The metal restraining chains are gone - now it is time for those "invisible chains" to go: WORDS. The vocabularies of the medical and psychological models with their disease terminology and deficit-focus have got to go. It is about time that the mental health profession enters into the light of the broader historical and philosophical revolution of postmodernism and its consequent linguistic paradigm. In this light we will finally recognize that words are much more powerful when used as "tools" to facilitate change and connection as opposed to when used to try to describe some "objective reality" (such as a psychiatric diagnosis). The purpose of this paper is to help free participants on both sides of the helping relationship from the socially constructed and socially destructive illusions created by the current medical-psychological-pathologizing and deficit-based languaging.

This goal will be accomplished from several different points of view: the history of philosophy, linguistics, power, cognitive science, and an examination of consequences. We will conclude with the implications this knowledge will have for the recovery model.

History of Philosophy

Philosophy since Plato has been about the search for absolute Truth through the use of reason. Science and the scientific method were a natural extension of this. Since the Enlightenment, science had been trying to "discover" a "reality" that our senses and scientific instruments only detect shadows of. Comte's philosophy of Positivism (about 1853) held that everything could be understood in terms of science - in opposition to a historical reliance on metaphysical, and theological explanations. The scientific method sought to explain phenomena by analysis, i.e. by reducing them to constituent interacting parts. Science soon found application in medicine and psychiatry, which continue this tradition of "discovering" and labeling parts of the whole. This reductionism taken together with the medical-disease focus has produced the familiar clinical terms of diagnosis and treatment in the mental health profession.

Another product of the Enlightenment that has been foundational in the mental health profession is Newton's laws of motion and mechanistic view of the universe. The universe was seen as operating like a giant clock set into motion by God. Soon everything was seen as a machine, including human beings. From this perspective human beings can be diagnosed and treated just like computers and automobiles can be fixed. This mechanistic view of human beings is foundational in mental health despite all the contradictory evidence.

Along came Ludwig Wittgenstein (1889-1951). Prior to Wittgenstein philosophy involved the use of reason to arrive at absolute truth - a search similar to that of science. Having taken philosophy to its limit, Wittgenstein decided to inquire into the nature of language, that taken for granted substrate of philosophy and science. Wittgenstein concluded that the typical problems of philosophy (the nature of reality, mind, etc.) were unsolvable and he focused instead on the role of language in everyday social activities. Furthermore, he asserted that communication was better seen as "language games" that influenced human action as opposed to exchanges of representations of "reality." Wittgenstein later became one of the founding fathers of postmodernism.

Postmodernism asserts that there are no absolute truths, and, instead, there are only different interpretations formed in language. Pragmatism later adds the requirement of utility to the mix. Postmodernism acknowledges how human relationships and communication create vocabularies that interpret our experience - that is, our "realities" are socially constructed. This is also referred to as the linguistic paradigm.

To illustrate how realities are socially constructed let's look at a thought experiment from Berger & Luckmann's (1966) The Social Construction of Reality (from Narrative Therapy, Jill Freedman and Gene Combs, 1996):

"Imagine two survivors of some ecological disaster coming together to start a new society. Imagine that they are a man and a woman who come from very different cultures. Even if they share no language, no religion, and no presuppositions about how labor is to be divided, or what place work, play, communal ritual, and private contemplation have in a good society, if culture of any sort is to continue, they must begin to coordinate their activities. As they do this, some agreed-upon habits and distinctions will emerge: certain substances will be treated as food, certain places found or erected to serve as shelter, each will begin to assume certain routine daily tasks, and they will almost certainly develop a shared language.

Between the two founding members of the emerging society, the habits and distinctions that arise will remain 'tenuous, easily changeable, almost playful, even while they attain a measure of objectivity by the mere fact of their formation' (Berger & Luckmann, 1966, p. 58). They will always be able to remember, 'This is how we decided to do this,' or 'It works better if I assume this role.' They will carry some awareness that other possibilities exist. However, even in their generation, institutions such as "childcare," "farming," and "building" will have begun to emerge.

For the children of the founding generation, 'This is how we decided …' will be more like 'This is how it's done.' Mothers and farmers and builders will be treated as always-having-existing types of people. The rough-and-ready procedures for building houses or planting crops that our original two survivors pieced together will be more-or-less codified as the rules for how to build a house or plant corn. In all likelihood laws will have been written about where, when, and how buildings may be built or crops may be planted. It is hard not to imagine that customs governing the proper rites for starting a family or harvesting a crop will have come to be, and that certain individuals will be identified as the proper people to perform those rites. Institutions like women's societies and masons' guilds will have begun to emerge.

By the fourth generation of our imaginary society, 'This is how it is done' will have become 'This is the way the world is; this is reality.' As Berger and Luckmann (1966, p. 60) put it, 'An institutional world… is experienced as an objective reality.'"

This is true not only from the perspective of the evolution of civilization and culture - it is also true in terms of the development and institutionalization of professions. If we replace the original two survivors with the original thinkers and arbiters of psychology and psychiatry we have development of the mental health profession together with its vocabulary (meaning words, concepts, and practices). Like the children in the thought experiment, everyone receiving a formal education in mental health receive the words and concepts as "reality." This process is called reification. Reification, according to Berger and Luckmann (1966, p. 89), is

"… the apprehension of the products of human activity as if they were something else than human products - such as facts of nature, results of cosmic laws, or manifestations of divine will. Reification implies that man [sic] is capable of forgetting his own authorship of the human world. (emphasis in original)"

So what does this all mean in terms of the mental health profession? The vocabularies of the medical and psychological models, indeed the idea of "mental illness" itself, are social constructions - THEY'RE MADE UP. Furthermore, they are vocabularies that describe disease and deficit. They view a human being as something that can be "assessed", "diagnosed", and "treated" much like a machine - hence comes the obsession with "compliance." These models make distinctions between "normal" and "pathological." They position practitioner as expert and client as more or less passive recipient of "treatment." The focus of "treatment" is on the elimination of "symptoms." As will be discussed later, the recovery model is a state of partial transformation: it is truly client-centered; however, it is contextually "weighed down" by the vestigial and anachronistic use of the medical and psychological vocabularies. These vocabularies invisibly and insidiously support the old paternalistic roles.

From a postmodern perspective these medical and psychological vocabularies are not representing reality, but, in fact, creating a "reality" or perspective. The fact is that words simply "carve up" our undifferentiated sensory experience leading to many possible interpretations of the human condition. The question then becomes "What is the best 'reality' or perspective with which to help people reach their goals?" John Walter and Jane Peller (2000), both prominent leaders in postmodern consultation, describe this shift from belief to utility:

"From our reading of postmodern philosophy and pragmatism, we decided to abandon the debates over epistemology and the debates over the foundation of knowledge. Taking his cue from Nietzsche and William James, the contemporary author of the new pragmatism, Richard Rorty, suggested: 'Instead of saying that the discovery of vocabularies could bring hidden secrets to light, [the pragmatists] said that new ways of speaking could help us get what we want' (1982, p.150). So, instead of asking, 'How do we know what is real about the client?' we have decided the more relevant question is 'What do our clients want and what new ways of speaking or conversing might help?'" (p. 32)

Yet the power and importance of language goes beyond even this. Like "water is to the fish," language and its implications are very difficult for human beings to discern. When we create words and concepts describing aspects of ourselves or of our environment (also know as making distinctions) they appear as "truths" and, consequently, they dictate our actions. Martin Heidegger (1971), widely regarded as one of the most original and important philosophers of the 20th-century, put it this way: "we do not use language"; rather, "language uses us".

Linguistics

From the perspective of linguistics we see that the reified categories (e.g. mental illness, schizophrenia, bipolar disorder) are abstractions defined by clusters of what we call "symptoms." Schizophrenia is defined as the presence of audio hallucinations (or other "thought disorders") in the absence of a "mood disorder." You can even throw in other correlates like "negative symptoms", PET scans, response to medications, etc. The issue of the DSM's poor reliability and validity aside (Caplan, 1995; Sparks, Duncan, & Miller, 2005), the term "schizophrenia" is a word used to communicate the presence of these "symptoms." The various human manifestations of thought, feeling, and behavior (aka "symptoms") exist like the chair you are sitting on as you read this exists. But the next level of abstraction, the word "schizophrenia", and the next, "mental illness", only exist through consensus and only persist by convention. Even if the correlations of defining symptoms was perfect (which it is far from), in light of the linguistic paradigm we have to ask ourselves whether using a pathologizing, deficit-based vocabulary is useful in helping people improve the quality of their lives.

