Saturday, August 16, 2008

The Pathology Of Lying...

I recently received an email from a CHEESE reader, who asked, "Why do people lie about their (MS) symptoms?" I asked permission to discuss the context of this question here (while maintaining said person's anonymity), because I think it is the CONTEXT or situation surrounding the reader's question that is most important. The fact is we ALL lie about things in our life...and if you piously try to tell me you don't and have NEVER spread your truth thin, well...let's face're a LIAR. LOL But this emailer's question runs far south of the everyday lies we ALL tell, running right along the line of the pathological. And, since I work in psychiatry, I will attempt (at best) to shed some light on her disturbing experience.

The email I received was regarding a particular "chat" and message board in the Multiple Sclerosis community (which I will not disclose here to maintain anonymity!), where it appears many MSer's go to discuss their current symptoms, find MS friendships, and generally "bond" with each other around the common theme of MS. The emailer has been a member of this community for quite some time and, themselves, diagnosed with MS for just as long.

On this particular MS chat and message board, the emailer met a "new" member who had many questions about MS and generally seemed "lost" in the diagnosis. The emailer (being an old "pro" at MS) decided to graciously lend an ear to this newer member and try to guide them through the maze of living with MS. What transpired AFTER this initial contact was several WEEKS of intense contact, emails, exchanged phone numbers and conversations, plans to meet each other in person, etc. The emailer felt as if she and the new member were developing a solid friendship...having found their initial bond around the common theme of MS.

I will not go into gory details of the rest of this story (because it is just too long to disclose and I will NEVER get to the "why lie?" portion of this post if I do!)...but suffice it to say, after a series of accumulating and strange events (like 911 calls to assist the new member), it was discovered this person did NOT have MS at all! In fact, they most likely had never experienced MOST if ANY of the symptoms and hardships professed on the chat and message board. WHOOT, you say?!?

Interestingly enough, this is really NOT the first time I have heard a similar tale of deception. I know of at LEAST 3 other incidences of very similar circumstances from other MS friends or message boards. Knowing this fact, however, did not calm the emailer's woes...she felt angry, "stupid", and extremely hurt...and thus, posed the question to me, "Why do people lie about their (MS) symptoms"?

This is a very complex question and one that cannot be answered in generalization. And I think the FIRST order of business is to attempt to explain why ANYONE would tell a lie, deliberately deceive another, or not disclose their ENTIRE truth...something each and every ONE of us has engaged in one or more times in our lives, not just John Edwards (and research proves this number to be FAR more than a one time thing for anyone, myself included!).

Most people can identify who they believe to be "everyday liars"...a small list might include lawyers, car salesmen, and criminals/con artists...people who might lie for a living or to meet needs to sustain their livelihood. Somehow in society, we accept this. We KNOW this to be "true" as a general consensus, which is what we base many of our "truths" upon...a general societal belief or consistent pattern of behaviors in a society. For various reasons, we don't QUESTION these liars because we already ASSUME what might be coming from their mouth contains falsehoods! We therefore, as a society, "accept" we will most likely be lied to by these individuals and we put in place safeguards in our psyches, behaviors, and laws when dealing with these individuals directly.

We also, on a very deep level of our OWN ego/psyche, understand and can RELATE to the lies of the above mentioned (and above mentioned being generalized! emails from lawyers telling me they will now SUE me for defamation...sigh.). We can rationalize this type of lying because we have engaged in it OURSELVES in one form or another.

Most of us prefer to use the watered-down term of a "white lie" when discussing this form of deception. And the word *white* in the description refers to deception for "good". White lies are told when we believe on some level telling our TRUTH (or all of our truth) could be harmful, either to ourselves or another. WE, you and I, tell "white lies" to avoid hurting another person's feelings, to avoid embarrassment, or to reassure another, believing that this type of action is "best" for ourselves or the person involved (as possible rationales)...we, you and I, as a species AVOID pain and painful situations REFLEXIVELY, both physical and emotional in nature. It is a very basic form of survival, taking us from the simple reflexive physiological response to the more complex mental negotiations we make in our brains (psychological) to AVOID pain.

