Pathology of Lying, Etc.

W >> William and Mary Healy >> Pathology of Lying, Etc.

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Inez came when the mother was unusually advanced in life, and the
brothers and sisters, of whom there were five, had long since
been born. There was a difference of 10 years between Inez and
the next older. In telling the facts, the mother dwells much on
this and the bearing which her chagrin during pregnancy may have
had upon the girl's physical and mental development. She was
born, then, after a troubled pregnancy, a weak and sickly child,
``almost like a skeleton.''

Inez was rather slow at walking, but at one year spoke her first
words. We do not know with accuracy about the earliest factors
in the mental environment. (Inez has told various stories about
early family friction, and even about contracting an infection at
home, much of which seems highly conjectural.) Between the ages
of 7 and 10 several sicknesses, diphtheria, measles with some
cardiac complication, etc., kept her much out of school. Part of
the time she lived in New Orleans, and part of the time in a
country district. She only went to school until she was 14, and
was somewhat retarded on account of changing about and illnesses.
However, it is said she always liked her school and showed fair
aptitude for study. At 14 she returned to New Orleans and,
desiring to be a dressmaker, started in that trade. She worked
in several places, but finally went back to her home.

At the age of 18 Inez met with what, according to her family, was
a decisive event in her life. She was in a trolley car accident;
after being knocked down she was unconscious for some time. No
definite injury was recorded. Her family marked an entire change
of character from that time. They say she then began lying in
the minutest detail about people and seemed to believe in her own
falsifications. Besides this she started the roving tendency
which she has shown ever since.

The extensive information which we have received concerning the
later history of this remarkable case we can only take space to
give in summary. We know definitely that Inez has received
attention, during periods varying from a few days to six months,
in no less than 18 different hospitals. Besides this she has
been under the care of physicians at least a score of times. Her
swindling in this matter was so flagrant in one eastern city to
which she had journeyed that she was handled through the police
court and was sentenced to a state hospital for the insane for a
term of 6 months. The charge was that she was an idle person and
a beggar, and she was regarded as perhaps being unbalanced. The
report from this town is that she would be taken with ``spells of
apparent violent illness on the street, in the trolley cars, at
railroad stations, and so be carried to various hospitals and
doctors' homes.'' She has visited numerous cities, getting her
sustenance largely through hospitals and physicians.

After being admitted into one famous hospital and showing some of
her curious manifestations she was transferred to a state
institution in the vicinity to be studied for insanity.
Correspondence with one physician tells the story of how five
years ago he was called from a medical meeting to attend this
``girl'' who had been taken from a trolley car into his home.
She was apparently suffering great pain in the region of the old
appendicitis scar and she was conveyed in an ambulance to a
hospital. After investigation for a few days, it was decided she
was hysterical or a simulator.

On numerous occasions her feigned illness has been so apparently
overcoming that she has had to be transferred in an ambulance to
a hospital. One of her usual performances has been to get into
some home or institution and then keep others awake all night
with her signs of distress. It is interesting that she has used
the same methods over and over again, but has been adroit enough
to vary the illnesses which she has simulated. At one time
investigation in a hospital seemed to show that she was
neurasthenic. She has been given chances in homes for
convalescents, but has never maintained herself in such a place
for long. We note she was sent back from one of these to the
main hospital on account of having vomited the medicine she had
been given. In fact, she has repeatedly been found resisting the
treatment which had been prescribed.

The record of admission and treatment given in one hospital is of
peculiar interest. She was received there four years ago and
evidently had been unable just previously to take care of herself
properly on account of roaming. Her clothing was dirty and her
head unclean. She was found to have the old appendicitis scar,
which contained a small sinus. She remained in bed after
admission, complaining of much pain in her abdomen, not well
localized however, and would lie moaning, crying, and rolling
across the bed. She was then running a slight temperature.
After a time an operation was decided upon and a hairpin was
found in the abdominal wall, undoubtedly inserted through the
scar by the patient herself. (The findings of the surgeon in
Chicago, then, revealed a repeated performance.)

