- There is a distinction between normal lying and pathological lying.
- Several psychotherapy interventions can help pathological liars.
- Psychopharmacological interventions do not seem to be helpful.
- With evidence-based treatments, pathological liars can become more honest.
Imagine that you are at a party and you meet someone who tells you, “Once, I saved a friend of mine… I had to jump a mile down from a helicopter into a pool of alligators and sharks in Florida. I was able to fend off the shark attack and outmuscle the alligators with my strength. My friend treated me like I was a hero. And I had to use a harpoon to kill the many sharks and gators. The harpoon went into the alligator’s eyeball.”
Most people would quickly realize that the person was lying. In fact, this heroic account is a real one, from a pathological liar that my co-author, Drew Curtis, and I discussed in our book, Pathological Lying: Theory, Research, & Practice. When people lie pathologically, their chronic deceit often causes considerable problems in their lives. So, can we treat them and reduce their habitual dishonesty? Can pathological liars be cured?
Pathological Versus Normal Lying
First, I will distinguish pathological lying from "normal" lying. Most people lie occasionally, whether to avoid embarrassment, protect someone's feelings, or make themselves look good. Pathological liars, on the other hand, lie habitually, often for no obvious reason. The lies can range from small exaggerations to elaborate fabrications. This pattern of deception can have significant negative consequences on the individual's personal and professional relationships, as well as their overall well-being. Many of them want to stop lying, as it causes them considerable distress. About 90 percent of people report that they have interacted with a pathological liar, and they note that lying is often a central feature of the person.
Pathological lying is not an official psychiatric diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, the primary reference guide used by mental health professionals. That is, it is not recognized as a standalone mental disorder, although we make the case that it should be. However, pathological lying is listed as a symptom or characteristic of other psychiatric conditions, such as personality disorders (such as narcissistic personality disorder, borderline personality disorder, and antisocial personality disorder) and factitious disorder.
Treatments for Pathological Lying
So, is there a cure for pathological liars? Treatment can be a challenge because it is often intertwined with other mental health issues, the individual is often not motivated to change, and the lies may have become a deeply ingrained part of their identity. However mental health professionals can offer various treatment options that are empirically supported.
Cognitive-behavioral therapy (CBT) has proven to be an effective approach. CBT helps people identify and change dysfunctional thinking patterns such as a yearning for attention that trigger the urge to lie and identify alternative more honest patterns of responding.
Another potential treatment option is dialectical behavior therapy (DBT). Originally developed to treat borderline personality disorder, DBT combines elements of CBT with mindfulness techniques and teaches patients how to regulate their emotions, tolerate distress, and improve interpersonal relationships. This approach may be particularly helpful for pathological liars who struggle with emotional instability and impulsivity.
Pharmacological interventions may also be considered, particularly if the pathological lying is accompanied by other mental health disorders, such as anxiety or depression. However, while researchers have examined treatments such as fluoxetine and lithium, there is not yet compelling evidence that pharmacological interventions can successfully decrease problematic lying.
Group therapy and family therapy are also helpful. Lying is a social phenomenon, so addressing it from a social perspective can help pathological liars gain insight into the problematic ways they relate with others. Group members and family members can help the pathological liar understand how their dishonesty is harming their social connections. These confrontations can also help the liar develop new tactics for relating in honest ways.
Pathological Liars Can Change
Instead of dismissing pathological liars as nefarious manipulators, we should recognize that they are often struggling with very real psychological problems. While there is no "one-size-fits-all" solution to treating pathological lying, there is strong evidence that some treatments lead to significant improvements. The journey toward "curing" pathological lying is typically a complex and challenging one, but with the right combination of treatments and a motivation to change, pathological liars can become more honest.
To find a therapist near you, visit the Psychology Today Therapy Directory.
Curtis, D. A., & Hart, C. L. (2022). Pathological lying: Theory, research, and practice. American Psychological Association.