One of the traditional rationales for diagnosing is to have a shorthand way of communicating with other professionals, presumably for the purposes of "treatment." One thing that gets communicated is a cluster of "symptoms" under the heading of the "diagnosis." Unfortunately, what also gets communicated is the hierarchical role relationship as well as the pathologizing and deficit-focused context.

Often so called "mental illness" is described as similar to physical illnesses, such as diabetes, where the patient needs to manage it the rest of his or her life with medications. This comparison is used to explain how medications work as well as to make the diagnosis and treatment more palatable to the client - as if to imply that their "mental illness" is something they "have." This analogy completely breaks down for the following reason. When we are talking about a person's thoughts and feelings we are essentially talking about their identity (which includes values, beliefs, memories, fears, and desires). This is not like something physically wrong with part of their body. A "disorder" of thought or feeling is a labeling of a person's identity. The labeling of subjective experience feeds on itself and perpetuates itself. Paula Caplan (1995), former consultant to the creators of the DSM, writes:"The professionals most concerned with labeling claim that they assign people to categories of mental illness so that they will know how to help them. If such assignments to categories really did help very much, that would indeed be encouraging, but treatment of emotional problems and conflicts is very different from medical or surgical treatment. If I broke a limb, I would want to be properly diagnosed as having a broken arm so that the surgeon would not mistakenly set and put a cast on my leg. But diagnosing individuals as mentally ill has not been shown to do much to alleviate their anguish and indeed often makes it worse." (p. 12).

Remember that the rest of the postmodern-enlightened world understands that words associated together comprise PERSPECTIVES and not descriptors of some discovered "objective reality." Another way to look at this is that symptom clusters are like stars comprising a constellation. The constellation (say the "big dipper") only "exists" from our point of view on earth. From another point of view far from our solar system the abstraction "big dipper" no longer exists. We have to get beyond our entrenched perspective.

Psychology, like psychiatry, has found ways of linguistically contorting, convoluting, and confusing lived experience with essential "truths" of its own. Bill O'Hanlon, a preeminent postmodern consultant and author, uses his holiday cookie making experience to communicate what happens in the therapy room (O'Hanlon and Wiener-Davis, 1989). A client's problem that s/he brings to therapy is like cookie dough. The experience of it is vague and malleable. Once the "blob" of cookie dough is forced through the cookie press (a tube, funnel, and mold pressed against a baking pan) it becomes a Christmas tree, star, or Santa Claus. Similarly, when a client exposes his or her problem to a therapist it gets "molded" or interpreted in the language of the therapist. So a client attending a psychodynamic therapy session would leave having unresolved childhood conflicts. The same client leaving a behaviorist's office would walk away with problem behavior shaped by reward and punishment. An interaction with a Jungian therapist would result in the need to deal with the various archetypes that apply to him or her. Talking with a diagnostically (and thereby pathologically) minded clinician will leave one with the idea that they "have" "bipolar disorder", "depression", "obsessive compulsive disorder", a "mental illness" - along with all the stories that go with them ("chemical imbalances", life-long duration, the need to "comply" with a treatment regimen, etc.). Like cookies, continued exposure to the "heat" of the theoretical lens causes these interpretations to "harden" or "reify" (to make real). O'Hanlon concludes that if our languaging creates "the problem" then why not leverage the use of language and create a problem that is easiest to solve. Harlene Anderson (1997), author of Conversation, Language, and Possibilities, adds:

"What seems to be an identifiable objective reality - a problem - is only a product of descriptions, the product of social construction. (p. 73)"From a linguistic point of view, the recovery model is still saddled with the baggage of pathological and deficit-based vocabularies. Let's take a look at the recovery model concept of hope. Hope, an integral component of recovery, is constantly being weighed down by the languaging of diagnoses, "treatment", neurochemical correlation to "disease", psychiatric history taking, predictions of life long "illness", and on and on. In contrast, postmodern consultation (therapies) use language to maximize strengths and optimism. For example, presuppositional questions such as "What will you be doing differently when the current difficulties are resolved?" have a built-in supposition that the client will resolve the current difficulties. Simply by answering the question the client affirms the presupposition that they will resolve their current difficulty. Is there any proof that a client will resolve a current difficulty? Of course not. But if you speak as if they will, they become empowered - and, empowerment is the point.

This is one of the many ways in which language is used to empower people as opposed to coming from the scientific paradigm where reason and rationality are mistakenly applied to human beings in order to reductively nail down "objective" truths about them. Such misapplication of reason is an example of what is referred to as scientism: the attempt to use scientific method in domains where it does not belong (Barzun, 2000).

The power of language and positive expectations has long been observed in the forms of placebo effects and self-fulfilling prophecies (Miller, et. al, 1997). Common sense has had an insurmountable problem penetrating the theoretical lenses of mental health professionals. And, as if common sense wasn't enough, cognitive scientists have discovered that the human brain operates according to complexity theory (as opposed to mechanistic theory described above) and, as such, it conforms to role expectations and resists overt or covert means of control or manipulation (McCrone, 1999).

Power

The mental health profession's isolation from other disciplines such as history and philosophy, as a whole, has left it with only a superficial understanding of the power of language. In the best cases, experienced practitioners view diagnosing as a "necessary evil" and do it with caution or, in the case of the recovery model, clients are seen as "having" a diagnosis rather than being a diagnosis. In addition to the understanding of language above, language is involved in setting and maintaining power relations in society. In postmodern circles this is referred to as the political aspect of language.

The mental health consumer movement has long recognized its struggle as similar to that of other marginalized (to use another postmodern term) groups such as women, gay men and lesbians, African Americans, and other minority groups. How this relates to language is as follows.

The vocabulary of the medical and psychological models inherently positions the clinician as expert interpreter of the client's experience. Seemingly benign words like "clinical", "treatment plan", "case", etc. also bring with them a context in which the client is seen as "abnormal" or having a "pathology" while the clinician has the role of performing "interventions" or other activities (such as wellness centers) to help the client overcome their "pathology." The power of definition is in the hands of the clinician. Once labeled "abnormal" (aka "mentally ill") you've been pushed to the edges of society - where your views and concerns are considered not important.

Humanitarian, political, and financial pressures have given birth to the recovery model. Being outcome-driven, recovery programs have had to bend to the truth of what works. This includes being client-centered, being passionate about helping clients get what they want and find meaningful roles in life, having a vocational and community integration focus, and really meeting clients where they're at. However, the discourse of the medical and psychological models still lives in the language spoken in recovery programs.

So you can have the best recovery program in the world and still be linguistically casting clients in roles in which they are in fundamental ways different from the rest of humanity. The discourse, the spoken language, creates the distinction "mentally ill" versus "not mentally ill."

Let's switch gears and take another look at the where the rest of the world has been heading. Michael Foucault, the very influential French philosopher and social critic, around the mid 20th century began to inquire into the relations between language and power. In short, he revealed that part of the way the powerful stay in power is through a monopoly on "truth" or "knowledge." With the emergence of democracy, politicians understood the need to manipulate public opinion. In developed countries corporations, through marketing, create need. The mental health profession says what's "normal" and what's "pathological." Furthermore, the vocabularies of the medical and psychological models together with the professional titles become something that seemingly elevates the professional from the persons subject to the labels (and, in many instances, from all non-professionals).

The designation "being insane" or "having a mental illness" originally implied the need for incarceration in mental hospitals. Through political and humanitarian pressure "treatment" became the alternative. The distinction "mental illness" became differentiated into all the diagnoses we have today. The point being that, though we have more humane treatment and more sophisticated designations, our languaging is still defining people as "abnormal" and subject to "treatment" where, despite more empowering structuring of roles (as in current recovery models), the center of power and definition lies in the clinician. Then it follows that these power relations, maintained in the vocabulary, powerfully undermine efforts at community integration and self-determination.

