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Mythomania: A Mental Disorder or a Symptom?

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Although the act of lying is common and is seen in our everyday interactions, pseudologia fantastica or mythomania[1], otherwise known as pathological lying, is defined as a condition (but not an official psychiatric condition) where a person continuously tells false statements for seemingly no purpose at all for an extended period of time[2]. Lying is defined as intentionally telling false statements - but it isn't this easy to define pathological lying, as it continues to be a controversial and underwhelming subject to this day[3]. Although there are many websites and published medical articles describing pathological lying, the question remains as to whether it is a symptom of a bigger condition or a separate entity of its own. The DSM-5, the guide for classification of mental disorders published by the American Psychiatric Association in 2013[4], only considers mythomania to be a symptom of anti-social personality disorder and not a mental disorder by itself[5]. As a result, a concrete and official definition of mythomania isn't listed. The absence of an official definition and classification prevents scientists from efficiently researching treatments for this condition. Research into pathological lying is worthwhile as mythomania can be a source of frustration and falling out between friends and family members.[6] We will be reviewing pathological lying and its background to support the claim that pathological lying should be classified as a mental disorder.[5]

What is the difference between the "white lie" and pathological lying?

Lying is a trait that many people may be accustomed to, but pathological liars are abnormal because they tell lies constantly. Usually, when one lies, they lie to gain an advantage or deflect from retribution in some way. On the other hand, a person who has mythomania may purposelessly lie and self-incriminate themselves in doing so, making the condition even more perplexing to investigate[7]. Historically, pathological lying is nothing new to the psychological world. The first instance of mythomania being described is by German physician Anton Delbruck in 1891. Delbruck was observing a set of patients and was amazed at how some of the patients were describing fabrications in great detail. This was so bizarre to Delbruck that he coined this behavior as "pseudologia fantastica"[7][8]. Since the coined term, Delbruk identified and discussed five case studies concerning mythomania[2].

The DSM-5 Cover

The DSM-5, or the "Diagnostic and Statistical Manual of Mental Disorders", and the ICD-10, or the "International Classification of Diseases", both define the term, mental disorder, as "a syndrome characterized by clinically significant disturbance in an individual's cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning"[9][10]. With this definition in mind, we can somewhat create our own definition for mythomania since there isn't a set definition. Mythomania can be defined, per the DSM-5's definition of a "mental disorder", as a continuous cognitive condition where an individual displays a pattern of purposeless, exuberant lying which leads to cognitive impairment due to stress. This definition affirms to a disturbance in the individual's biological processes and results in some sort of biological mental dysfunction. As mentioned earlier, pathological lying can lead to self-incrimination, such as a loss of position, job, or social status, which could lead to stress.

What evidence is out there to prove that our definition is valid? According to the DSM-5, a mental disorder must meet one of the three criteria. The condition in question must either exhibit behaviors that stray away from societal norms, exhibit behaviors that negatively affect areas of "social, vocational, or educational functioning", or the exhibited behaviors must cause significant stress[8]. As mentioned before, what separates pathological lying from "regular" lying is its repetitiveness, obscure nature, and aimlessness of it. An example that portrays the obscurity of mythomania is Los Angeles Superior Court Judge Patrick Couwenberg. In August 2001, he was removed from his position for "[making] misrepresentations to become a judge, continu[ing] to make misrepresentations while a judge and deliberately provid[ing] false information to the commission"[11]. These "misrepresentations" were repeated fabrications of "heroically" serving in the Vietnam War, including working for the CIA in Laos[11][12]. The lies were even more detailed than that, claiming that he won a Purple Heart for the groin injuries he received in Laos[12]. A psychiatrist and Cowenberg's lawyers testified that he had "pseudologica fantastica", which caused him to fabricate his resume when he was applying to be a judge[12]. As of today, he is not eligible to practice law in California[13].

Professor Ellis was removed from his teaching position in 2001 at Mount Holyoke College due to extensive lying in regards to his "service" in Vietnam

As detailed, Cowenberg's habit of consistently lying has proven to be detrimental to him. Cowenberg's lies were so unusual in their consistency and detail that they strayed away from societal norms of lying. As compared to the time-time "white lie", Cowenberg repeatedly lied on several occasions for a purpose that seemed almost absent. These lies, therefore, led to a vocational dysfunction: he was terminated from his position. From what we can reasonably, but are not obliged to, assume that the self-destruction that he caused through his lies caused a significant amount of stress on Cowenberg (although this has not been proven).

Cowenberg is not the only one to exhibit such extensive patterns of mythomania. Professor Joseph Ellis, an American historian who won the Pulitzer Prize for History in 2001, fabricated stories of representing the US in Vietnam in the Vietnam War towards his students and the public media. Unlike Cowenberg, it has been recorded that Professor Ellis apologized for the lies[14] and soon was restored to his position as the "Ford Foundation Professor of History" in 2005[15]. In 1999, English novelist and former politician Jeffrey Archer effectively ended his political career after it was revealed that he lied in a 1987 trial concerning a prostitute named Monica Coghlan. For these fabrications, he was charged with perjury and was reported, in a 2006 BBC interview, to not have any interest in returning to politics and instead pursue his pre-existing writing career[16]. In both cases, both individuals inflicted severe reputation damage through detailed lies. In cases of mythomania, we can see consistent patterns that match with the DSM-5's classification of a mental disorder.