So, can "we" (and as my mother used to say whenever I'd use the word "we" inappropriately, "What? Do you have a turd in your pocket?", meaning myself and my "turd"...) at this juncture accept at face value the generalization that "WE" all tell lies or do I need to continue to beat this dead horse?!? Stop reading if you are in denial about your own behaviors here...this post isn't for you.

In the case of my emailing acquaintance, the person she speaks of fell far out of the boundaries of everyday deceptive/lying behavior. And because of this, the emailer had no basis--no format--to conceptualize WHY or HOW anyone would ever behave in such a manner...she simply could not relate. And this, my friends, is where "white lie" behavior morphs into "black lie" behavior, and is deemed *pathological* in nature. The lying does not fall into our society's accepted guidelines of *lying*.

In my 22 years of psychiatric nursing experience, I have encountered countless examples of *pathological* lying. I have also witnessed OFTEN a feigning of psychological symptoms in which a person "pretends" (or may even believe) or "puts on" symptoms to meet their needs. In my business (of controlling WHO might get admitted to a psychiatric hospital and WHO does not), we (the OTHER collective "we") sometimes refer to this behavior as "looking for three hots and a cot". In other words, the patient/individual feigns psychiatric symptoms to obtain access to a warm bed/shelter and three meals a day...NOT because they need the environment to treat psychiatric symptoms...but because they DESIRE this environment to meet food and/or shelter needs. Again, WHOOT you say?!? Yes, it does happen...frequently. But this is an entirely DIFFERENT topic to be chronicled in magazines such as "Psychology Today", and NOT something that needs to be addressed here. ("Thank gawd", you say.)

If I, as a behaviorist (and I am actually a behaviorist existentialist in my educational background and belief...meaning, I believe ALL behavior has meaning AND sometimes Sh!+ happens!...psych joke, sorry.), can convince you that ALL behavior has meaning, no matter how dysfunctional, I can perhaps form a context for understanding the pathology of lying and *pathological lying* as well. And, if you "can't go there" with me, then the rest of this post is going to be pretty boring.

Generally speaking, theorists believe it is human nature to begin our "lying paths" around the age of 5 or 6 years old. This is the age when most of us mature enough to understand the consequences of our actions, when we also developmentally begin to feel guilt, particularly surrounding issues with our parents or authority figures, and when we are most seeking attention. By the ages of 7 to 8, we tell lies to avoid punishment or to avoid certain tasks. By adolescence, our lying becomes more skilled and complex as we begin to navigate our independence from parents/authority figures and try to establish our own sense of self. It is believed lying is a LEARNED behavior, and for the most part, by the age of adolescence we are capable of feeling remorse...for our actions AND our lies.

When lying or the art of deception becomes *pathological*, is when there IS no remorse or the act of lying is habitual. It becomes pathological when the individual themselves may not be able to distinguish the untruths they tell from other words, the individual has told so many lies, THEY no longer know where the truth *lies* (pun intended). This is NOT to say, however, that the act of lying or the habit of lying has ceased to meet a fact, quite the opposite is true. The individual must tell more and more lies to maintain the image or facade they are creating to MEET that need...whether it be for attention or some other gain entirely.

So, exhaustively you may ask again, "But WHY would someone lie about their MS symptoms?"

I believe the answer to that question is both simple and complex. Simply put, someone might lie about their MS symptoms or even HAVING MS to meet a need...and generally speaking, that need is for attention or belonging or identity. Those of us with MS know the importance we place upon SHARING our symptoms with one another...we desperately want to know we are not alone with this disease. We very much want to help another who might be struggling with this disease. We often refer to a "club membership" with this disease. We "belong" with each other under the common theme of Multiple Sclerosis.

To someone very much needing a sense of belonging, identity, or attention, the MS Community is a wonderful group of caring individuals...we are both knowledgeable and educated about our disease and most of us have a sense of wanting to help others "get through" the rough bumps of the diagnosis because we have EACH BEEN THERE OURSELVES BEFORE. We understand what it is like to have a hidden disorder that is both illusive and sometimes GRAND in it's presentation. We know what it is like to be "poo poo-ed" (discounted) about strange neurological symptoms and we know what it is like to feel isolated by this disease at one time or another. Imagine the ATTRACTION one might find to a group of MSers when they, for reasons unknown (or extremely complex reasons), have felt isolated, alone, discounted, not belonging, or needing of attention? Wow! They may not HAVE MS, but they certainly can relate to those feelings...but they can't *BELONG* to the MS Community without Multiple Sclerosis.