Though recovery-oriented programs are more client-centered, the double-bind communications of days of old are still alive and well. The content of our conversations with clients can be about their goals, their quality of life, accountability, community integration, high expectations, self-determination, independence, self reliance, etc.; but the context of our communication is "you have a pathology that makes you different from the rest of society" and "we have the expertise to help you overcome this pathology in order to live meaningfully like normal people do." Don Jackson (1965) drawing on Gregory Bateson's work on systems theory, asserted:

"Every message (communication bit) has both a content (report) and a relationship (command) aspect; the former conveys information about facts, feelings, experiences, etc., and the latter defines the nature of the relationship between the communicants." (p.8)

The "command" or role relationship aspect of the communication, brought forth in the vocabulary, creates and privileges clinician knowledge and marginalizes the client's knowledge and skills. This will be the case no matter how much the client accomplishes. This is true no matter how many wonderful recovery-based systems you have in place as long the medical and psychological vocabularies are still being used. The result: many so-called "mentally ill" people have skills and resourcefulness that go unnoticed and therefore uncapitalized on. The skills of negotiating the public transit system, living off welfare (in California about $250 dollars plus food stamps per month), adapting to often dangerous and unhealthful living conditions, negotiating the bewildering and often unfair social service and child protective agencies, coping with the "mental illness" stigma and ostracization, dealing with being "infantilized" (treated as a child or infant) by others, struggling with being pathologized by helping professionals, coping with being manipulated and taken advantage of by family members, and developing a whole array of "street smarts" - are all barely noticed behind the "mountain" of pathology "heaped" upon them from the medical and psychological perspectives. [1] Often their quite understandable reactions to so many of these challenges get thrown into the "symptom list" which adds support to "the diagnosis," which implies an inherent and internal "pathology" - all of which contributes to feelings of shame, humiliation, and self-blame. The "iron-grip" of these pathologizing discourses causes us to rarely sufficiently consider a client's life circumstances when the pathologizing labels are applied.

This brings to mind the fact that the Euro-centric version of "intelligence" and skill is but of one kind. Anthropologists were among the first to discover how the human brain does amazing feats regardless of the environment in which it finds itself - that is, regardless of such conditions as time period, geography, or degree of technological or economic development (Pinker, 2002). Individuals in primitive societies used to be viewed as having undeveloped brains (e.g. lacking intelligence). Their lack of technology (among other factors) prejudiced researchers (who are predominantly immersed in the dominant western Anglo culture) from seeing the amazing ways in which their genius and creativity manifested themselves. The most obvious example of this is the ancient Egyptians. The contributions of non-dominant cultures and those of other marginalized groups such as the so-called "mentally ill" are often devalued in a similar way. Real acknowledgement of these knowledges and skills in some fundamental way puts all of us humans on an equal footing: it's not about being better or worse, just different.

Our clients often are talented poets, artists, and musicians - traditionally vocations for those on the fringe of society. The long list of accomplished people with so-called "bipolar disorder" includes: Ted Turner, Jimmy Hendrix, Sting, Francis Ford Coppolla, and Jane Pauley. The link between "mental disorders" and creativity has been well established (Rothenberg, 1990). How many potential future Van Gogh's, Schumann's, Tolstoy's, Beethoven's, Hemmingway's, etc. have been prevented from enriching our society because their talent has been disabled and hidden by these vocabularies. The wealth of creativity and genius lost is incalculable.

Non-dominant cultures have had to liberate themselves from the pathologizing "lens" of mental health professionals as well. The "gays" in the 70's got themselves out of the DSM. Since the 80's cultural pluralism and cultural competency have been emphasized to keep the arbiters of what's "normal" and "healthy" away. Now it's time for the rest of us!

The point being that the powerful in society promote a dominant discourse (ideas and practices) that often pathologizes and devalues practices of non-dominant cultures and marginalized groups. The mental health profession acts as an agent of society in this way. Harlene Anderson (1997) asserts:

"The dominant voice, the culturally designated professional voice, usually speaks and decides for marginal populations - gender, economic, ethnic, religious, political, and racial minorities - whether therapy is indicated and, if so, which therapy and toward what purpose. Sometimes unwittingly, sometimes knowingly, therapists subjugate or sacrifice a client to the influences of this broader context, which is primarily patriarchal, authoritarian, and hierarchical." (p. 71).The very words and concepts used create a perspective in which clients and their talents are subjugated to the professional knowledges. To review, because of the way language works this happens despite all the rhetoric and programs promoting client self-determination, client strengths, client empowerment, etc.

The movement to put an end to the use of the medical and psychological models and vocabularies has every element of a social-political movement - with something like emancipation, liberation, or inclusion being the objective.

Cognitive Science

What about the old favorite "chemical imbalance" - the often called-upon "proof" of the "disease model" or the "reality" of "mental illness?" Once again we look outside of the profession of mental health in order to get perspective. During the last half of the 20th century there has been a strange and wonderful confluence of scientific disciplines - including evolutionary psychology, sociobiology, genetics, cognitive science, and anthropology - that have dramatically changed our view of the human condition. Steven Pinker, Richard Dawkins, Robert Wright, Daniel Dennett, E.O. Wilson, and Noam Chomsky are among the contributors. While keeping in mind this inter-disciplinarity, for the purposes of this article we will focus on cognitive science.

Perhaps due to the hegemony of psychiatry and perhaps due to power of the pharmaceutical industry (another powerful interest group that promotes the medical vocabulary) the mental health profession has been shamefully unaware of what's been happening in non-disease-model-presupposed brain research: cognitive science. What does cognitive science or its cousin, neurobiology, have to say about the notion of "chemical imbalance" and its relation to people's various mental conditions?

The distinction "chemical imbalance" is employed among other reasons to give credence to the "illness" interpretation and to justify the use of medications. The argument is made that a biological basis means it is a disease like other physical diseases.[2] The causality is assumed in the direction from biology to mind and behavior. Much current research, however, is revealing that mind and behavior (e.g. that which happens with psychotherapy) equally influence brain chemistry. Harrop, et. al. (1996) states:"[It] is possible for physiological differences associated with the condition [schizophrenia] to be the result of the condition and not the cause. . . . [The] relationship between the psychological problems and the physiology should be viewed not as a simple cause-and effect relationship, but more as a reciprocal and iterative relationship where psychological effects can affect the physiology that can in turn affect the psychology." (p. 641)

Since Harrop's research in 1996, the effect of psychotherapy on brain chemistry has been well documented (Teasdale, J., et. al., 2000; Shapiro, F., 2000; Schwartz, J., 2002; Goldapple, et. al, 2004; Etkin, et. al., 2005; Otto, et. al., 2005). Researchers now use the terms and "bottom-up" and "top-down" to characterize the effects of psychotropic medications and psychotherapy respectively. Medications are thought to change brain chemistry in "lower" or emotional regions of the brain (i.e. limbic system) which, in turn, effects the "higher" or thinking regions (i.e. the cortex). Psychotherapy (most researchers used cognitive-behavioral or mindfulness approaches), on the other hand, works from the "top-down." Better thinking results in changed brain chemistry. The term "biological basis" needs to be replaced with "biological correlate" where there is correlation and bi-directional causation.

Like diagnoses, the concept of "chemical imbalance" is an abstraction used mistakenly with universal application - despite similar validity and reliability problems (Sparks, Duncan, & Miller, 2005). Both the concepts of "mental illness" and "chemical imbalance" comprise some of the arsenal used to try to break down the "denial" and persuade (or coerce) clients into treatment. The question of "chemical imbalances" becomes moot when we look at all the negative consequences.

An equally important finding of cognitive science to the mental health profession is that of neuroplasticity. The old functional mapping of the brain has been discarded in favor of neuroplasticity. In his groundbreaking book The Mind and The Brain: Neuroplasticity and the Power of Mental Force (2002), Jeffrey Schwartz chronicles the discovery of neuroplasticity by Edward Taub during the famous Silver Springs Monkeys experiments. In short, monkeys were used to show that in response to environmental demand and repetitive effort the brain will recruit healthy neuronal networks to perform the function of damaged ones. These findings have subsequently formed the basis for treatment of stroke victims and people with dyslexia.

Similar to the situation in California, where the Mental Health Services Act has provided the financial incentive to removing other entrenched-paradigms in favor of the recovery model, Schwartz points out how it was the potential for profit in the treatment of dyslexia that finally broke the grip of the old brain paradigm. Schwartz:

"When Ed Taub once expressed frustration about how slow the rehabilitation community was to embrace constraint-induced movement therapy for stroke, Merzenich responded that only the profit motive was strong enough to overcome entrenched professional interests and the prejudice that the brain has lost plasticity after infancy." (p.234).