At another place the patient maintained she was unable to
urinate, but at the same time strongly resisted catheterization.
From the variability of her complaint it was found it could not
be caused by a local condition, and examination showed no reason
for the difficulty. Analysis of her symptoms undertaken at this
time led to several stories, one about urethritis, which Inez
claimed to have contracted from her brother at 3 years; an
episode when she had received a great fright during micturition;
an incident when she had seen a man exposed when she went to the
toilet. (Of course, our experience with this type of case leads
us to appreciate the difficulties of psychological analysis with
extreme liars.)

On one occasion she entered a hospital, claiming to have been
recently injured; she had been taken in a supposed fainting
condition from a car. Then it was she maintained that she had
been struck by an iron bar and that a spike had entered her back.
She also claimed at this time to have had her toes frozen. Study
of the case here, too, showed no signs of injury or frost bite.
On another occasion she told of having been dropped by a nurse
while being lifted from a bed. Altogether her stories and her
simulations have been convincing enough to get for her on many
occasions good attention during at least a few days.

We can get no account of true hysterical signs being discovered
by any one. There has been no showing of anything but that she
is a liar and a simulator. In the hospital records the portions
devoted to previous history are thoroughly vitiated by her
untruthfulness, and they contain statements which offer great
contradictions, one to the other.

Inez has been observed, then, for two long periods by
psychiatrists. While at the end of neither period were the
observers willing to state that the young woman was compos
mentis, still their verdict in this matter had to be made up from
considerations of her social behavior rather than from what they
were able to discern by direct observation of her mental
processes. From one case-record we read that ``The patient was
quiet, pleasant, and agreeable, replied promptly and
intelligently to questions, and talked spontaneously of her
affairs. She was quite clear as to the environment, had
apparently a satisfactory memory, with the exception of a recent
period preceding admission. Her statements, too, were probably
not altogether truthful, but frequently a reason for the
untruthfulness was made out. She thought that her mind was all
right, but complained of having occasional difficulty in
thinking.''

Another prolonged study of her mental status was made four years
ago. From the record we learn that there were no apparent
reactions to hallucinations. Consciousness was clear and the
patient was completely oriented for time, place, and persons.
The train of thought was coherent and relevant. Questions were
readily answered and attention easily held. Memory was fair for
most events. School knowledge was reasonably well retained.
Judgment, to this observer, seemed impaired, although no definite
delusions could be elicited. Emotionally she was found more or
less irritable, fault finding, and at times a trifle despondent.
(Certainly the latter would be a natural reaction under the
circumstances.) Often, however, she was found cheerful and
contented. No special volitional disturbances were noted. Was
found to act in an hysterical manner when she felt ill. She was
neat, tidy, and cleanly in her habits. Appetite was good and she
slept well. Such was the report from the institution where she
was held for six months. There was no material change in her
condition during this time; she showed herself very proficient
with the needle; she was discharged when her sentence expired.

We note a statement from one hospital that this ``girl'' gave no
evidence of having had any direct sexual experience, or that she
had ruminated much over these matters. Her story about frequent
fainting attacks given at this time was not corroborated by
observation. The diagnosis from one hospital was neurasthenia,
but investigation of her case in most places seems to have led
merely to the conclusion that she was a tremendous liar.