"But why would anyone in there right mind even WANT to have MS?", you MSer's say. They DON'T want MS...the person wants the attention or sense of belonging to a community WITH MS.

OK...that said, now on to another reason someone might lie about their MS symptoms or having MS. There is a well-known disorder (it's in the DSM-IV Revised, so you can check on me here) in the psych world called, Munchausen's Disease (it is a classified disorder, falling under the scope of factitious disorders). By definition, Munchausen's is a psychiatric disorder in which an individual *fakes* an illness, trauma, or symptom for the very purpose of gaining sympathy or attention. This person will often CREATE a medical crisis or disorder to gain the attention of the medical community (and just to scare you further, there is also Munchausen's by proxy, where an individual will create a disorder in ANOTHER to gain attention...usually parents of small children!). This person KNOWS they do not have symptoms of a particular illness, yet their need for attention is so great, they will feign or even self-impose the illness (sometimes by injecting themselves, beating themselves, and a whole HOST of grueling ways of obtaining an illness). This diagnosis has the primary SYMPTOM of lying...pathologically.

Someone with Munchausen's Disease must choose their illnesses well...or be "found out" by the medical community. They cannot chose to fabricate symptoms of an illness that can easily be detected with lab work, x-rays, or tests, otherwise the medical community will quickly discover the pathology of the lying and their source of attention will cease. Multiple Sclerosis is the PERFECT illness to feign! I mean many of us have struggled to get a definitive diagnosis of MS for weeks, months, or even years?!? And there STILL remains no conclusive test that will absolutely, one hundred percent-ly, PROVE we've got MS percolating in our brains and spinal cords!!! Ta da...welcome the pathological MS symptom LIAR. It could take months or even years for someone or the medical community to *discover* specific neurological symptoms do not exist AT ALL in this individual.

Now, this is NOT to say everyone WITHOUT a diagnosis of MS must be lying about their symptoms...this is also NOT to say the MS Community shouldn't welcome those with loosely defined illness into the fold. MOST OF SOCIETY DO NOT FEIGN SYMPTOMS OF MULTIPLE SCLEROSIS TO GAIN ATTENTION. But, for that very small percentage of troubled folks that do, I am hoping this post will shed some light on the question, "Why would someone lie about their MS symptoms?"...

I'm tired now...I need to go *lie* down...I won't even add, "pun intended" here...



I've personally known a pathological liar (related), but did not realize many of the lies were untrue. Very natural and convincing. Interestingly this person thought that others were clever liars and feigners which led to doubts spread through relatives regarding one's autoimmune diagnosis (not me, and not MS) which is often illusive as well.

Unfortunately I tended to believe the liar and doubted the truth-sayer. Talk about a head trip when all of that came to light (triangulation anyone?). I questioned many times the "why would anyone lie about that?" often for things which simply didn't seem to matter. No need to lie about it.

The lies of pathological liars (at least the one or two I've known well) seldom make sense in that they seem completely unnecessary. And if you go so far as to try to show that you can see the evidence of the truth, the liar can become rather dangerous and volatile. Best to leave it be sometimes.

Your explanation of the need to belong and be accepted (without requirements) is excellent. Give understanding and compassion but also protect your own emotional attachments and gullibility, I say.

thank you for this excellent post.

Denver Refashionista said...

Wow, that "liar" needs to get a life. While I have learned a ton from MS I would happily live without. What they did was incredibly mean-spirited and cold toward a person who already had enough on their plate. This does not jade me but it does piss me off.

I am also an existentialist and if this is how someone sees their purpose they are really missing the point!

have myelin said...

Thanks for this wonderful post. I have a family member with this problem and it's certainly "eye-opening" to get some clarity on such a strange problem.

I wonder where the ROOTS of pathological lying come from...surely they start as a small child? I know in my case the family member I'm talking about lied even as a small child. *groan*

Good post, Linda D!