Merzenich's company, Scientific Learning, was so successful in treating dyslexia - having a 90% success rate - that in July 1999 it announced its initial public offering.

Schwartz took it a step further. In trying to help people diagnosed with "obsessive-compulsive disorder (OCD)" he recognized that traditional cognitive behavior therapy didn't work because knowledge of the irrationality of their cognitions made little difference to "OCD" clients. Instead, he redescribed the obsessive thoughts as products of "brain lock" (using PET scans showing lockstep functioning of the orbital frontal cortex, anterior cingulated gyrus, caudate, and thalamus), impressed upon them the idea that "thoughts were not facts" and that "they were not their thoughts", and devised alternative behaviors to replace the compulsive ones. He essentially divested the thoughts of their reality status thus making mindful awareness possible.

The results were astounding. The mindfulness training proved better than all other psychotherapies used with "OCD" and, more importantly, they produced the same neuronal changes seen on PET images after treatment with powerful psychotropic medications (Schwartz, 2002). Similar mindfulness-neuroplasticity mediated changes have been reported in the process of EMDR (Shapiro, 2001) and in the "treatment of depression" (Teasdale, et. al., 2000). Mindfulness continues to be a pioneering modality among many that live and thrive outside of the confines of the medical and psychological models (Bennett-Goleman, 2001; Shapiro, 2001, Hayes, 1999).

I am not trying to disqualify the use of chemicals (aka medications) to help people improve the quality of their lives. I am saying that psychiatry will have to recognize that it is an art to be applied in a highly individualistic, non-pathologizing, collaborative way - perhaps something akin to how the East practices herbal medicine. [The book to read is A Road to Recovery by Mark Ragins, MD]. We have to view chemicals as "crutches" in order to reduce the all-to-prevalent dependency and to position clients as responsible for taking many other actions that support their personal and spiritual growth. The chemicals sometimes are a helpful and temporary "tool" - it is the "story" that goes along with them that carries with it the iatrogenic problems (problems caused by the attempted solution).

These findings all point to the need to replace the paradigm of "chemical imbalance" with that of "neuroplasticity" - replacing determinism with possibility, medication dependence with better linguistic tools. So much industry attention on "bottom-up" change using pharmaceuticals has made clinicians "dependent on medications" in the sense that clinicians have not paid enough serious attention to developing their empowerment skills - making "biochemical determinism" a self-fulfilling prophesy. No doubt the neuroplasticity paradigm will result in practitioners with much greater empowerment skills; hence, greatly reducing the need for medications. Mindfulness is one of the perspectives and practices that will eventually replace the old medicalization of experience (see Implications for the Recovery Model section).

In light of neuroplasticity, rigid abstractions such as "chemical imbalance", "mental illness" and psychiatric diagnoses, such as "borderline personality disorder", are linguistic "balls and chains" when it comes to helping people become self-determining.

Examination of Consequences

Ignorance of the linguistic paradigm has resulted in profound iatrogenic problems (commonly referred to as iatrogenic illness): problems caused by the attempt at helping. Mental health professionals may be creatingmuch (being conservative) of that which they are trying to cure.

When we speak as if someone has a diagnosis or has a "mental illness" we are unwittingly creating a reality - a reality in which human beings are transformed into the "mentally ill". When we use words such as "mental illness", "schizophrenia", "symptoms", "tangential speech", "clinical this or that", "treatment plan", "assessment" - we are unwittingly bringing forth the entire context, the hierarchical and paternalistic role relationship together with the sticky morass of pathological and deficit-based perspectives. Jill Freedman and Gene Combs (1996) write:

"Speaking isn't neutral or passive. Every time we speak, we bring forth a reality. Each time we share words we give legitimacy to the distinctions that those words bring forth." (p. 29)

Words, abstractions, theories, and beliefs focus our attention. Heinz von Foerster (1984), the famous cybernetician and constructivist, concluded: "Believing is seeing." We "see" those behaviors that confirm the diagnosis and hardly notice those behaviors that don't. Because those are the behaviors noticed and responded to, the client experiences herself defined as such, and, by way of self-fulfilling prophecy, feels a strong "relational pull" to behave accordingly. It doesn't take an advanced knowledge of systems theory or cybernetics to see how we amplify the "symptoms" and reify (make real) the "labels" by the use of the pathologizing language. The irony and tragedy is profound.

We know not what we do. By seeing the medical and psychological vocabularies as truths (as opposed to perspectives) we cannot see the profoundly destructive consequences of them. These vocabularies comprise closed conceptual systems in which everything can be explained within them (not unlike a so-called "delusional" system). Martin Heidegger called these often impenetrable, closed interpretive systemshermeneutic circles. For example, a client who doesn't fit into the Procrustean bed [3] of "treatment" is seen as resistant, not ready to change, irresponsible, employing "defensive mechanisms", at the effect of "transference", manipulative, etc. The therapist's actions (frustration, resignation, avoidance, etc.) are in perfect accord with this cadre of pessimistic terms and, of course, have their complementary responses in the client (further lack of desire to participate with the therapist, increased pessimism about their own prospects, more inaction) - thus confirming the initial interpretation. Ironically, such "client blaming" keeps the professional from taking responsibility for doing something different that might produce a better outcome. Equally disturbing is the fact that this "hermeneutically sealed" conceptual system keeps us from hearing and taking seriously the emerging "voice" of the people we are trying to help (e.g. the Mental Health Consumer Movement).

The emerging client-centered recovery model acts as a counterbalance to this. Recovery programs look to make client goals (as well as removing barriers to these goals) and strengths the focus. In this way recovery programs go a long way towards ameliorating much of the negative effects of the medical and psychological vocabularies in which they are immersed.

Without a recovery focus pathologizing runs rampant: A client can't be angry without being accused of "not taking their medications". A client can't be persistent in getting his needs met without being written off as being "manipulative." A productive day becomes hypomania. A tired day means signs of depression. A client asserting themselves with their clinician is defensive or resistant. And, of course, the "spin" put on client's behavior confirms the clinician's expectations. Despite the gains of the recovery focus the disabling conceptual reality continues to "live" in the minds and "breath" in the speaking of these recovery programs. Paula Caplan (1995) writes on some of these effects:"When terms like abnormal or mentally ill are spoken, what kinds of images come to mind? Usually, images of difference and alienation, suggesting that 'they' are not as competent, human, or safe to be around as the rest of 'us.' And often, 'abnormal' and 'mentally ill' are equated with 'crazy,' a label that calls forth images of someone who is out of control, out of touch with 'reality,' incapable of forming a good relationship, untrustworthy, quite possibly dangerous, and probably not worth one's attention, time, or energy. If such labeling had some positive effects, it might be worth risking the negative consequences for those who are labeled abnormal."

Furthermore, recovery's focus on community integration is continually sabotaged by the medical and psychological vocabularies. The normal ups and downs of working or being in relationship quickly get pathologized. Remember, it's about focus and language; recovery programs are currently only addressing focus. A problem with managing work tasks or a pang of jealousy in a relationship is quickly referenced back to a "mental illness." Shery Mead and Cheryl MacNeil (2004) in their paper titled Peer Support: What Makes it Unique? poignantly illustrate this problem:

"Recovery in mental health has most often been defined as a process by which people labeled with mental illness regain a sense of hope and move towards a life of their own choosing (President's Freedom Commission Report, 2003). While this definition on the surface seems obvious, what remains hidden is the extent to which people have gotten stuck in a medical interpretation of their experiences. With this stuckness comes a worldview in which one is constantly trying to deal with their perception of what's wrong with them instead of what's wrong with the situation. In other words, even if I have hope of moving into a better life, I have been taught to pay a lot of attention to my 'symptoms.' This interpretation of my experiences leaves me constantly on guard for what might happen to me should I start to get 'sick.' Even with recovery skills (learning to monitor my own symptoms), I find myself creating a life that is ultimately guided by something inherently wrong with me. With this understanding, I may continue to see myself as more fragile than most, and different than 'normal' people. I then continue to live in a community as an outsider, no matter what goals I achieve." (p. 7).

Mead and MacNeil advocate client peer support that is free from the vocabulary of the medical model - I am advocating this for the profession as a whole.

