How is Pathological Lying Treated?
The term pathological lying essentially translates to uncontrollable lying. This can mean that a person who is suspected of pathological lying is considered to have a disease, and therefore cannot control the lying. However, psychologists and psychiatrists fail to account for a specific definition of pathological lying as a disease. It can be symptomatic of other conditions, like antisocial personality disorder, obsessive compulsive disorder (OCD) or attention deficit and hyperactivity disorder (ADHD). It is not always present in these conditions, so a clear treatment set for pathological lying has not been defined.
An interesting study on pathological lying published in the October 2005 British Journal of Psychiatry suggest that the pathological liar may have a slightly different brain than those people disposed to tell the truth. In the prefrontal cortex of the brain, pathological liars were shown to have 26% more white matter than do people with other psychological disorders who don’t lie. Previously, white matter has been linked to ability to lie. Lower amounts of white matter is typical in the brains of people with autism, who generally cannot lie, suggesting that more white matter disposes one to the increased ability to lie.
From research in child development we know that children tend to become much more credible liars when they are about 10. Before that, they generally are not believable. This 10-year mark coincides with noted development of white matter in the prefrontal cortex. More white matter may simply mean more lying, and too much white matter might translate to pathological lying.
Unfortunately, this study does little to address how these new findings could affect treatment. In fact, it specifically states that this research hasn’t led to any new ideas for treatment. Like the autistic, who suffers from too little white matter in the prefrontal cortex, pathological liars may not be able to have their condition resolved if the basis for their condition is a result of brain structure.
Many people who exhibit pathological lying also clearly exhibit symptoms of other treatable conditions. Conditions like ADHD and OCD are treatable through medication, though different ones. This makes accurately diagnosing underlying conditions important. The last thing one would want to give a person with OCD is a stimulant like Ritalin, which would likely exacerbate their disorder.
Personality disorders that contribute to pathological lying may also respond to a combined treatment of psychiatric medication and cognitive behavioral therapy. The goal with pathological lying must in the end be to treat any evidence of illness or conditions that may influence the lying. This may include medications and the use of behavioral therapy to help the person overcome compulsive lying.
Therapy and medication require compliance from the person being treated, and the pathological liar who has antisocial disorders may not wish to be treated. A person who suffers from pathological lying must on some deep level be committed to the work required in cognitive behavioral therapy, as well as be willing to take medications. The trouble with these methods is that pathological liars can quite easily lie about taking their medications, or about their effectiveness of medications. They can also quite credibly lie about what is happening in their life, which may void the efficacy of therapy.
Pathological lying remains an issue of much debate in the medical community. There is, as yet, no clear path to treatment. The best that can be said is that some treatments will work for some people, but no one treatment will work for all.
Written by Tricia Ellis-Christensen