Notwithstanding our long record of this case and the accounts
which have been handed in to us of experiences with her in other
localities, we do not presume to know a tithe of the places Inez
has been to or lived in during the last eight years. It is more
than likely that she herself would find it difficult to give any
accurate account of her rovings. At the time we first saw Inez
her parents had not heard from her for about three years.
Shortly after this we found that she had renewed correspondence
with them and had sent them money as if she were now prosperous.
Her family have all along, in spite of her stories, been poor.
At one period she visited several cities in the southeastern
states and was at a hospital in one of them. In Charleston there
is a family by the name of B. (spelled the same as the name of
the people she was with in Tennessee). These were the people
Inez asked us to write to in an appeal, because they had long
known her and were wealthy, for a chance to get an education.
She stated they were immediate relatives of the B.'s in
Tennessee, and that she had visited them once at their fine home
in Charleston for three or four months. These people replied to
us that they had been receiving letters for years from
associations and organizations in regard to this girl whom they
had never seen. They were convinced she had assumed their name
because she had understood they were well-to-do and liberal.
``We know nothing about her education, but judge she has enough
to dupe people with; posing as poor at one time, sick at another,
and anxious for an education at another, as you inform us.''

From another correspondent with whom Inez had lived in Alabama
for a few weeks we had a marvelous tale which they heard from
her. She had told them she formerly lived in the most beautiful
part of New Orleans and when 5 years old was placed in a convent,
and then taken to a boarding-school, from which she was kidnapped
and taken to a small town in Georgia. She was later placed in
another boarding-school and there met the wealthy B.'s of
Charleston who took her home with them. While there she had to
go to a hospital on account of some infection. One day she was
thrust into a taxicab, taken on a boat, landed at another city,
etc. The B.'s of Charleston have thus figured long in her story,
and we learned from several correspondents that this kidnapping
has figured over and over as a big event in her life.

Once, years ago, Inez was taken into a private home accompanied
by a trunk, we hear, which was found to contain a considerable
amount of jewelry. This was pawned in the name of the people
with whom she then lived and was redeemed later by some one else.
Inez laid claim to the jewelry after a time, but apparently was
unable to produce anybody who could vouch that it was really
hers. Its ownership has remained unknown.

When she went to St. Louis at one time she had stated she was to
meet a relative there, but the person, we have come to know, was
a certain very decent young man who had become acquainted with
her through a correspondence bureau. He had thought well of her
and warned her not to come to that city, but when she did so he
met her and took her at once to his own home where the womenfolk
looked after her until she was found a place elsewhere. The
deliberate attempt to throw herself upon his protection was thus
frustrated by his relatives. Many other reports of the
misrepresentations of Inez have been given us. She has
discovered that borrowing money on the strength of invented
statements is sometimes possible, particularly for her with her
good presence and convincing manner. The B.'s complained that
when she left Tennessee there were in her trunk many dollars'
worth of articles that belonged to them.

Throughout our long experience with Inez we have never been able
to make up our mind whether or not she remembered all of her
past. Her lying always stood in the way of getting at anything
like the real facts. On no occasion has she truthfully dealt
with her career as we know it. She has professed absolute lack
of knowledge of her accident, and of the time and place of its
occurrence. It is interesting that none of her acquaintances
mention this. Although Inez has told long stories of her past to
many people, and with some inclusion of truth, she never seems to
have mentioned this important event of which we learned from her
family. We cannot, then, decide about possible amnesia for this
occurrence.

On occasion Inez has expressed the same desire for religious
experience as for education, and has written to friends that she
had become imbued with the Spirit. Her story of her religious
upbringing is altogether unreliable and contradictory, but while
in one hospital she professed belief, took communion, and was
baptized in a certain faith. Her behavior was not, however, in
the least modified by this.

One serious minded woman took Inez at her word when she said she
wanted to study algebra and offered her a good opportunity which
was never accepted. This demonstrated clearly that the desire
was a matter of words only. Inez' constant assertion of
independence has been one of her main sources of temporary
success. Kindly people have speedily taken up with her.
Sympathy is undoubtedly, in spite of her statements to the
contrary, one of the strongest needs of her nature. In one of
her letters we note her expression of satisfaction in a certain
situation where she found herself much ``mothered'' by kind
nurses. All her chances, however, have been spoiled by her
indulgence in lies.