Another devastating consequence of the medical and psychological vocabularies is their effect on our ability to recognize and capitalize on client's strengths. There are several ways in which client strengths are wasted. First, the hierarchical role relationship wherein the clinician is the expert and the client is the passive recipient of "treatment" puts the focus on the clinician and her expert knowledge. Secondly, the expert knowledge that both clinician and client are relying on focuses on current deficits (e.g. symptoms) and historical failure & tragedy (aka psychiatric history). Thirdly, the vocabulary hides, minimizes, and explains away strengths as "flights into health", superficial in comparison with "the illness", or even manifestations of "the illness" (e.g. hypomania, manipulation). Fourthly, the medical and psychological vocabularies comprise "normative perspectives" where clients are implicitly compared to what is "normal" in society; hence, making their strengths, accomplishments, and incremental change seem insignificant (or not given nearly enough attention, admiration, wonder, and analysis). Finally, even if the professional wants to build on client strengths, there is no vocabulary and associated practices in these models with which to do it. Let's get a taste of such empowering perspectives and practices by taking a look at an example from postmodern consultation.

Postmodern consultation leverages the power of language and focus. For example, in solution-focused therapy (a postmodern modality) we start by building on "exceptions": times when the problem is less intense or less frequent. For example, with a client whose goal is social skill, we might ask, "What is different about those times when you're a little more socially skilled?." Often clients say that they are more socially skilled in one-on-one situations where they are talking about common interests. Exceptions are always occurring, even BEFORE any contact with the helping person. After engaging in them in a collaborative inquiry into theinterpretive structure that made this exception possible, I ask them to do more of this and keep track of what else they do that works. Therapy quickly becomes about reporting all the new distinctions (ways of viewing situations) and strategies that are working. This process immediately makes client's feel more confident. Moreover, all the life-enhancing strategies, derived from exceptions, are tailor-made to the client's temperament and circumstances. By focusing on pathological constructs exceptions are hardly noticed, ignored, minimized, or explained away. The very building blocks of change are ignored! Instead, "symptom management" and skill building programs start from scratch, assuming everything must be taught to the client - which also communicates to the client that what they already know is of little or no use.

The roles taken and words used by mental health professionals prevent an existential "I-Thou" (Buber, 1958) connection with clients. There is a maddening kind of inauthenticity and duplicity that comes with interactions with today's mental health professionals - not unlike the patronizing experienced by many minority groups. A kind of gulf between their personhood and professional role makes real human connection impossible. This disconnect manifests in barriers to effectively listening, accurate empathy, limit setting, etc. For example, labeling people as having "borderline personality disorders" has historically retarded clinician's interpersonal skill development (such as being able to compassionately set limits). The label creates the problem in the client as opposed to between two people - effectively relieving the professional from the responsibility for maintaining a warm, nurturing, and respectful relationship.

Only someone hypnotized by the current medical and psychological dogma - hence blind to their effects - could not see the isolating and otherwise debilitating consequences of being inauthentic in a helping relationship (assuming they can recognize their own inauthenticity) and of designating someone as having a "mentally illness." These relational and definitional acts isolate the person from the rest of society, from the so-called "normal people." Being contextualized by the medical and psychological vocabularies, it would be a miracle for so-called "community integration" to be truly successful. You'd be better off having a case of amnesia and being kidnapped to a developing country where, by the way, the outcomes are much better (Jablensky & Shapiro, 1977).

Implications for the Recovery Model

The recovery movement reflects a humanitarian impulse prevailing despite the power of medical and psychological dogma; however, most recovery model practitioners still use the vocabulary of the medical and psychological models. I hope that this paper has made clear the double-bind communication with all its consequences. The content says go after what you want in life, find meaningful roles, and integrate with the rest of society. The context says you are different from "normal" people, you are classified as "mentally ill" (with all those connotations), and you have "pathologies" or "symptoms" to overcome; which is why you need mental health professionals who are themselves "normal" to "explain" your "condition" and to provide expert advice (i.e. knowledge and perspective you can never possess) designed to help you reach your goals which are modest compared to "normal" people because you are by nature of your classification "weaker" and more "fragile" than "normal people." You will have to be on the alert for your "symptoms" as you try to work and maintain relationships - for you must manage your "illness" for the rest of your life. The content says "go" while the context says "no".

There are many effective tools currently employed by recovery programs, such as wellness centers, peer advocacy, community integration, and employment programs. The culture of recovery programs is undeniably client-centered. Collaborative (and, in many cases, collegial) relationships replace the old paternalism. So why keep the invisible chains of the most powerful factor of all - language?

The belief that the medical and psychological vocabularies represent scientifically "discovered truths" is the biggest obstacle for traditional community mental health programs transitioning to recovery-based services. If "mental illness" and psychiatric diagnoses are seen as being essential "realities" then so are the associated constructs that are part of the same closed-conceptual framework: pathological interpretations, the focus on deficits, the hierarchical-paternalistic role relationship, practitioner-as-expert role, and client-as-fragile role. Recovery leaders are asking their staff to overlook these "realities" and instead focus on things they can hardly "see" or take seriously (i.e. client strengths, client self-determination, client goals, independence, etc.) given the context they're embedded in. The initial weak, vague, and superficial understandings of the recovery process will be layered over the "realities" of medical and psychological dogma. The transition from the medical/psychological paradigm to the linguistic paradigm is essential.

A similar revolution is occurring in the substance abuse field. Like current mental health recovery models emphasize finding meaningful roles outside that of being a mental health client, substance abuse recovery is increasingly emphasizing the importance of a non-addict identity (McIntosh & McKeganey, 2000). The "disease" model of substance abuse is being challenged as well. Arthur Horvath (2001), president of SMART Recovery Inc., illustrates three other important parallels: 1.) the disease model is based on dogma versus fact and does more harm than good; 2.) forcing acceptance of having a disease/illness actually delays or prevents people from dealing with their problem; 3.) the biggest leverage a person has in changing is to focus on what's most important to her or him:"The disease model does more harm than good. If someone has a firm belief in it, and finds it helpful, I make no effort to persuade otherwise. However, public policy is better based on facts than dogma. Almost our entire US treatment system is based on treating this 'disease.' Individuals with addictive behavior are led to think that the most important question is, am I an alcoholic/addict? Of course, rather than admit this, many just ignore problems until they get worse. A more rational system would encourage earlier problem identification, and present a range of options for responding to problems. When you have a receptive audience, I suggest you present our message of hope: You don't have a disease, you are not powerless. By staying focused on what is most important to you (which might be a higher power, but could be all sorts of things), you can gain full control of your behavior, and learn to lead a wonderful life!" (p.3)

This paper is calling for nothing less than a total transformation in education in the mental health profession. The labeling has disconnected both professional and client from humanity. The elaborate psychological theories have led to what Bill O'Hanlon calls "analysis paralysis." Emphasis on categorizing and analyzing has severely hampered the development of professionals' empathetic, empowerment, and coaching skills. Paula Caplan (1995), asserts:

"…Furthermore, much of the time and energy that professionals who use the DSM invest in learning about and trying to apply its contents could be more usefully invested in such endeavors as paying careful, caring attention to what one's patients say and working, free from dogma, to understand and help them." (p. xviii)

Despite the scientization and medicalization of the mental health profession, practitioners have all acquired certain common sense skills that work and that, by themselves, don't have all the disabling "side effects" of the medical and psychological vocabularies. These include skills such as rapport building, empathy, Socratic inquiry, persuasiveness, etc. No longer embedded in their pathologizing context, these skills will serve as our foundation in a post-medical-psychological-model world.

Postmodern (including solution-focused, narrative, and collaborative perspectives) consultation and coaching will build on this foundation and carry us into the 21st Century. Motivational Interviewing, life coaching skills, EMDR, Acceptance and Commitment Therapy, mindfulness-based therapies, and others not mentioned in this paper - and still others not yet invented - will also forward this movement.

Many dialogic skills are necessary for an authentic and collaborative relationship. The medical and psychological ways of relating have left most mental health professionals in the habit of somewhat mechanically reflecting back, nodding their heads, or saying "uh ha" while their minds are preoccupied with interpreting the client and his experience through the lenses of all the medical and psychological constructs. Remember: believing is seeing. Authentic and collaborative dialogue is an exhilarating experience and is the means to connect and stay connected with the people we consult with. It is a learned skill and requires a significant amount of training.

