- There are a variety of treatment considerations for pathological lying.
- Cognitive behavioral therapy is one potential treatment for pathological lying.
- Habit reversal training could be implemented to help raise awareness of lying behaviors.
People are quick to recommend the treatment of just stopping a behavior if it is problematic. If you have problems with gambling, alcohol consumption, panic attacks, smoking cigarettes, or overeating, then many people will easily recommend a treatment: Just stop. Those on the receiving end of this advice know all too well that it is much easier to prescribe than to follow. For some people, telling them to “stop” or “calm down” may make things worse for them, as they may be reminded of their difficulties with controlling a behavior or even feelings of guilt and shame about not stopping a behavior. With lying, there may be the same tendency for people to tell others to just stop lying and be honest. If these treatments were highly successful then therapists may easily find themselves without employment. The reality is that telling someone to just stop engaging in a behavior is rarely successful.
This is the theme, and often explicitly stated, in several emails that I receive from individuals who struggle with pathological lying or who are in close relationship with a pathological liar. Many individuals indicate that they have sought out professionals for help for excessive lying without much success. Some individuals have claimed that they cannot find anyone who is trained or specialized in treating pathological lying. These individuals truly express helplessness, not knowing where to go or who to reach out to. Several people indicated a willingness to drive across many states to visit me for treatment or recommendations. Thus, these people are often looking for any help, recommendations, contacts, or even knowledge that will assist with getting them or their relationship back to healthy functioning.
One of the current problems within psychiatry and clinical and counseling psychology is that pathological lying is that it has yet to be recognized in diagnostic manuals. I, along with some others, have made the case that we should recognize pathological lying as a diagnosis. We, along with Charles Dike, argue that the failure to recognize pathological lying as a diagnostic entity results in a lack of clinical trials and research related to its treatment.
However, there are some treatment considerations and recommendations for pathological lying. In our book, we dedicate an entire chapter to treatment recommendations. One study we conducted with licensed psychologists found that most of the practitioners indicated cognitive behavioral therapy (CBT) as a treatment for pathological lying. Judith Beck has written about the use of CBT and its effectiveness to treat a wide variety of psychopathologies. Further, some research has indicated some success with using CBT to decrease lie-telling behavior and increase mood. Essentially, pathological liars could examine their beliefs related to telling lies and identify consequences that reinforce lying. For example, attention gained from telling lies could increase lying behaviors. Telling people that you have driven 400 miles per hour to evade police and that you have jumped one mile from a helicopter into a pool of alligators and sharks to save a friend are things that would garner attention from others (see Gogineni & Newmark, 2014). If lies are being reinforced by attention, then therapists (and others in relationships) could reinforce truth-telling behavior and do their best to not give attention to the lies. Praising (or giving attention) to honesty and ignoring the dishonesty would be referred to as differential reinforcement of other behaviors (DROs)—a technique used in behavioral therapies. We often give more attention to people when they are doing problematic behaviors than when they are engaged in prosocial or beneficial behavior. Think of a child who misbehaves or an intimate partner who does something annoying. Are you more likely to tell them that they are doing a good job when behaving well or when you enjoy their company or when they are coloring on the walls or not loading the dishes properly (respectively)?
There are a number of people who identify as pathological liars who indicate they lie for no reason or that the lying behavior is outside of their awareness. For these individuals, a CBT technique called habit reversal training could be implemented. Essentially, people gain awareness about their lying behavior (where and when it occurs most frequently) and then learn to implement other (non-lying behaviors) in those situations.
Lying is relational and our research has found that it mostly impairs social functioning. Thus, people may consider couples, family, or group therapy. These various treatment modalities allow people to work on relational dynamics as well as engage in support, confrontation, and conflict resolution.
Keep in mind that telling the truth may work out well, or sometimes even better than you think. In some situations, telling the truth can be or may seem painful to deliver. Consider telling the truth and other ways to handle the awkwardness or uneasy relational tension.
In closing on a message of hope, future research efforts will unveil the effectiveness of treatment recommendations. In my lab, we are working to examine if these efforts are effective at treating pathological lying. Researchers and clinicians are encouraged to examine these recommendations and find ways to help those who are in need.
To find a therapist, please visit the Psychology Today Therapy Directory.
Beck, J. S. (2021). Cognitive behavior therapy: Basics and beyond, 3rd ed. The Guilford Press.
Curtis, D. A. & Hart, C.L. (2021). Pathological Lying: Psychotherapists’ Experiences and Ability to Diagnose. American Journal of Psychotherapy. 1-6.
Curtis, D. A. & Hart, C. L. (2022). Pathological Lying: Theory, Research, and Practice. American Psychological Association.
Dike, C. C. (2008). Pathological Lying: Symptom or Disease? Psychiatric Times, 25, 67–73.
Gogineni, R. R., & Newmark, T. (2014). Pseudologia fantastica: A fascinating case report. Psychiatric Annals, 44, 451–454.