Inez has remained adamant to every plea and suggestion made by
many well-wishing friends that she reform and begin again. After
her parents and other relatives were found and communicated with,
her career partly known, and her mother's need of sympathy shown
to her, she still refused to change her story in many
particulars--even when she knew that we had discovered about her
writing home within recent months. She steadily refused to
acknowledge her true age. When the evidence was complete,
showing that she could not be held as a runaway girl, but must be
treated under the law as a woman, she went forth to begin, as we
heard from many other sources, her old misrepresentations of
herself, which speedily got her into further trouble.

We were not astonished, even after we had accumulated almost the
entire knowledge of the career which we have outlined above, and
Inez knew that we had done so, to be visited by two fine
philanthropic women who wanted to consult with us about an
unfortunate girl who had won their sympathy, and who had been
placed by them in a leading hospital after having shown some
signs of acute bronchitis. In fact, she was in such a bad
condition that she had to be transferred in an ambulance. But
her illness had rapidly cleared up and now after ten days of
observation an eminent diagnostician had thoroughly scolded her
for simulation, and the girl was once more on their hands.
Indirectly they learned that we knew of the case of this ``girl
of 16.'' They realized that they had been taken in, but it had
been done so cleverly, and, as they expressed it, Inez showed
herself such a splendid actress, that they wondered if she had
not extraordinary histrionic abilities which could be utilized.
(It remains to be seen whether anything constructive can be done
by following this lead. We feel that previous psychiatrists who
gave earlier an unfavorable prognosis in this case were perhaps
quite right. But perhaps we should not let our opinions in this
be swayed by the fact that my associate, Dr. Bronner, who went to
this last hospital was met by an absolute denial on the part of
Inez of the essentials of the above career, by her insistence
that she was not the same person as the daughter of the Smiths,
and that she was only 17--all this in spite of her knowledge of
our correspondence with her family and others, and her own
previous acknowledgments of lying.)

Summary: In summarizing the characteristics of this woman we may
first insist that she has ambition, push, and energy in high
degree. Her personality as expressed in general bearing,
features, and facial action is remarkably strong and convincing.
Her ambition was shown in her work on our tests as well as in her
social behavior. (We have wondered if it was not her desire to
shine which prevented the typical performance of the pathological
liar on the ``Aussage'' test.) Her self-confidence as expressed
on numerous occasions is no less striking. ``I tell you, doctor,
that I have told lies, but you will see that I will come out on
top.''

Inez has been free from the overt problems of sex life. We have
repeatedly been informed that she has been a girl of good
character in this respect. ``I ran away from home for a good
cause. I'm not one of those girls who is crazy about the boys.''
Usually Inez shows a very even temper. It is only when her own
personality is trod upon that she grows angry, and obstinacy is
then her leading reaction. Some pathological liars may be weak
in character, but not Inez. She is the firmest of persons. On
occasions her attitude is entirely that of the grand lady. Her
type of lying is clearly pathological. It would often be very
hard to discern a purpose in it, and over and over again she has
defeated her own ends by further indulgence in prevarications.
To her the utterance of lies comes just as quickly and naturally
as speaking the truth comes to other people. Even in interviews
with us when she was voluntarily acknowledging her shortcomings
in this direction she went on in the same breath to further
falsifications.

The medical aspects of the case come under the same category as
the lying. The dysuria, the spitting of blood, the sugar in the
urine, the hairpins found twice in the abdomen, the simulated
pains, neurasthenia, and bronchial attacks, together with her
stories of accidents and fainting spells illustrate her general
tendency. This behavior, like her lying, serves to feed her
egocentrism, her craving for sympathy and for being the center of
action. As with the lying, repetition of this type of conduct
probably is largely a matter of habit.

The bearing of this case on the problems of testimony is
interesting. As shown in our account of tests done, when
objective concrete material was considered by this woman she
reported it well. It is only when her egocentrism is brought
into play that she becomes so definitely unreliable. This is a
line of demarcation that students of this subject would do well
to recognize.

