Pseudologia Fantastica

What is Pseudologia Fantastica?

Pseudologia fantastica, also known as pathological lying or mythomania, was first described in 1891. This is a psychological condition characterized by habitual or compulsive lying. This concept is actually quite controversial within the psychological community, especially when it comes to diagnosing and treating the condition. Part of this is because doing so can be incredibly difficult.

Generally, individuals diagnosed with pseudologia fantastica tend to create extensive and complicated lies that may manifest over short or long periods of time. While some people with the condition are aware of the lies they tell, many tell lies almost without thinking. Understanding pathological lying can be difficult, but it is an important part of determining how to proceed with treatment or prevent the psychological condition.

Causes of Pseudologia Fantastica

Researchers are still not exactly sure what causes pseudologia fantastica, but there are a few popular theories floating around. Causes range from emotional to physical, and it is possible that there are actually several causes of pathological lying involved. More research is required to fully understand why this type of mental illness manifests in the way it does.

In one theory, researchers believe that a chaotic home environment may be a major factor involved in pseudologia fantastica. This is especially the case when a close family member, such as a parent or sibling, was diagnosed with a mental illness that caused disturbances within the home. Lying may begin to develop as some sort of coping mechanism or perhaps as a way to draw more attention to oneself.

In fact, attention may have a lot to do with the reasons why this condition manifests as well. Attention-seekers may feel that the lies they tell make them look favorable to those around them. In some cases, the patient may even lie to make themselves appear negatively for the sake of receiving some attention.

Some researchers believe that one component of the condition is the belief that one’s own life is boring or uneventful. In lying to other people, the patient appears fascinating to them, at least in the patient’s own mind. To those around the patient, the lies are often painfully obvious.

Researchers also believe that cases of pseudologia fantastica may have a biological basis too. This may include abnormalities of the central nervous system. Conditions like epilepsy may also contribute to pathological lying, as do head trauma and ADHD. More research is necessary to find this definitive link between these types of conditions, so researchers are not yet able to figure out if one condition causes another in this case.

According to some experts, individuals who have been diagnosed with pseudologia fantastica may also be more likely to exhibit abnormal EEG results. Again, not enough information is known at this point to determine causation or specific correlation.

Additionally, researchers believe that there tends to be an increase in prefrontal white matter in the brain among those with pseudologia fantastica. This also means that the ratio of gray and white matter is atypical.

Symptoms of Pseudologia Fantastica

The major symptom of this condition is that the patient lies frequently, generally for no extrinsic benefit at all. The patient will create fantastic stories that are likely not true in the slightest.

Most stories are easy to see through, and so it may become more clear to friends and family members that the patient has a condition that facilitates or encourages the lying. For instance, the patient may lie about having met a famous actor last week in an obscure location. When pressed on the issue, the patient may not let up on the story and may even provide details that double down on the lie.

The lies are typically chronic and do not occur out of necessity or social pressure. For this reason, there is a distinct difference between somebody who is a pathological liar and a teenager who lies about their parent abusing them. The teenager has reason to lie, as he may not want to be removed from his house or to anger his parent.

Additionally, the lies also tend to present the liar in a positive light. The lies may be built on a small kernel of truth. For example, the patient may consider the fact that they had good grades in high school and then lie that they were the valedictorian of the school. The purpose of this lie is to make the patient appear more intelligent and successful, even if the truth was nothing to be ashamed of.

In rare cases, the lies may be incriminating or negative. Somebody may lie about committing specific crimes so that they appear “cool” to a group of people. Ultimately, the lies may be negative, but they do allow for some internal positivity.

The motivation to lie for a patient with pseudologia fantastica is internal. There is not typically any hope to gain money or access to funds. This is not typically based on romantic desires or career success. This is not to say that people do not lie in the course of romance or career, but typically not to a pathological level.

It is important for doctors to note that the patient must not believe the lies in order for this diagnosis to be accurate. Pseudologia fantastica is not a delusion, nor is it a form of psychosis. It is simply a matter of lying. The patient does not believe that they were in these situations and they are not recounting memories they believe they have.

