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Doctors say pathological lying should be a mental disorder

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Pathological lying has been recognized since the 1800s, although it has never received a great deal of medical attention. But that may be about to change.  

According to CNN, “Psychiatrists have recognized pathological lying as a mental affliction since the late 1800s, yet experts say it has never been given serious attention, funding or real study. It doesn’t have its own diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, or DSM, the bible of psychiatry. Instead, it is recognized as a feature of other diagnoses, like personality disorders.  

As a result, there’s no evidence-based way to treat it, even though many pathological liars say they want help to stop.  

The standard approach to treating lying relies on techniques borrowed from cognitive behavioral therapy, which emphasizes understanding and changing thinking patterns. But no one is sure that this is the most effective way to help.” 

Physicians from around the world discuss this topic on Sermo. In a recent poll of about 400 doctors, 77% said pathological lying should be its own diagnosis in the Diagnostic and Statistical Manual of Mental Disorders. And 97% believe that pathological lying could also be a feature of another diagnosis, such as a personality disorder. 

Regarding true pathological liars, 66% said this condition is very rare; and 48% said they have treated a pathological liar at some point.  

83% of doctors said most people lie sometimes, even daily—and that is normal. 

Below, Sermo physicians share more of their perspectives and opinions on this health topic—in their own words: 

I think it is a symptom indicating other psychopathology like personality disorder, deep underlying shame, social anxiety. I think I have seen one case in 40 yrs. George Santos could be a good candidate for this as a problem behavior.”

Psychiatry, Canada 

“The pathological liars I’ve met had significant underlying trauma.”

Rheumatology, U.S. 

These people are rare and extremely difficult to deal with at times…..almost all end up in trouble with their families and the law. Many of these pathologic liars have delusions of grandeur – as things are whatever they say they are….and every lesser person should agree with them.”

Family Medicine, U.S. 

“I find the article very interesting. I have never treated patients with this disease, many people lie on occasion and should not be included, and many times the act of lying is part of other psychological disorders. Although the saying goes that it is easier to catch a liar than a lame person, I consider that this is not always the case, because in my opinion these patients can be very cunning, and behind continuous lies they hide their low self-esteem. I think the diagnosis is difficult, as is its acceptance by the patient. In this sense, the family could play a very important role.”

Family Medicine, Cuba

“Lying is a complex human behavior. While it is not necessarily “normal” or desirable to lie, it is a common and often accepted part of human communication, many people may engage in small or “white” lies as a way to present themselves in a more favorable light or to avoid consequences for their actions. However, it is important to note that lying can have negative consequences, both for the person doing the lying and for the people around them. It can erode trust, damage relationships, and lead to feelings of guilt and shame.”

Family Medicine, Spain 

“Since this entity is given by the unstoppable desire to lie before any need of the person, be it to please, to be the center, etc., I consider it brings a lot of suffering to both the person and to friends, families, couples since it becomes unreliable for all leading to rejection, we must help these people, show them affection and concern for their situation, thus contributing to their restoration in society.”

G.P., Cuba 

“This is often a spectrum. People adapt to survive and the symptoms of personality disorders generally feature both high levels of early adversity leading to disorders of self-organization and more primitive survival mechanisms. The DSM is not and has never been a guide to treatment and should never be used as such, it’s simply a guide to a common language with no base in causation. Treat the adversity and work on foundational themes with people with PDs if you have the patience and training – for these extreme adaptations there are rarely quick fixes – yet, every patient, every person is different.”

G.P., Canada 

“I think that this type of person does not do it consciously, so I consider it a pathology, I know a person who does it in such a natural way that you even manage to believe everything.”

Anesthesiology, Cuba 

“I truly believe that Pathological lying is strongly related to Delirium of Grandeur.”

Family Medicine, U.S. 

“Psychologically, the pathological lie is a conscious and deliberate act, but not intentional, since the person does it unconsciously.”

G.P., Venezuela 

“Mythomania is the compulsive need to lie about matters big and small, regardless of the situation. Unfortunately, it is a somewhat forgotten topic since there are no studies that address it in more depth.”

G.P., Cuba 

“I have treated pathological liars. Challenging. There are features of the disorder that are similar to borderline personality disorder.”

Psychiatry, U.S. 

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