Why do some people lie compulsively — even when it costs them everything? A deep, compassionate look at the psychology, brain science, and real treatment options for pathological lying.
In This Guide
- What is a pathological liar?
- How common is it? Key statistics
- 10 signs of pathological lying
- Types of liars: what’s the difference?
- The brain science behind compulsive lying
- Why people lie pathologically
- How it destroys relationships
- How to deal with a pathological liar
- Treatment that actually works
- Frequently asked questions
What Is a Pathological Liar?
The term pathological lying — also known as pseudologia fantastica, mythomania, or morbid lying — was first documented in medical literature in 1891 by psychiatrist Anton Delbrück. He described it as “falsification entirely disproportionate to any discernible end in view, which may be extensive and very complicated, manifesting over a period of years or even a lifetime.” Modern researchers have refined that definition. A 2020 study defined pathological lying as “a persistent, pervasive, and often compulsive pattern of excessive lying behavior that leads to clinically significant impairment of functioning in social, occupational, or other areas; causes marked distress; poses a risk to the self or others; and occurs for longer than six months.”Is Pathological Lying a Mental Health Diagnosis?
Not currently. Pathological lying does not have its own entry in the DSM-5, the manual used to classify mental health disorders. However, psychologists Drew Curtis, PhD, and Christian Hart, PhD — authors of Pathological Lying: Theory, Research, and Practice (APA Books) — are actively advocating for its inclusion. Their research confirms it causes genuine clinical distress and impairment, and they argue that recognizing it as a formal diagnosis would allow people to access insurance coverage and targeted treatment. The word “pathological” itself signals that an underlying condition — a pathology — is driving the behavior.By the Numbers: How Common Is This?
“Like anything in life, the sooner a problem is acknowledged and worked on, the less damage done.” — Kim Egel, licensed therapist
10 Signs of a Pathological Liar
Not every lie is pathological, and not every liar fits a single profile. But certain patterns, when seen together and over time, paint a clear picture. These are the most widely recognized signs:1
Elaborate, detailed lies
Stories are unnecessarily complex, with vivid details that make them seem more believable — and harder to disprove.2
Dramatic, unlikely tales
The stories often feel almost too extraordinary — achievements, experiences, and connections that strain credibility.3
Lies with no apparent purpose
Unlike strategic lying, pathological lying often happens when there’s nothing tangible to gain — no clear motive.4
Inconsistent or shifting stories
Details change over time, contradict earlier statements, or become vague under questioning — because the liar is tracking multiple versions.5
Defensiveness when confronted
Even when shown clear proof that a lie occurred, the pathological liar doubles down rather than acknowledging the truth.6
Apparent relief or “high” from lying
Some pathological liars describe an anxiety reduction — a brief sense of relief — immediately after successfully deceiving someone.7
Passing off others’ stories as their own
Borrowing stories from movies, books, or people they know and retelling them as personal experiences.8
Actions that contradict words
What they say and what they do consistently don’t align — a pattern that becomes harder to ignore over time.9
Exceptional charm or charisma
Many pathological liars possess a magnetic quality that makes others naturally trust them — which is part of why the lying is so effective and so hard to detect.10
Guilt that surfaces later
Unlike individuals with psychopathy, most pathological liars do experience remorse—just not in the moment. The guilt typically arrives hours or days after the lie has been told.Don’t Rely on Eye Contact
A common misconception is that liars avoid eye contact. Pathological liars — especially those who have been lying for years — can maintain steady, confident eye contact while telling an untruth. Some have told the same lies so often that they feel true to them. Eye contact alone is not a reliable indicator of honesty.Types of Liars: Understanding the Spectrum
Pathological lying sits at one end of a broad spectrum of dishonest behavior. Understanding where it falls — and how it differs from other types — is important for knowing how to respond.White Liar
Tells untruths specifically to protect others’ feelings. Generally prosocial, low harm, and relatively rare.Habitual Liar
Has fallen into lying as a default because it feels easier than the truth. Not compelled — just conditioned. Can change with motivation.Compulsive Liar
Feels a noticeable urge — sometimes described as a “high” — when successfully deceiving others. Similar to addiction in structure.Pathological Liar
Lying is pervasive, persistent, causes real distress and dysfunction, and is often rooted in underlying mental health issues or trauma.Natural Liar
Identified by researcher Paul Ekman — highly skilled at deception, able to control facial expressions flawlessly. Unlike psychopaths, they typically have a conscience and don’t use the ability to harm others.
