a
consciousact and whether pathological liars always have
control over their lies; an external reason for lying
(such as financial gain) often appears absent and the
internal or psychological purpose for lying is often
unclear;the lies in pathological lying are often unplanned
and rather impulsive; the pathological liar may become a
prisoner of his or her lies; the desired personality of the
pathological liar may overwhelm the actual one; pathological
lying may sometimes be associated with criminal behavior;
the pathological liar may acknowledge, at least in part,
the falseness of the tales when energetically challenged;
and, in pathological lying, telling lies may often seem to be
an end in itself. However, it is evident that
no single descriptive tableau of a pathological liar settles
all the nosological and etiological questions raised
by the phenomenon of pathological lying” (p.344)
Source:
Dike and colleagues then went on to list a wide range of psychiatric conditions
that have been associated pathological lying in an attempt to contextualize
how the lying behaviour is manifested within these known conditions. The
list of psychological and psychiatric conditions included: (i) Malingering,
(ii) Confabulation, (iii) Ganser’sSyndrome, (iv) Factitious Disorder,
(v) Borderline Personality Disorder, (vi) Antisocial Personality Disorder,
(vii) Histrionic Personality Disorders. Arguably it is these last
three disorders with which pathological lying is most associated with.
The following briefly describes the symptoms and context of each of these
conditions as outlined
by Dr. Dike and his colleagues:
• MALINGERING : This is deliberate lying where the person
grossly exaggerates or totally lies about physical and/or
psychological symptoms. Unlike ‘archetypal’ pathological liars, malingerers are typically motivated to tell lies for a specific
purpose such as to obtain financial compensation, to avoid
working, to avoid military service, to avoid criminal
prosecution, etc.
• CONFABULATION : This is where people tell lies incessantly
as a way of covering up memory lapses caused by specific
memory loss conditions (e.g., organically derived amnesia).
In ‘archetypal’ pathological liars, the condition is psychological
(rather than organic) in origin.
• GANSER'S SYNDROME (GS): GS is a rare dissociative
disorder (only 101 recorded cases ever) characterized by
affected people giving nonsensical answers to questions
(and goes under many other names including ‘nonsense
syndrome’ and ‘balderdash syndrome’). Unlike the elaborate
and sometimes fantastical stories told by ‘archetypal’
pathological liars, the lies told by those with GS are very
simplistic and approximate.
• FACTITIOUS DISORDER (FD): FD is the deliberate use
of lies and/or exaggerations concerning psychological
and/orphysical symptoms solely for the purpose of assuming
the role of a sick person (formerly known as Munchausen’s
Syndrome). In contrast, the ‘archetypal’ pathological liar
doesn’t want to appear sick to other people.
• BORDERLINE PERSONALITY DISORDER (BPD):
BPD isthe condition where people have long-term patterns
of unstable and/or turbulent emotions. Pathological
lying and being deceitful are core characteristics of BPD
and lies are typically told for personal profit or pleasure.
Although. BPD patients typically have contradictory
views about themselves and lack a consistent self-identity.
A lack of impulse control may
facilitate the distortions and lies told.
• ANTISOCIAL PERSONALITY DISORDER (APD):
APD is the condition in which the sufferer has a long-term
pattern of manipulating, exploiting, or violating the rights
of others (and is often criminal). Those with APD often lie
repeatedly and consistently for personal satisfaction alone.
Although those with APD are often pathological liars,
‘archetypal’ pathological liars rarely have disordered
antisocial personalities.
• HISTRIONIC PERSONALITY DISORDER (HPD):
Those with HPD act in a highly emotional and dramatic
way to draw attention to themselves. They often lie as
a way to enhance and/or facilitate their dramatic and
attention-seeking behaviour. In contrast, ‘archetypal’
pathological liars do not constantly seek attention.
Based on the list above, it is evident that the symptom of
pathological lying can occur in some mental disorders
(e.g., FD, BPD) and could be called secondary
pathological lying. However, it is much less clear whether
it can occur independently of a known psychiatric disorder
and be seen as primary pathological lying. Unlike the other
forms of lying outlined above, Dr. Dike says pathological
lying appears to be unplanned and impulsive. Despite all
the speculation, there is still relatively little known, although
it’s thought to affect men and women equally with an
onset in late adolescence. There are no reliable prevalence
figures although one study estimated that one in 1,000
repeat juvenile offenders suffered from it.
On a biological and neurological level, a paper published in
the Journal of Neuropsychiatry and Clinical Neurosciences
by Dr. J.G. Modell and colleagues reported the case of a
pathological liar who was given a brain scan. Results showed
that his condition was associated with right hemithalamic
dysfunction. This supported the hypothesized roles of the
thalamus and associated brain regions in the modulation of
behavior and cognition.
A 2007 study published in the British Journal of Psychiatry
by Dr. Y. Yang and colleagues reported differences in brain
structure between pathological liars and control groups.
Pathological liars showed a relatively widespread increase
in white matter (approximately one-quarter to one-third
more than controls) and the authors suggested that this
increase may predispose some individuals to
pathological lying.
Those working in the mental health system need to pay
attention to pathological lying so that they can inform
legal practitioners about whether pathological liars
should be held responsible for their behaviour.
Whether pathological liars are aware of the lies they
tell has major implications for forensic psychiatry
practice. Dr. Dike says it could help determine how a
court deals with pathological liars who provide
false testimony while under oath.
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Mark Griffiths, Ph.D., is a chartered psychologist and Director of the International
Gaming Research Unit in the Psychology Division at Nottingham Trent University.
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