The DSM-IV TR, Diagnostic and Statistical Manual, Fourth Edition, Revised Text, used by mental health professionals to diagnose for billing purposes, fails to have a specific definition of pathological lying as a psychiatric disorder, so a clear treatment for pathological lying in itself has not been defined.
The DSM recognizes that this type of lying can be symptomatic of other psychiatric disorders, especially Antisocial Personality Disorder or APD and Narcissistic Personality Disorder or NPD.
Pathological Liar Verses Compulsive Liar
When used properly, this refers to people who lie constantly to get their way and do so with little concern, regard or respect for the feelings and rights of others. It’s often associated another psychiatric disorder. Pathological liars are often goal-oriented as long as they get their own way. They are usually seen as manipulative, cunning and egotistical.
Many people confuse a pathological liar with a compulsive or habitual liar. These liars lie out of habit. They might bend the truth about everything. Telling the truth feels awkward; lying feels good. Most compulsive liars are not overly manipulative.
Warning Signs of Pathological Liars
A pathological liar might exhibit the following behaviors:
- Lie to control and get their own way
- Often change stories
- Exaggerate, lying about almost everything, but tell the truth about major ones
- Not value truth
- Live in their own reality most of the time
- Behave defensively when questioned or challenged
- Lie for sympathy
- Don’t admit they lie
- Contradict what they say because they don’t remember their lies, although there are exceptions
Pathological Liars with APD and NPD
While this type of lying can be present in other psychiatric disorders, they are most prevalent in the APD and the NPD. The hallmark of the APD is lacking conscience. They’re exploitive, have no regard for others’ feelings and lie repeatedly. The hallmarks of the NPD are a sense of entitlement and grandiosity. They exaggerate their achievements, lack empathy and exploit others.
Treatment for these types of liars must begin with addressing the personality disorders. This includes psychotropic medications and therapy which usually is behavioral and cognitive behavioral. Both therapies focus on changing the behavior of the patient with APD or NPD. Cognitive therapy also identifies and changes dysfunctional thinking and emotional responses.
Therapy requires cooperation from the patient. The problem with this is that treating people with APD and NPD can be difficult because these individuals generally lie to the therapist about taking medications and their behavior. Many people with these conditions routinely fail to recognize their behavior as problematic and are therefore unlikely to seek psychological help. They seem content to continue to lie as long as their egocentric needs are being satisfied. Some NPDs, if committed to changing, can be helped. There is no known effective treatment for the APD.
Options - How to Deal with Pathological Liars
Coping with these liars can be frustrating. Sometimes it’s hard to separate truth from their lies. It’s best not to confront these liars directly because, they will probably become defensive and rationalize by lying again, they might be angry or they might exhibit both behaviors. There are other options for dealing with them.
- Some believe that one should suggest the liar seek professional help. This can be a delicate situation because these liars don’t see anything wrong with their lying. Some believe their lies. In both cases it’s likely they would be offended and get angry. It’s the least desirable choice.
- Others believe one should realize the person is a pathological liar and to ignore the lies.
- People, when they hear two different versions of an event, can act confused and say, “I thought you said…. Please help me to understand.”
- The last option is to end the relationship with the liar, if possible.
Sources:
- Abnormal Psychology, Ephraim Rosen and Ian Gregory, (Saunders, 1965).
- Without Conscience, Robert Hare, (Guilford Press, 1999).
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