Pathological Liar vs. Psychopath: A Critical Distinction
Pathological Liar
- Often feels guilt or remorse after lying
- May genuinely not understand why they lie
- Typically does not have a history of criminality
- Usually not aggressive toward others
- Can form genuine emotional bonds
- Often wants help and seeks treatment
- Motivated by anxiety relief, attention, or coping
Psychopath / Antisocial PD
- Absence of guilt, remorse, or empathy
- Lying is deliberate, purposeful, and cold
- Often has pattern of rule-breaking or criminality
- May be aggressive or exploitative
- Shallow emotional connections only
- Rarely self-identifies as needing help
- Motivated by manipulation and personal gain
The Brain Science: Why Some People Can’t Stop Lying
Pathological lying isn’t just a moral failure. There’s growing neurological evidence that the brains of people who lie chronically are structurally different from those who don’t.Prefrontal Cortex
Responsible for judgment, impulse control, and decision-making. Neuroimaging studies have found structural differences in this region in people who lie pathologically — meaning the brain’s “brake” on impulsive behavior may be less effective.The Amygdala
Key to processing emotions and empathy. Alterations in amygdala structure may reduce the emotional discomfort normally associated with lying — making it easier to continue without the natural deterrent of guilt or fear.The “Slippery Slope” of Lying
A landmark study published in Nature Neuroscience found that each lie a person tells makes the next lie easier. The amygdala’s emotional response to dishonesty diminishes with each deceptive act — meaning the brain literally adapts to lying over time, reducing the psychological friction that would otherwise keep most people honest. Small lies truly do escalate into larger ones. This is not weakness — it’s neuroscience.Why Do People Lie Pathologically?
Pathological lying rarely exists in a vacuum. It’s almost always a symptom of something deeper — a personality disorder, a trauma history, a childhood in which the truth felt unsafe. Understanding the “why” is essential to finding the right treatment.Childhood trauma and unmet needs
Perhaps the most common root of pathological lying is early childhood experience. Children who grew up in environments where their emotional or physical needs were chronically unmet may have learned to lie as a survival mechanism — to get love, to avoid punishment, to create a reality that felt safer than the one they were living in. Over years, this coping strategy becomes automatic. By adulthood, the person may not even consciously connect their lying to those early experiences.Personality disorders
Pathological lying is strongly associated with several personality disorders, though it is distinct from them. In narcissistic personality disorder (NPD), lying often serves to inflate self-image and maintain a false sense of superiority. In borderline personality disorder (BPD), lying frequently functions as a way to avoid perceived abandonment or rejection. In antisocial personality disorder (ASPD), lying is more calculating and purposeful — though Curtis and Hart’s research shows that most pathological liars don’t actually meet full criteria for ASPD.Anxiety and the relief response
For many pathological liars, the act of lying produces a momentary relief from anxiety. Telling a lie — even an unnecessary one — reduces immediate psychological tension. This makes lying function almost like a compulsion: it provides short-term relief at the cost of long-term consequences. The guilt and regret typically arrive hours or days later.Munchausen syndrome
Munchausen syndrome (also called factitious disorder) involves fabricating illness — either in oneself or in a child or patient under one’s care — to attract attention and sympathy. The lying here has a specific, psychologically-driven purpose: to fulfill deep emotional needs for caregiving and concern.Other co-occurring conditions
Pathological lying may also appear alongside ADHD, bipolar disorder, obsessive-compulsive disorder, substance use disorders, and impulse control disorders. In these cases, treating the underlying condition often reduces the lying behavior as a secondary effect.How Pathological Lying Destroys Relationships
If you’ve been on the receiving end of a pathological liar’s stories, you may already know the specific kind of damage it does. It’s not just the individual lies — it’s the erosion of your confidence in your own perceptions. You start to question what’s real. You replay conversations wondering what was true. You feel gaslit, even if no deliberate manipulation was ever intended.“The area of greatest impairment in functioning for those in the [pathological lying] group was in social relationships. Deception often damages trust, especially when used to conceal a transgression.” — Drew Curtis, PhD & Christian Hart, PhD, Psychiatric Research and Clinical PracticeTrust, once broken repeatedly, becomes almost impossible to rebuild without professional support. Relationships with pathological liars often follow a painful arc: early charm and connection, growing confusion, escalating conflict, and eventually a rupture — or a painful decision to stay in something that continues to hurt you.
