Pathology of Lying [124]
The slight mental confusion of chorea, which may lead to false accusation, as we have seen in Case 23, is one of the most curable of all abnormal mental states. With proper attention to diagnosis and treatment, favorable outcome of cases of hysteria, such as that in Case 24, is frequently seen. Another type which cannot be handled except by permanent segregation is the thoroughly aberrational and socially dangerous class represented by Case 25, however one designates the type. Much more, undoubtedly, can be done for such a border-line individual as Case 12, if there is sufficient cooperation among educational and reformatory institutions and the courts. It has seemed to us that the chief cause of failure in this interesting case has been the fact that this young man could go on ever entering new social situations and finding new worlds for exploitation because no one had the means at hand for securing facts concerning his past or for ascertaining what any good diagnostician could easily perceive to be his limitations and tendencies.
Very much more to the point is consideration of the actual and possible outcome in cases of pathological lying by normal individuals. Here, as in other matters where bodily, mental, and social issues are blended, no prognosis or outlook can be rationally offered without consideration of possible changes in the circumstances peculiar to the given case. First and foremost stands out the fact that cure of the tendency sometimes happens even after long giving way to it. In this statement we are not contradictory to some previous writers.
As Stemmermann says, out of the general literature there is not much from which one can deduce any principles of prognosis. But, again, we would insist that one of the great weaknesses has been that earlier studies have not carefully distinguished between the mentally normal and the abnormal cases of pseudologia phantastica. When, for instance, Forel speaks of pathological liars as being constitutionally abnormal individuals who are not curable, he fails to differentiate where profitable differentiation can be made. If our own work is of any practical value it is in offering safer grounds for prognosis and treatment. Stemmermann summarizes well her follow-up work done upon cases seen years previously by other observers. Some of these are still in institutions. After a period of well- doing several of these have become backsliders and reverted again to lying and swindling. Very few appear to have been cured, but yet some of the facts of betterment are most convincing. This author states that, at the most, one dares to ponder over the point as to whether there are not cases which recover, particularly when the pathological lying is a phenomenon of adolescence.
Our own material is, in part, too recently studied to form anything like a generalization concerning prognosis. Many years have to elapse before one can be sure there is not going to be a recurrence. But one is not altogether certain that prognostic generalizations are of practical worth for this group of mentally normal pathological liars. So many incidental factors of physical, mental, and social life, with all of the complicated background of the same, come in to make the total result, that experiment and trial with the individual case, while hesitating to give an exact prognosis, is perhaps the only sane procedure. What we do know definitely is the immensely favorable outcome in Cases 1, 4, 7, 19, and the promising betterment in several other instances--all in direct contradiction to what we had expected from survey of previous literature. In several of these cases the years have gone by with nothing but steady improvement. The difficulty in getting adequate treatment, either in home life or by the necessary individual attention elsewhere, makes it impossible to say that many of the others also could not have been favorably influenced. Frequently a total alteration of environmental conditions is necessary, and this, of course, is often very difficult to obtain. Also it is extremely
Very much more to the point is consideration of the actual and possible outcome in cases of pathological lying by normal individuals. Here, as in other matters where bodily, mental, and social issues are blended, no prognosis or outlook can be rationally offered without consideration of possible changes in the circumstances peculiar to the given case. First and foremost stands out the fact that cure of the tendency sometimes happens even after long giving way to it. In this statement we are not contradictory to some previous writers.
As Stemmermann says, out of the general literature there is not much from which one can deduce any principles of prognosis. But, again, we would insist that one of the great weaknesses has been that earlier studies have not carefully distinguished between the mentally normal and the abnormal cases of pseudologia phantastica. When, for instance, Forel speaks of pathological liars as being constitutionally abnormal individuals who are not curable, he fails to differentiate where profitable differentiation can be made. If our own work is of any practical value it is in offering safer grounds for prognosis and treatment. Stemmermann summarizes well her follow-up work done upon cases seen years previously by other observers. Some of these are still in institutions. After a period of well- doing several of these have become backsliders and reverted again to lying and swindling. Very few appear to have been cured, but yet some of the facts of betterment are most convincing. This author states that, at the most, one dares to ponder over the point as to whether there are not cases which recover, particularly when the pathological lying is a phenomenon of adolescence.
Our own material is, in part, too recently studied to form anything like a generalization concerning prognosis. Many years have to elapse before one can be sure there is not going to be a recurrence. But one is not altogether certain that prognostic generalizations are of practical worth for this group of mentally normal pathological liars. So many incidental factors of physical, mental, and social life, with all of the complicated background of the same, come in to make the total result, that experiment and trial with the individual case, while hesitating to give an exact prognosis, is perhaps the only sane procedure. What we do know definitely is the immensely favorable outcome in Cases 1, 4, 7, 19, and the promising betterment in several other instances--all in direct contradiction to what we had expected from survey of previous literature. In several of these cases the years have gone by with nothing but steady improvement. The difficulty in getting adequate treatment, either in home life or by the necessary individual attention elsewhere, makes it impossible to say that many of the others also could not have been favorably influenced. Frequently a total alteration of environmental conditions is necessary, and this, of course, is often very difficult to obtain. Also it is extremely