Causative Factors: Our study of causation in this case, as we
intimated at first, is necessarily incomplete. But some things,
probably explanatory, stand out very clearly. Heredity is
moderately defective. Inez was the outcome of an unfortunate
pregnancy and was a poorly developed infant. She suffered early
from a number of illnesses, which, however, left no perceptible
physical defects. Her unusual relationship to the other
children, based on the difference in age, was perhaps a starting
point for the development of her inventional theories of her own
origin. She has given us many hints of this in speaking of her
earliest remembrances of hearing the Smiths whispering something
about adoption, and of her feeling that the other children were
too old for her to belong to their family.

Then we insist on the positive bearing which this woman's native
traits have had in the production of her career. Her facility
with language marks her as possessing one of the chief
characteristics of the pathological liar. Added to this she
showed the other personal traits which we have described in
detail, leading to her success in misrepresenting herself. Her
strongly developed physiognomy has caused many people to believe
her older than she stated, but still one has seen such lineaments
belonging to girls of 17.

The bearing which the accident at 18 had upon the case it is
impossible for us to estimate. Her family are very clear on this
point; they maintain that all her bad conduct has developed since
then. Through unwillingness, or barely possibly real amnesia for
the injury, Inez has not helped us to know the facts. Dr.
Augusta Bronner, who has studied this case with me, cleverly
suggests that just as anyone becomes confused in distinguishing
really remembered experiences from what has been told by others
was one's experience, so Inez gets confused between what has
really happened and what she herself has told as having happened.
This finally involves a pathological liar in a network which is
difficult to untangle. Part of the causation of the present
lying, then, is the extensive lying which has been done
previously.

Psychological analysis in such a case is most difficult because
of the unreliability of the individual's own statements about her
life, inner and outer. Psychoanalysts will be delighted, in the
light of what we long afterward found out, at the pregnant
opening sentence of an interview, recorded above, when Inez
blurted out that she was once in a State hospital. However, from
what we ascertained, we may see clearly that here is an
individual with a past that she desires to cover up. Much more
delinquency may be involved of which we know nothing. As the
result of circumstances and traits she finds herself, despite her
very good ability, inadequately meeting the world. Her forceful
personality carries her into situations which she is incompetent
to live up to. The immediate way out is by creating a new
complication, and this may be through lies or the simulation of
illness, at which she has become an adept. Altogether, Inez must
be thought of as one who is trying to satisfy certain wishes and
ambitions which are too much for her resources. Towards the goal
to which her nature urges her she follows the path of least
resistance. Being the personality that she is, the social world
offers her stimulation which does not come to others.

To discuss the problem of her responsibility would be to
introduce metaphysics--it is sure that in the ordinary sense she
is not insane. The cause of her career is not a psychosis,
although we readily grant that out of the materials of her mental
experience she may ultimately build up definite delusions.

CASE 4

Summary: A girl of 16 had been engaged in an extraordinary
amount of clever shoplifting under the influence of her
``mother.'' In the courts where the cases against her were heard
there was much sympathy with the girl, but it was difficult to
carry out any measures for her benefit because of the excessive
prevarications which had characterized her for a long period.
Under oath she falsely accused her ``father'' of sex immorality
with her. She was removed from her home, and with knowledge of
the mental conflicts which beset her, splendid efforts to
``cure'' this girl met with success. It is another case where
supposed inherited traits turn out to be the result of
environmental influences.

Through frequent communication with the highly intelligent woman
with whom Edna F. was placed in a small western city after she
was taken from her previous miserable environment, we have been
able to keep close check on the progress of the case for several
years. It was also very fortunate for our understanding that a
nurse who knew the girl's real mother in New York, where Edna was
born, appeared on the scene and gave us data upon which we could
base some opinions of the outcome. The case in its entirety had
proved very baffling to detectives because of the mass of
contradictory lies told by both the girl and her ``mother.''

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