The Truth About Pathological Lying
What is pathological lying?
In the field of mental health, pathological lying (PL) is controversial. The psychiatric community has yet to agree on a formal definition, although many core elements have been identified. In short, PL is characterized by a lifelong history of recurrent lying for which there is no psychological motive or external benefit. For instance, as ordinary lies are often goal-oriented to obtain an external benefit or to avoid punishment, pathological lies are often purposeless.1 In fact, sometimes pathological lies can be self-incriminating, making the behavior even more confusing.1 Division Medical Director at Whiting Forensic Services at the Connecticut Valley Hospital and Assistant Clinical Professor of Psychiatry at Yale University, Charles C. Dike, M.D. states that although PL is under-recognized, it has been written about in psychiatric literature for over a century.1 In fact, German physician Anton Delbruck coined the term “pathological lying” and described its concept in the late 1800s. Delbruck stated that some patients told such abnormal and elaborate lies that they “deserved a special category.”1
More Research on Pathological Lying Needed
Unfortunately, the epidemiology of PL has not been studied in detail. Its prevalence of one percent is based upon a study of 1,000 juvenile offenders, which also stated that it is equally prevalent among males and females, the IQ is usually average or slightly below average, and there is usually a history of CNS abnormalities.2 According to Dike, PL is known for its incessant lies and the lack of benefit they produce.1 In fact, they are usually easily disprovable, although elaborate and complicated in nature.1 Often, the boundary of fiction and reality is blurred. Researchers have concluded that the behavior of lying seems to be gratification itself, with an internal reward for the liar.
Many debate whether or not pathological liars are able to recognize their own lies—some believe they can and others state they cannot.1 For some, pathological lying has been described as impulsive and unplanned; therefore, the pathological liar’s ability to control their behavior is doubtful.1 Also, the self-incrimination and repetitive nature of the lies further contributes to the liar’s inability to recognize their behavior.1 On the other hand, others state that if the liar is challenged persistently, they often recognize their lies, thus showing they have the ability to understand their behavior. Dike states that it is not uncommon for pathological liars to have solid judgment regarding other areas in their life, with the association between PL and crime only occurring in 50 percent of cases.1 Often the crimes associated are theft, swindling, forgery, and plagiarism.
According to Dike, PL should be differentiated from other psychiatric conditions commonly associated with lying, such as personality disorders malingering, Ganser syndrome, and confabulation.1 Personality disorders, malingering Ganser syndrome, and confabulation often do not show falsifications to the elaborate and complicated extent that PL does.1
Treatment Options for Pathological Lying
Treatment options for PL are limited, as not many have been thoroughly researched.1 The main treatment remains psychotherapy, as there are not pharmacological treatments available.1 However, further examination of the PL associated CNS abnormalities may lead to other therapeutic interventions.1 First, though, according to Dike, is to view PL as its own diagnostic entity.1 Currently, it is a symptom of factitious disorder, and emphasis on treatment is only researched for overall disorders, not separate symptoms.1 However, the consequences of PL may be severe for the individual. All relationships with the liar are at risk as the person cannot be held trustworthy and credible, and at work, they are at risk of being bullied, alienated, or fired due to their lying.1 Therefore, treatments must be researched.
Overall, Dike states that PL is a special form of lying, complicated and rare.1 Psychiatrists treating pathological liars should take an extensive history of their lies from the person, their family and their friends.1 Also, psychotherapeutic treatments may be considered, such as cognitive-behavioral therapy.1
 Dike, C.C. (2008, June 1). Pathological Lying: Symptom or Disease? Psychiatric Times. Retrieved from http://www.psychiatrictimes.com/display/article/10168/1162950
 Healy W, Healy MT. Pathological Lying, Accusation, and Swindling: A Study in Forensic Psychology. Boston: Little, Brown, and Co; 1915. http://books.google.com/.
 Deutsch H. On the pathological lie (pseudologia phantastica). J Am Acad Psychoanal. 1982;10:369-386.
 Wiersma D. On pathological lying. Character Pers. 1933;2:48-61.
 King BH, Ford CV. Pseudologia fantastica. Acta Psychiatr Scand. 1988;77:1-6. pathological lying.