When Lying Becomes Abuse
Pathological lying can overlap with patterns of emotional abuse, particularly when combined with gaslighting — where the liar denies events that occurred, disputes your memory, or makes you feel “crazy” for noticing inconsistencies. If you are in a relationship where you consistently feel confused about reality, unsure of your own perceptions, or afraid to bring up the truth, please consider reaching out to a therapist. You deserve support.How to Deal with a Pathological Liar: Dos and Don’ts
Whether this is a family member, a partner, or a friend, navigating a relationship with a pathological liar requires specific strategies. Here’s what the research and clinical experience tell us works — and what makes it worse.- Don’t expect them to admit to lying, even with proof. They will almost always double down.
- Don’t take the lying personally. The behavior is rooted in their psychology, not your worth.
- Don’t lose your temper. Anger escalates defensiveness and can trigger more lying as a coping response.
- Don’t rely on eye contact as a truth indicator. Skilled liars maintain confident eye contact.
- Don’t enable the behavior by constantly making excuses for them to others.
- Do trust your perceptions. Check in with other trusted people if you feel confused about reality.
- Do focus on actions, not words. Patterns of behavior reveal far more than individual statements.
- Do set clear, firm boundaries about what you will and won’t accept in the relationship.
- Do gently encourage them to seek therapy — not as a punishment, but as a path toward understanding themselves.
- Do seek therapy for yourself too. The impact of being repeatedly lied to is real, and you deserve support.
Treatment That Actually Works
The good news is that pathological lying is treatable. It’s not easy, and it requires the person who lies to genuinely want to change — but real, lasting improvement is possible. The most effective approaches address both the lying behavior directly and the underlying causes that drive it.1
Comprehensive assessment first
Effective treatment begins with a thorough evaluation to identify any co-occurring conditions — personality disorders, trauma, anxiety, ADHD — that may be fueling the lying. Without this, treatment targets only the surface behavior.2
Cognitive Behavioral Therapy (CBT)
CBT is considered the most promising evidence-based approach. It helps clients identify the triggers, thoughts, and situations that precede lying; challenge distorted beliefs about why lying is necessary; and build new, healthier responses. Habit reversal training — a specific CBT technique — reinforces honesty behaviors through consistent positive reinforcement.3
Trauma-informed therapy
When pathological lying is rooted in childhood trauma, healing the trauma is often the most direct path to changing the behavior. Approaches like EMDR, somatic therapy, and trauma-focused CBT help people process the early experiences that made lying feel necessary for survival.4
Group therapy
Group settings offer a unique advantage: when a therapist observes lying behavior, calling it out can feel confrontational. But when peers in the group notice and name it, the dynamic shifts. The liar is suddenly accountable to people who understand the struggle — which can be far more powerful than any therapist-led confrontation.5
Motivational interviewing
This therapeutic approach helps clients explore their own values and the gap between those values and their behavior. It builds internal motivation for change rather than relying on external pressure — which is crucial when the behavior is compulsive rather than purely intentional.6
Intensive Outpatient Programs (IOP)
For people who need structured, consistent support without residential treatment, an IOP provides several hours of therapy per week alongside individual sessions, group work, and — where relevant — family therapy. The routine and accountability of an IOP can be particularly stabilizing for people with compulsive behaviors.An Honest Note on Treatment
Because pathological lying lacks a formal DSM diagnosis, there are no officially “approved” treatment protocols with large randomized controlled trials behind them. What clinicians have — and what researchers like Curtis and Hart are building toward — is a growing body of case literature, expert consensus, and adapted CBT approaches that show real promise. Progress is possible. Many people who have sought help for compulsive lying describe meaningful, lasting change in their relationships and sense of self. It begins with a single honest conversation.You Don’t Have to Navigate This Alone
Whether you’re struggling with compulsive lying yourself, or you’re trying to cope with a loved one’s dishonesty, Oasis Counseling Florida offers compassionate, trauma-informed care tailored to your situation. Serving clients throughout Florida — in person and via telehealth. Schedule a Free Consultation →Frequently Asked Questions
Do pathological liars know they are lying?
