Some people know an acquaintance, coworker, friend, or family member as a compulsive liar. They lie when there doesn't seem to be any reason for it, and the consequences of lying seem to outweigh the benefits the lie will bring. To outsiders, the person lies about almost everything and anything, and seems to do it almost compulsively, as if the person cannot stop himself from lying. Treatment for compulsive lying is complicated, but not impossible.
Know that when you seek treatment for lying, your mental health professional might spend a great deal of time in the treatment process making sure he or she knows everything about your situation in order to make an accurate diagnosis. If lying is your most prominent concern, know that it could be part of several different disorders, it could be behavior associated with your life experiences, or for a number of other different reasons. Your clinician will want to differentiate the lying in context of your life and disorders that have lying as an inherent part of the disorder.
Extreme lying is seen as part of a variety of different disorders, and is always treated within those contexts. Addictions, such as addiction to gambling, have lying as one of the symptoms of the disorder. Most commonly, extreme lying behaviors are associated mostly with psychological disorders listed in the DSM-5 as well as other types of conditions, such as:
- Personality disorders (narcissism, borderline, antisocial, and histrionic)
- Factitious disorder (lying about having a disease for attention)
- Malingering (lying to avoid consequences or gain a benefit)
- Confabulation (lying to cover periods of amnesia)
- Pathological lying
There is a lot of debate surrounding pathological lying, including providing a unified definition of what it is and its clinical manifestations. Some feel that extreme lying can occur with the absence of other psychological disorders. Others feel that this rarely, if ever, occurs. Either way, your clinician will give you a full assessment to understand your lying in the context of many different factors.
Some disorders, such as personality disorders, have extreme lying behaviors as part of the disorder. When a person is treated for extreme lying, the person is assessed for other symptoms or life situations that could contribute to pathological lying, such as abuse or neglect. This helps clinicians treat pathological lying in context of the person's life experiences.
Since lying in itself can be a symptom of many other disorders, the treatment process begins with a careful, thorough assessment and diagnosis.
Interview and Observation
Mental health professionals will use a number of interviewing and observational techniques to gain an understanding of you as a whole person.
The mental health professional will ask you questions regarding your childhood, your present problem, your life experiences, and many other questions. This helps the professional learn about you, who you are, where you come from, as well as other clues from your past and present that will assist you in understanding the problem of lying and how it is relevant in your life.
Assessment and Diagnosis
The mental health professional might seek to verify observations with a psychological assessment. A psychological test, part of the overall diagnostic process, helps clinicians make a more reliable and valid diagnosis.
There isn't a test specifically for lying in general. However, there are tests that do take lying into consideration and are built into the tests to help you and the clinician understand more about the nature of your lying. One common test is the Minnesota Multiphasic Personality Inventory (MMPI), which is very helpful in understanding personality disorders and other types of mental disorders.
Treatment for excessive lying, pathological lying, or lying associated with a disorder is a highly individualized plan to help you gain control of your lying behaviors. The treatment can vary depending on the type of disorder and your life experiences that led to chronic lying.
Most often, lying will be treated in the context of other disorders. Here are some treatment options for some disorders that have lying as an inherent part of the disorder.
- Borderline personality disorder is characterized by fluctuating between emotional extremes, for instance defining people as bad or good with no gray areas in between.
- Dialectical Behavior Therapy is often seen as the treatment of choice for this disorder. This treatment required individual and group therapy sessions on a weekly basis. Also, the client completes homework assignments and works on developing social skills. Anti-productive behaviors such as lying are considered in treatment to help you develop better coping skills and understand where the behavior originated.
- Some medications, such as antipsychotics, antidepressants, and mood stabilizers might be helpful in treating some of the symptoms of borderline personality disorder. However, patients should be carefully assessed for suicidal tendencies, as some medications enhance suicide ideation.
- Pathological gambling inherently has lying as part of the symptoms.
- A pathological gambler will lie to cover the addiction, especially when the losses accumulate into the tens of thousands of dollars. First, compulsive gamblers often have other addictive disorders. Therefore, you might be assessed for other addictions. Compulsive gamblers might become part of Gamblers Anonymous, and also have individual psychotherapy to overcome the addiction and stop the lying to cover up their behaviors.
- Medications such as "serotonin reuptake inhibitors, opioid antagonists, and mood stabilizers" were researched in the treatment of compulsive gambling. Each were found to have some benefits in compulsive gambling according to case history and symptoms and triggers for gambling. However, using medications for pathological gambling are still under study.
- Antisocial personality disorder is particularly challenging to treat, and people will most likely only get treatment if it is court ordered.
- For antisocial personality disorder, psychotherapy and cognitive therapy are the treatment choices for this group of people.
- As with many of the personality disorders, no medication is approved specifically for the treatment of antisocial personality disorder. Some medications, such as antidepressants or antipsychotics can be used to treat some of the symptoms of this disorder.
If you know a compulsive liar and are interested in getting this person into treatment, know that this is a very difficult thing to do. Most often, when a person is lying, the person is likely trying to avoid a negative outcome, lying to get his or her needs met, or is hiding the truth from him or herself. If the person is still living in a state of denial, the therapeutic process cannot be forced upon the person, and can actually do more harm than good.
If lying is taking over your life, ruining your relationships, and squelching your professional potential, you need to seek the advice of a mental health professional.