Pseudologia Fantastica and DBT: Mindfulness Strategies to Disrupt Compulsive Fabrication

Pseudologia Fantastica, sometimes called “compulsive lying” or “mythomania,” is a condition marked by a tendency to lie frequently without apparent profit or gain. The lies are often dense in narrative and detail, making them believable to many listeners. They differ from situational lies, which have a specific purpose, and from “white lies” which tend to have a particular, well-meaning purpose, such as avoiding hurting another person’s feelings. Furthermore, clients with Pseudologia Fantastica sometimes believe their falsehoods, which differentiates it from many other types of lying that are deliberately intended for a specific purpose.

A number of neurological conditions and psychological disorders are associated with Pseudologia Fantastica.

• Some studies have shown a correlation between Pseudologia Fantastica and abnormalities in certain brain regions associated with decision-making, namely the prefrontal cortex.
• One study found that around 40% of people with Pseudologia Fantastica have had issues related to their brains, including epilepsy, head trauma, or infections of their central nervous system.
• Pseudologia Fantastica is also associated with personality disorders, including Munchausen Syndrome, in which people fabricate symptoms of illness, Antisocial Personality Disorder, and Borderline Personality Disorder.
• It can also be tied to shame or trauma in childhood or later in life.

While Pseudologia Fantastica can appear in a wide variety of clients, DBT skills can provide a path forward to personal insight, emotional balance, and more appropriate behavior, regardless of the cause.

DBT can target many of the psychological patterns and issues associated with Pseudologia Fantastica through skills that improve self awareness, emotion regulation, distress tolerance, and interpersonal effectiveness. Even for clients with underlying neurological issues, these skills help navigate social situations and address inherent challenges. The shape that the client’s progress takes will depend on the client’s history and whether their condition is tied to emotional patterns, identity insecurity, trauma, or a mixture of causes.

Mindfulness skills are core to DBT, and can help clients become aware of their thoughts and urges without immediately acting on them. This skill can help clients self-diagnose the issues that lead to Pseudologia Fantastica, such as anxiety, shame, or lack of self-esteem. Learning to pause at the moment when they feel compelled to lie can help clients identify the types of situations in which lying has become habitual. Mindfulness can also help with the patience required for the healing process itself – deep-seated issues are generally not solved overnight.

Once this level of awareness is achieved, a client can move toward radical acceptance. In DBT, this term means accepting reality as it is with all of its pain and imperfections. Mastering this skill is often easier said than done, but the rationale for it is quite straightforward: fighting or denying the truth will inevitably lead to misguided actions, continuing problematic behavior, and more suffering. Acceptance of reality is, of course, lacking at a fundamental level for clients with Pseudologia Fantastica, and developing this mindset, even just with oneself, can be a profound shift and a key moment in the healing path.

In parallel, emotion regulation skills help individuals better tolerate difficult feelings that often drive lying, such as fear of rejection or inadequacy. These include:

• Identifying and Labeling Emotions: When clients can recognize and name their emotions accurately, the emotional urgency that fuels compulsive storytelling often decreases. This can make those emotions feel less overwhelming and point the client toward techniques to dampen their power.
• Understanding the Function of Emotions: Emotions are not random, they evolved in a certain way to increase the chances of survival. For instance, fear increases blood pressure, breathing rate, and muscle tension to aid in escaping a dangerous situation. Understanding the “why” of emotional reactions can reduce judgment and facilitate a sense of control.
• Checking the Facts: The practice of “checking the facts” builds off of mindfulness: clients pause to evaluate whether an emotion fits the facts of a situation or is based on assumptions, distorted thinking, or knee-jerk reactions. If the emotion doesn’t fit the facts, they can consider letting go or shifting the emotional response.
• Problem Solving: When emotions are valid and justified, clients can take concrete steps to address the underlying problem. Emotions evolved to solve problems, but ironically, in modern life they can consume a person and become an issue unto themselves. By identifying the problem and taking action, the client is empowered to address the underlying cause and builds confidence in their own efficacy.
• Take Opposite Action: When an emotion is pulling a client in a direction that is problematic or harmful, they can learn to take the opposite action. When they might be tempted to lash out, they can try listening sympathetically. In the case of Pseudologia Fantastica, a client can build toward understanding the triggers that cause them to fabricate stories, and then taking the opposite action by telling the truth.

Pseudologia Fantastica can seem deeply rooted in who a person is, but the behavior pattern reflects underlying issues that can be worked with and treated. DBT therapists can teach clients skills and mindsets to address emotional patterns at their core. Over time, DBT can both lead clients to adjust behavior while understanding and unwinding the issues that caused it. This work  can eventually do more than simply empower the client to avoid the lying associated with Pseudologia Fantastica – it can help the client live a more authentic, fulfilling life.

Training:

• Live: 2025 Cohort | Comprehensive Dialectical Behavioral Therapy (DBT)
• Introduction to Dialectical Behavioral Therapy (DBT)

Blog Posts:

• Pseudologia Fantastica: Layers of Deceit
• Getting Rid of a Behavior You Don’t Like
• Using Mindfulness in DBT to Counteract Deindividuation and Impulsivity

eBook:

• Dialectical Behavioral Therapy