Most do, at least in the moment. Research by Curtis and Hart found that the majority of pathological liars are aware of their lies when they’re telling them — though some have repeated certain stories so often that those stories begin to feel true. The awareness of lying doesn’t make it easier to stop. For many, the lying happens almost automatically, especially under social pressure or anxiety, and the conscious recognition comes shortly after.
What is the difference between a pathological liar and a compulsive liar?
The distinction is subtle and debated. Compulsive lying tends to be more random — the person lies habitually without a specific goal, experiencing it as an urge they can’t easily resist. Pathological lying typically involves more elaborate, self-serving stories and is associated with greater distress and dysfunction. In clinical practice, the terms are often used interchangeably, and the two patterns frequently overlap in the same person.
Can a pathological liar change?
Yes — but it requires genuine motivation and typically professional support. Because lying often serves as a coping mechanism for anxiety or trauma, simply trying to “stop lying” without addressing the underlying drivers rarely leads to lasting change. With therapy — particularly CBT and trauma-focused approaches — many people with pathological lying patterns make meaningful, sustained progress. The key variable is whether the person genuinely wants to change, not just whether others want them to.
What mental health conditions are associated with pathological lying?
Pathological lying has been linked to narcissistic personality disorder, borderline personality disorder, antisocial personality disorder, obsessive-compulsive disorder, Munchausen syndrome (factitious disorder), ADHD, bipolar disorder, and substance use disorders. It can also occur without any formal co-occurring diagnosis, particularly in people with unresolved childhood trauma. A thorough clinical assessment is the best way to understand what’s driving the behavior in any individual case.
How can you protect yourself emotionally when dealing with a pathological liar?
Grounding yourself in your own perceptions is essential — because one of the most damaging effects of chronic lying is that it makes you doubt your own reality. Seeking outside perspectives from trusted friends, keeping a journal of events and conversations, and working with your own therapist can all help. Setting clear limits about what you will accept in the relationship — and following through on them — is also critical. You are not responsible for someone else’s compulsion to lie, and you deserve relationships built on honesty.
Is pathological lying more common in men or women?
Research by Curtis and Hart found no significant difference in the frequency of lying between men and women. There are some differences in the types of lies — women tend toward more relational lies, men toward more self-serving ones — but the overall rate is comparable. Age is a stronger predictor than gender: lying peaks in late adolescence and gradually declines across adulthood.
About Oasis Counseling Florida
Oasis Counseling Florida is a trauma-informed counseling practice providing individual therapy, couples counseling, and specialized treatment for anxiety, depression, trauma, and co-occurring conditions. Our therapists bring clinical expertise and genuine compassion to every session. We offer in-person and telehealth appointments throughout Florida. Visit oasiscounselingfl.com or call to learn more.Sources: Curtis, D.A. & Hart, C.L. (2022). Pathological Lying: Theory, Research, and Practice. APA Books. • Hart, C.L. & Curtis, D.A. (2020). How do others perceive the pathological liar? Psychiatric Research and Clinical Practice. • Ganis, G. et al. (2003). Neural correlates of different types of deception. Cerebral Cortex, 13(8). • Garrett, N. et al. (2016). The brain adapts to dishonesty. Nature Neuroscience, 19, 1727–1732. • Ekman, P. Blog: Pathological Liars, Psychopaths & Natural Liars. Paul Ekman Group. • American Psychological Association. Speaking of Psychology Podcast: Episode 222 — Can a pathological liar be cured? • Beltrani, A. (2024). Pseudologia Fantastica: Layers of Deceit. Palo Alto University CONCEPT Blog. • This content is for educational purposes only and does not constitute medical or therapeutic advice. Please consult a licensed mental health professional for personalized guidance.