In many cases, the patient is unwilling to admit that the statements he or she is saying are lies until forced. With some pressure, the patient may be willing to admit that they have lied. Oftentimes, the patient will experience shame and guilt in admitting the truth. In some cases, the patient may admit that they have a long-term problem with lying. This is more common if the patient believes that others know about the pathological lying.

In spite of the fact that patients with this condition may lie often, they are not unempathetic in most cases. In fact, they do not tend to exhibit the same antisocial behaviors associated with personality disorders when the only diagnosis is pathological lying. If somebody with this diagnosis does begin to exhibit these behaviors, it is not considered pseudologia fantastica. Rather, it could be another issue like bipolar disorder or a personality disorder. This is why an accurate diagnosis is so important.

Ultimately, the lies take over all rational judgment, and it may seem as if the patient is living in a fantasy world of their own creation. To most people, the lies are completely transparent, but the patient may believe that everybody else accepts the lies as facts.

Pathological Lying Diagnosis

Diagnosing this condition is difficult because there is no single test doctors can use to achieve a diagnosis. Diagnosis may be a trial-and-error process because there are so many options. Doctors typically want to talk with the patient to get a grasp on the extent of the lies.

Pseudologia fantastica occurs equally in men and women. It is not associated with any one gender or sexuality as far as research has been able to determine. The only time this may be different is when the pathological lying is associated with another condition, such as bipolar disorder or histrionic personality disorder.

Generally, pathological lying is discovered early on. Lying behavior tends to start in the teenage years. The condition is often discovered in the following years. Close family members and friends are typically the first people to notice the trend of lying.

Pseudologia fantastica may be easily confused with other illnesses because there is so little information available about the condition. These include false memory syndrome, in which the patient believes that the events they are discussing actually occurred. In fact, the events will have been imagined. This could be a misdiagnosis if the doctor is unsure if the patient is lying or experiencing some sort of psychosis.

Co-Morbidity of Pathological Lying

Often, pathological lying is the symptom of another disorder in itself. It coincides with another mental illness. These include psychopathy, antisocial personality disorder, narcissistic personality disorder, and histrionic personality disorder. It may actually be easier to pinpoint some of these other mental illnesses than it is to diagnose pseudologica fantastica.

Treatment of Pseudologia Fantastica

Few treatments are thought to be effective for pseudologia fantastica. In fact, there is a low success rate for the psychological condition. Research is ongoing to determine if there is another method of treatment that will be more effective.

Psychotherapy is the main treatment associated with pathological lying. In talking out the potential causes of the condition, many patients are able to manage the desire to lie in the future. This is most effective when the cause of pseudologia fantastica is environmental.

Ultimately, therapy works to heal many psychological wounds that may lead to pathological lying. The desire for attention can be addressed in therapy, as can the wounds often caused by childhood abuse. In addressing these issues, there may not be a need for further treatment. In some cases, psychotherapy may last several years to correct common problems faced by patients who are diagnosed with pseudologia fantastica.

Additionally, it is important to note that patients must want to receive help in order for psychotherapy to work. This is not something that can be forced on the patient. Intrinsic motivation is essential for effective therapy.

Generally, medication is only used with this condition when it is paired with another mental illness. Prescription medication is not typically effective in treating pathological lying, so it is better to treat underlying conditions that may contribute to it. For example, doctors can treat bipolar disorder with medication. On the other hand, personality disorders do not have a known treatment. Again, this may be a trial-and-error process working with a doctor on a long-term basis.

Researchers also believe that with some training over a long period of time, patients with this condition may see an increase in the volume of white matter in the brain. With frequent activation of certain areas of the brain, researchers believe that patients will experience a permanent shift in the ratio of white matter to gray matter. This is still an experimental issue, but researchers are hopeful.

Prevention of Pathological Lying

At this time, there is very little known about prevention of pseudologia fantastica. When paired with other mental illnesses, pathological lying may be prevented by addressing the other condition. When doctors understand more about the causes of pathological lying, this may change.

Ultimately, pseudologia fantastica can grow into a serious concern. It is important to seek the help of a doctor or psychotherapist to address pathological lying before it grows into a bigger problem.

Last Reviewed:
September 14, 2017
Last Updated:
September 14, 2017
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