Conclusively, all evidence outlined here has pushed the narrative that mythomania should be considered a mental disorder rather than just a symptom of bigger causes. According to the DSM-5's manual for classifying mental disorders, the condition must be abnormal in comparison to societal norms, show behaviors that ruin one's social, vocational, or educational status, and cause clinical stress. In the highlighted cases of Cowenberg, Ellis, and Archer, we were able to clearly depict each case of mythomania and tie it back to the DSM-5's conditions for a mental disorder. With a set definition and straightforward evidence to back up the claim of mythomania being a separate condition, we can hope that the health community can move forward with adequate solutions or treatments for mythomania.

See also

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Search for Mythomania on Wikipedia.

References

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  1. ↑ Janssens, S.; Morrens, M.; Sabbe, B. G. C. (2008). "[Pseudologia fantastica: definition and position in relation to axis I and axis II psychiatric disorders"]. Tijdschrift Voor Psychiatrie 50 (10): 679–683. ISSN 0303-7339. PMID 18951347. https://pubmed.ncbi.nlm.nih.gov/18951347/. 
  2. ↑ 2.0 2.1 Healy W, Healy MT: Pathological Lying, Accusation and Swindling: A Study in Forensic Psychology (Criminal Science Monograph Series No 1). Oxford, Little, Brown, 1915. Google Scholar. Accessed 12. January 2022.
  3. ↑ Dike, Charles C.; Baranoski, Madelon; Griffith, Ezra E. H. (2005-09-01). "Pathological Lying Revisited". Journal of the American Academy of Psychiatry and the Law Online 33 (3): 342–349. ISSN 1093-6793. PMID 16186198. http://jaapl.org/content/33/3/342. 
  4. ↑ "DSM-5". www.psychiatry.org. Retrieved 2022-01-27.
  5. ↑ 5.0 5.1 Curtis, Drew A.; Hart, Christian L. (2020-12-01). "Pathological Lying: Theoretical and Empirical Support for a Diagnostic Entity". Psychiatric Research and Clinical Practice 2 (2): 62–69. doi:10.1176/appi.prcp.20190046. https://prcp.psychiatryonline.org/doi/10.1176/appi.prcp.20190046. 
  6. ↑ "Pathological Lying A Sign of Several Health Conditions". 2020-01-09. Retrieved 2022-01-12.
  7. ↑ 7.0 7.1 Dike, Charles C. (2008-06-01). "Pathological lying: symptom or disease? Living with no permanent motive or benefit". Psychiatric Times 25 (7): 67–67. https://go.gale.com/ps/i.do?p=AONE&sw=w&issn=08932905&v=2.1&it=r&id=GALE%7CA180555438&sid=googleScholar&linkaccess=abs. 
  8. ↑ 8.0 8.1 Treanor, Katie. Defining, understanding and diagnosing pathological lying (pseudologia fantastica): an empirical and theoretical investigation into what constitutes pathological lying. pg. 19. University of Wollongong, 2012. Accessed 12. January 2022.
  9. ↑ Thyer, Bruce A. (2015). Probst, Barbara. ed. The DSM-5 Definition of Mental Disorder: Critique and Alternatives (in en). Essential Clinical Social Work Series. Cham: Springer International Publishing. pp. 45–68. doi:10.1007/978-3-319-17774-8_3. ISBN 978-3-319-17774-8. https://doi.org/10.1007/978-3-319-17774-8_3. 
  10. ↑ [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3104876/ "A conceptual framework for the revision of the ICD-10 classification of mental and behavioural disorders"]. World Psychiatry 10 (2): 86–92. 2011-6. ISSN 1723-8617. PMID 21633677. PMC 3104876. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3104876/. 
  11. ↑ 11.0 11.1 "`Hero' judge booted off bench for lying about background". Chicago Tribune. Retrieved 2022-01-15.
  12. ↑ 12.0 12.1 12.2 Writer, Michael Taylor, Chronicle Staff (2000-07-07). "L.A. Judge Charged With Lying About His Past / He faces hearing, possible discipline". SFGATE. Retrieved 2022-01-15.{{cite web}}: CS1 maint: multiple names: authors list (link)
  13. ↑ "Patrick Couwenberg # 70507 - Attorney Licensee Search". apps.calbar.ca.gov. Retrieved 2022-01-16.
  14. ↑ "Further Statement of Joseph J. Ellis". web.archive.org. 2006-07-15. Retrieved 2022-01-26.
  15. ↑ "Endowed Chairs 2005". web.archive.org. 2012-10-11. Retrieved 2022-01-26.
  16. ↑ "Archer 'may vote in Lords again'". 2006-02-26. Retrieved 2022-01-26.
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