In session with Naomi, we discussed her ongoing moral dilemma about whether to disclose. She vacillated between an agonizing sense of guilt for occasions in the past when she hadn’t been honest, to a dry-eyed cynicism in which she’d argue that she might as well go on hiding the truth because she couldn’t undo the past.

“I realize that I’m lying to myself. I can hear it, but I don’t know what else to do.”

I offered a couple of suggestions and she looked at me scornfully. “That’s never going to happen,” she scoffed. Her plight felt hopeless; no solution seemed possible.

The connection between lying and hopelessness got me thinking about my book on psychological defense mechanisms and Meltzer’s view of them as lies we tell ourselves to evade pain. It certainly seems true in Naomi’s case: she feels utterly hopeless about her situation, mostly because to be honest feels as if it would expose her to unbearable shame. She feels so damaged, so “tainted” as to be beyond repair. Nothing can be done and no improvement is possible.

This helps me understand such personalities and even to feel some sympathy for literally unbearable pain, a sense of damage so pervasive and hopeless that all the person can do is lie about it — to himself and everyone else. At least in manic-depressive illness, the person tries to “cure” the damage, even if it’s a magical sort of cure.

In anti-social personality disorder, the truth is negated and replaced with an entirely fictional “reality” instead.

Lie detector photo available from Shutterstock.