We all could use consultation or coaching in order to more efficiently reach our goals. Without all the negative connotations and stigma it is likely that the market for mental health services will expand.Another common reason for labeling people as "mentally ill" and having such and such "diagnosis" is for insurance reimbursement and disability benefits evaluation. The need for services needs to be established. Currently this is done by some combination of description of "functional impairment" combined with psychiatric diagnoses.

This is where it is necessary to have a true understanding of the postmodern perspective. From a postmodern point of view there are no absolute or essential truths; instead all we have is interpretation. Furthermore, there can exist multiple valid interpretations - multiple descriptions. We can use different interpretations for different purposes. When it comes to third-party reimbursement, we simply have to change our point of view from that of empowerment of the individual to that of the institutions of our society - we take a "normative perspective" (i.e. comparing to that which is considered "normal" from the perspective of society as a whole). Using descriptions of behavior we illustrate what our clients can't do.

If insurance reimbursement requires psychiatric diagnoses we simply remember that we're changing focus (i.e. to that of "symptoms") and using different abstractions (i.e. those of diagnoses) to make summary statements. Insurance companies "believe in" (i.e. see them as essential "truths" or "entities") these reified linguistic constructs only as a result of their having been sanctioned by the medical profession. The profession can certainly establish the need for services or benefits based on behaviors, without resorting to making up "fictive diseases."

Remember from the old scientific-reductionist rigidly held perspective holding two contradictory points of view is impossible - because, as you will recall, the point is to reduce things to some unique essence. From the linguistic paradigm we're looking for words and perspectives that will help us solve a problem. To receive insurance reimbursement and to establish disability benefits simply requires an occasional translation from one language to another. Words are tools, not truths.

The recovery model as it currently exists is an incomplete transformation of the mental health profession. We are finally helping clients get what they want, taking them seriously, having high expectations of them, and eliminating barriers to employment, housing, financial stability, and relationship. The basis of our helping interactions has to be freed from the vocabularies of medicine and psychology.We human beings are all struggling with our feelings, thoughts, impulses, and habits. The illusory difference between "clinician" and "client" evaporates, like a bad dream - leaving us with one "condition": the human condition. It was Shakespeare that understood how our human roles are mere fabrications, where power and authority are based on image and ceremony.

The cultural pluralism in our country has led to an emphasis on "cultural competency" in the profession. Gays won their freedom from the DSM in the 80's; various non-dominant-culture-specific practices did so in the 90's. There doesn't seem to be any pride in membership in the DSM. I'm advocating freedom for all.

Finally free from the chains of the medical and psychological vocabularies, many people would immediately fit into society with a little extra help. Others would blend in immediately into artist studios, universities, and musician & literary communities. 19th century Paris was the mecca for such creative people. Bohemian was the term for the artists and intellectuals that didn't "fit in." Avant-garde referred to those who didn't "fit in" and led the rest of us. Something to think about.

How do you know he's not lying about that too?

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NO! but that is just my opinion, and I have dealt with a lot of liars. I don't think that people change their ways -- or it is very, very rare for someone to change and stay changed. I just don't think it's going to happen. A liar only says he's sorry because he got caught!

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My ex-boyfriend was a liar and after saying that he was sorry he still lied to me. He lied a minute after he told me he was never going to lie again! He is still lying now and I know that he has a psychological problem. I am not sure if his parents agree though. I think his dad and the younger family member have the same problem. Liar's remain liars. Unless they are changed by God. God is all powerful and with Him all things are possible!

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I am 15. I used to lie all the time about little things, major things, basically it was almost like a normal thing I would do. until about a year ago I realized just what I had been saying I liked attention. It was such a mistake to liar the amount of guilt I have is ridiculous, I cry often and punished myself I wish I never lied but people have accepted me, I have confessed a lot because otherwise it just builds up more and more inside and the guilt becomes worse and worse people have forgave me but I don't know if I can forgive myself. Please if you lie, try to stop. It isn't healthy.

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NO! No way. He's a Compulsive Liar. He does nothing but LIE. Why believe him if he tells you that he's working on it. That's another one of the LIES he tells you so he can get what he wants. Don't believe a word he says. Get away from the compulsive liar and don't go back. They are real good at making people feel sorry for them. They play head games. These kind of people should not be trusted. They're like drug addicts or alcoholics. First they need to admit they have a problem and then get PROFESSIONAL HELP!

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As a compulsive liar myself I find it very hurtful some of the things people say about the sickness, which is exactly what compulsive lying is A SICKNESS! I have just recently admitted to myself and the person who means the most to me (my wonderful boyfriend) that I am in fact a compulsive liar! Do drug addicts or alcoholics not deserve the chance to get help from a loved one so that they can recover. Yes you have to admit it but I find it comforting and helpful knowing that I have my family and my boyfriend to help me. Don't give up on the person, help them! If the person is trying to get help and admit it. They really want to change (at least this person)...

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It is possible for a compulsive liar to address their problem but they can only do it with help and support. It is no good saying they're working on it. They must have some kind of proof that they are getting help. Compulsive Liars are suffering from an illness. They need to change the way that they respond to themselves and their lives. It is not easy but everyone deserves the chance to try and change their lives. Sometimes they need someone to hold their hand to get help. Ultimately you can lead a horse to water but you cant make it drink!

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I don't think anyone who is compulsive would change, I think if you don't know for sure that they are getting help, they can't stop lying long enough for you to take their word for it!

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If a compulsive liar claims to be working on the issue, any attempt would be disingenuous and only for ulterior motives . A compulsive liar will continue to lie when the truth is in front of him in black & white. The only issue they will really be working on, will be how to keep you from finding out their next deception.

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It's possible. You need to take them to a psychologist, someone who knows the mind and knows how to get around the lies. Someone, who can show them how their lies affect others and why they need to stop lying.

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Of course it is possible to change if you are a compulsive liar, I am living proof. Many times there are reasons why you do this, for myself I was abused and had very poor self esteem. In certain instances I felt the need to lie to make myself feel more adequate in a situation, I always felt poorly about my life or personality so I would try to become something I wasn't through lying about my life. It is a hard cycle to break because you really need to deal with the abuse and the self esteem issues not the lying issues. The lying will stop after you learn to deal with your abuse and get some self esteem.

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The answer rests with the liar: only he can change IF he WANTS to change. However, I don't think that's likely to happen -- they are a predator who is happy that way.

I wouldn't recommend being a party to the liar's "recovery" -- unless you want to be absolutely gutted by a mind-bending, reality twisting, manipulative, using, abusing and violating subhuman.

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Compulsive liars are not "its." My best friend is a compulsive liar and I have been hurt many times by him because he told me he was abused and made up terrible things like that up to get attention. If I give up on him he will have no one, they need help and people like you aren't doing the job. His parents are both dead and I think that is why, most compulsive liars have probably been neglected in some way, and to help them you need to be there and give him positive feedback about who he really is like " you look great with the haircut" but check if hes a narcissistic. They want your pity, give it to them. He lacks self respect and self esteem people can change, but not by themselves or by being insulted. Be more mature about the issue and realize that most of them don't even know that they are lying trust me your friend probably has a very hard time sleeping at night.

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I am a compulsive liar. I have just been able to see the seriousness of my problem and that is sad. I lie because I think it is fun. I too have a low self esteem and I lie to build up a life that I perceive as more normal or more appealing to outsiders. I make up exciting stories all the time or elaborate on true stories. My friends love to hear me talk but most don't know I am lying. I am a very good liar, I learned that and how to be manipulative from my mother. I just told the guy that I have been in a relationship with for the past two months everything about me. He is the first that I have rescinded all of my lies and told only the truth to. Only, it is too late. He is hurt and torn up that I kept up the lies and the stories for this long, not being able to trust him with the sad truth that is my boring life. He made me realize just how hurtful lying can be to other people. Since I am a compulsive liar, I do not trust anything people tell me, so I am rarely surprised when someone comes to me and tells me that they have lied. I guess I expect that everyone is an undercover liar just like me. I do believe that I can change my ways but believe me, it's hard. Being a compulsive liar is like being a drunk or a druggie: lying is our fix. I still believe that there is a thrill to be gotten to lying with people and it does help to mask some of the problems in my life from time to time but I am wiling to give up this excitement so that I may foster normal relationships with people that I care about. I am tired of hurting others and losing others truth. It hurts me to think of how much someone believed everything I said and then when I tell them something different it makes them believe that they got to know the lie I created instead of getting to know me. I will seek professional help but I just wanted to say that there is hope for us, we just need to see how our selfishness truly effects those we care about for us to be willing to change.

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My wife and I of 8 years have always had problems like any other relationship. I used to be a compulsive liar, but only because everyone in my family was also. My mother was an alcoholic and so is my wife. I have gotten over the compulsive lying with one exception and that is with my wife. I always look up to her and love her more than anything in my life. I just can not stand to see the disappointment in her eyes and the mistrust that I have caused. She has always been very verbally abusive, and I was a liar! I left my wife three weeks ago not because of her verbal abuses but because I can not stand to see the hurt I am causing. I stopped lying to her for 2 years and then slipped and told a really stupid lie. I saw the look in her eye when I had done this again, and I left because I don't want to hurt her anymore. I appreciate the kind words above writer has about recovery and needing that helping hand. I am to the point that if I can hurt someone I love with that kind of ignorance, there is no help for us liars.

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I cannot answer yes or no to that question, In my heart I believe that my husband would change if he could, yet it smacks me in the face when he tells another lie that no amount of professional help can change him. Having read all the other views on this page, and knowing the reason behind my husbands lies, (he too was abused), I still feel non the wiser as to how to solve this problem because no matter how much you try to help someone get out of the habit of creating a seemingly better imaginary world inside their head, the real world doesn't stop turning and it doesn't stop the people you love the most from walking away. All I can say to the people out there who "lie for fun" is this... How would you feel if one day you had a real problem and there was no-one who cared because you had driven them away? My husbands problem is frustrating me no end, but when I think of my life without him it doesn't seem any richer. I guess time will tell whether he stops lying, its stupid because they aren't even huge whoppers either, it's stupid everyday little things, but its not even the subject of the lies that's cracking me up, it's the continuity of them.

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I can sympathize with those who advocate not giving liars another chance, and it seems to me that on the whole, like with any compulsive behavior, people are unlikely to change, until at least they hit rock bottom. I have been a compulsive liar most of my life. I have certainly told people that I would change, and not meant it, when I just wanted to get out of an embarrassing situation. I have also, many times, wanted to change from the bottom of my heart and failed. I even remember making a commitment to not lying when I was eight or nine. Nearly twenty years on, it's still an issue that I battle with and it makes me ashamed of myself.

Having said this, my lying has become much less frequent and serious over time, as my life situation has changed steadily for the better. Having achieved things that previously I would have lied about (like getting an education) I find now that the gap between who I am and who I would like to be is getting narrower, raising my self-esteem and slowly allowing me to let go of the habit of lying, which before was the only way to emotionally survive. It's taking time and habits are hard to break (sometimes I exaggerate things to make them more interesting or lie as a way to get out of a tricky situation), but I'm getting there, and almost without noticing, my mind is catching up with the idea that lying is no longer something I need in my life.

I do have a point: yes, liars can be exasperating and on the whole, should probably not be trusted; but they are still human beings with genuine emotions, capable of hurt and love and regret, and often they are trying to put behind them painful pasts, which taught them one had to lie to survive, to maintain a minimum of self-esteem, to be accepted by others. Even when these people's lives become better, the program is still in their heads, and automatically they continue to behave in the same way. Trust and believing, and believing once again, when someone is constantly lying to you is probably not the appropriate response, but a bit of compassion might be called for.

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I am a compulsive liar. Its very hard to quit. I really enjoy lying, but hate to feel the consequences. I hope someone out there understands the pain we go through.

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I believe that compulsive lying is not only a disease, but it is an addiction as well. My husband is addicted to lying - and at this point I firmly believe that he will never be able to change. Some of the lies are very extravagant, while others are simple. I have MANY times sat down and talked to him about his lying, and have asked him to be honest with me. He just cannot and will not change. His parents don't like to talk about it - they are in denial that their precious little boy is a compulsive liar. I know that when I leave him he will make up all kinds of stories about me, about what a horrible person I've been. He has lied to me for the 7 years we've been together. He lies to everyone he knows. He can't keep friends or jobs, because eventually they catch on to his lies. He would rather make up a story and risk losing his friends, etc, than tell the truth. He makes me feel like I am crazy - that's what happens when someone plays mind games with you and they are very good at telling lies. It would be great if he could recover from this illness, but it doesn't look hopeful at this point. Like someone else said in this forum, it would probably take him hitting rock bottom before he ever wanted to change. It's good to know I am not the only one who has been "abused" by a compulsive liar.

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Hello, I am a compulsive liar, I have been offered help many times. You need to hit bottom, period. My dishonesty has affected my wife and kids and our families, I have hit bottom. My parents denied any problem for years and when they did help I was not willing to accept it. It has affected the way my family treated me. I was sexually abused when I was in my teens by a stranger and it increased my anxiety and self-esteem especially in relationships to a high degree. This had a profound effect on my relationships and I have never felt worthy. As a result I suffer from depression. I am finally being honest with myself 'out loud' for the first time in my life. I am actively seeking help. I have tried to control it many ways and have never had the courage to face myself. I have no one to blame. It is not an easy thing but if you can find the courage you can start. I found my courage in the tears of my wife and our wonderful life which my lies have destroyed and hurt. The love she had for me and the hurt I have caused is apparent. My wife tries to explain my actions as psychotic or delusional or bipolar and it is a very difficult thing to grasp. I will forever regret how I have hurt her and my families. I am getting help, because this is destroying me. You just have to make the decision and realize that you hurt others that love you needlessly.

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As a person who's been married to a compulsive liar, and myself, have been pretty bad with lies as well, I can see it from both sides. Growing up, I lied about lots of things for various reasons. I, like your cookie-cutter case, was abused physically for 10 years by my father, and for different reasons, have self-esteem that's in the toilet. I haven't had a pleasant life, and rather than dealing with it, I sought solace in the lies I created to protect myself from the pain of dealing with reality. My lying, no matter what the reason was, was inexcusable. On one hand, you want to be loved, etc, but on the other hand, you will never get what you are truly looking for out of life when you live a lie - it will catch up to you in the end. I wouldn't necessarily classify myself back then as a compulsive liar, but I did lie a lot, and mostly to the people I didn't want to hurt, namely my mother. There came a point in my life where I realized just how much I hurt my mother - the tears she'd shed from my lies, and the fact that even the littlest things, she couldn't trust me with, or when she needed someone to lean on, as much as she wanted to lean on me, she couldn't, because she didn't trust me. I've become a lot better at telling the truth, and have devoted myself to making sure I do just that at all costs, as it is far more important to live my own life, and not a fake one that I created, and it is also important to me that I'm looked at with trust, and not a question. On the other hand, I suppose one could say I got a dose of my own medicine, as I'm now dealing with a true compulsive liar, and have been for nearly 6 years; Where everything that is said and done is a lie. Nothing is sacred and safe from his lies. We've almost lost our vehicles from him lying about car payments being sent. He's almost been arrested for lying about fines being paid, when it reality they weren't. The lies range from small ones "Yes, I scooped the litter box" when he hasn't, to bigger ones, like lying about mailing payments. It's hurt me terribly, and is to the point where it is literally making me crazy, when I'm constantly wondering what "dead body" I will dig up next. I thought I knew my husband very well, but the more I dig up on him, the more I realize, I don't. I don't really think I even know who this person is anymore. It's to the point where I can't even stand to look at him from all of the lies I've been dealt and continue to deal with. In the end, the only way a compulsive liar will stop, is when he/she truly recognizes what is going on and is willing to acknowledge his/her issues, and get serious help. It's very similar, IMO, to dealing with alcoholism, and the like. There is a very long drawn out process in recovery, not only for the liar, but for the one who has been coping with the lies as well, and even then, there is a real good possibility that one will fall back to old routines, rather than dealing with the reality of their life. They also need to get to the core of their need to lie and resolve that issue, in hopes that the desire to lie will lessen; you can't kill a weed without pulling out the roots. If they are not able to commit to a serious life change and some serious help... if they can not come to terms with the consequences of their lies, and are not willing to get to the root of the lying, then, no there is no possibility of recovering. It is in the liar's hands. In the case of my husband, he is most definitely not ready for this jump, and may never be - dealing with life as it is, rather than the fake world that one created, is very hard, and I don't feel he's ready to look into the mirror and see what he's done. I've been told many times by him that he wants the lying to stop, but in the end, even after 3 counseling sessions, we've gotten nowhere. Sometimes it's best to just get out of such a situation, before you yourself begin spiraling down because of their lies. If you can handle the mind games, the questions, and the "dead bodies" buried in your yard, and the possibility that these things may never end, then more power to you, but at the same time, it's rough being on the other end, and god help me, I'm terribly sorry for what I put my mother through, and glad I've matured from lying so much - I wish I could say the same for my husband, but unfortunately, it will probably be too late for him before he ever learns how much hurt and pain he's caused me.

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I'm turning 17 and I'm not really sure if I am a compulsive liar. I think I am because lies come out so naturally. I know it has hurt many people in my family and right now I really do not know what I should do! I don't want to lie any more I just want to live my life as a normal teenager. What can I do? I really need help. I have always denied this but I think I have hit rock bottom, and the thing is that I cant even lie! I am serious. l suck at it and most of the time I get found out! Please help

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It is possible for a compulsive liar to recover if he claims to be working on the issue, in my opinion at least. I myself was a compulsive liar at one point in my life. When I first started high school I had to deal with a lot of peer pressure and that's when I started lying. At first I wouldn't lie that much, I would only lie when it was necessary. As the years progressed I began to lie more and more and more. By my final year of high school, I couldn't tell anyone anything that had any facts in it what so ever. It didn't bother me either. I felt comfortable as I lied, I believed in what I said despite the fact that they were lies.

However there was light at the end of the tunnel. Without the help of a therapist of any psychologist I managed to recover from being a liar. It is not a hopeless cause. It all started when I began to realize all the damage I was causing. Despite the fact that I believed in what I said I knew something was wrong, it hurt inside. After a few weeks of hurting almost everyone I knew through the means of lying it just came to me. I realized I needed to stop.

It was hard trying to stop at first. I would try to talk without lying, and it wouldn't help that people would presume you were lying anyway. That's the kind of response you get from all of that lying. That makes it incredibly hard for the liar to ever recover on his own. I still knew what I was doing was wrong, and continued to try and tell the true. I continued to try and have a sensible conversation without lying. I knew they still thought I was lying about everything. Needless to say I pulled through and here I am today. I don't lie anymore at all. Well I shouldn't say at all, but when I do lie I get a miserable pit in my stomach that doesn't go away for weeks.

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To the CL that left his wife because he didn't want to hurt her anymore... Don't! You made it clear you love her. You are only lying more by running away from what you want. To all CL's there is hope. Find God. He can heal all things and he forgives you. Go home to your wife, God hates Divorce. The last thing your wife needs is to feel alone and that you don't love her.

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There is hope. I have been married to a CL for 7 years. He has committed adultery. He has spent the last 6 years looking at me in the face and making up so many lies to cover his tracks. Even his emails to other girls say the craziest things, ridiculous lies. I cant get him to confess or tell me the truth about anything. I have to completely show him proof of his sins before he will finally breakdown and say.... "ok, I did it". He like all the other CL's don't know why they lie. But, I trust in God. He can fix this. The Devil tells me to move on, be free of this, you will be so much happier... but God says in black and white that he hates Divorce. Trust in God, surrender and confess to him. You don't even have to confess it to anyone else, just God. Come clean.

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30/11/05

I am 32 and I have been a compulsive liar since l was a young boy. It has become second nature to me, l feel as if everything that comes out of my mouth is a lie. I have been with my wife 10 years now and have lied to her on many occasions. She has found out on several occasions that l have lied to her and she has told me that l lie once more then she will leave me. Even when she finds out that l have lied, l lie again to cover my tracks...why?

Finally today l have realized what l have been doing to my wife and children. My wife said to me today before leaving the house that she could not look at me without feeling sick and that she does not know who l am anymore. I don't know who l am and l have felt this way for a long time and lying is the only way l can fabricate a live that is interesting and exciting.

I have very few friends and feel that when l am out with them they are lying as well. I feel as l can not say anything without lying, l don't know who l am anymore.

I think now that l have realized that l am a compulsive liar l am on the road to recovery. I am going to book an appointment with the doctor this afternoon and seek some help. I don't know what happens now, but l want to get away from the feeling l have when l lie.

My wife and kids have just walked through the door while l have been typing this and l have not lied to them, l feel as if l have achieved something already. I am going to take everyday as it comes and try and save my marriage. I don't want my kids to become liars like me.

I believe lying is a habit, like any other habit you need to break it and it is finding the mechanism to do that. Good luck to every liar out there to break this illness.

I am going to say "Honesty is the best policy" in my head before l open my mouth and talk.

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I just stumbled across this site and I am really glad that I did. I don't feel so confused and unsure of myself anymore.

I have been involved with a person with whom I love very much, but I cannot stand to look at anymore let alone have a physical relationship with. We have been involved off and on for the past 13 years and have lived together for the past 5 and have two children.

I have encountered so many different kinds of lies from the little and meaningless to those that have cost me thousands upon thousands of dollars and me to live a debt and stress filled life.

I don't have any personal enjoyment derived from my family life, I feel miserable every time that I walk in the door and I have turned into a suspicious and sneaky person to enable me uncover some of his more serious lies and it makes me sick to my stomach.

We have had huge blown out arguments and fights where I want him so badly to move out and get out of my life and he admits and then apologizes and I'm sure tells some more lies, but our girls and their dad love each other very much and we've already done the visitation thing, again, lies and tension but derived directly at me, so keeping him at home is hard on me, but the right thing to do for the girls.

I am at the point of potentially having to claim personal bankruptcy for the second time, losing not much really because he's kept us from getting ahead financially for years. We haven't been able to buy a house, pay-off the car loan, purchase RRSP's or anything like that, well I guess you can all make the correct assumption on this one.

Anyways, it's just nice to be able to kind of tell this to someone and to know that I'm not alone in this type of situation.

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Hopefully we can recover. I have been a compulsive liar for quite sometime now. It never effected me until my boyfriend of 3 years broke up with me b/c of my lies. I didn't realize how bad lying could be until you hurt someone that means everything to you. Lying has became natural to me, one lie leads to the next. I can't understand why I lie, but hopefully one day I can figure it out. At least I came to the conclusion that I do have a problem and hopefully it can be solved. I have faith that I can change this so-called disorder.

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I believe that we can change for the better and get over this horrible problem. I just realized tonight how bad it has gotten for me. I have lost my wife's trust and it kills me inside. I realize I need help and have been calling counselors to set up appointments to help myself. My father is a compulsive liar and I remember seeing it at a young age. I saw how he lied to my mother and in the end they divorced because of it. I refuse to let that happen to my marriage!! You have to find the urge in yourself to want to change and to get better. I vow to beat this problem and earn my wife's complete trust and love back. There is nothing worse than seeing someone you are in love with heartbroken and crying because of your words.

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My ex-boyfriend is a compulsive liar. He thinks it's a funny game to lie and manipulate his friends and family and turn everyone against everyone else. He is only 22 yrs old. I have confronted him several times about his lies but he just tells more lies to cover the old ones up. He lies so much that he truly believes what he says. That's how I caught him and figured he is a compulsive liar. His lies are big and some involve things that could land him in jail cell. Is it true that when a compulsive liar gets intoxicated that his/her true self comes out, or is he just lying through the alcohol?

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I have decided to get help, to change radically, NOT because I got "caught" by someone else, but because in a moment of sudden clarity, I caught myself. My lies have been many. Some I could see in the moment. Others I believed so profoundly that I made personal and professional decisions based on things that never happened. Sometimes this feels like a form of amnesia; sometimes it feels like a narrative that starts spinning our of me and is out of my control. I am so convincing in my stories that I get to where I cannot tell the difference. recently I started a chronological chart of my life, placing next to each event a person that could confirm my claim. Much to my horror, some of the events that I was most convinced of in my past were denied by people who were around me then. I see now, looking both from therapy and my intention to change, that this is a complex problem. There are many grey areas between the diagnostic categories of psychology (pathological, compulsive, histrionic lying). I am less interested in finding a name for my condition than I am in addressing the profound fears and shame that created such a defense mechanism. Most of the things I lie about are in the past, but the habit leaks into even small behaviors in everyday life, always in places where I might feel shame. I often feel in a trance while covering myself with a lie, especially about my horrid childhood. Ironically, I have filled my life with real accomplishments and work in many ways that allow me to serve others. However, I am never enough, and am constantly ornamenting things that are fine in themselves in ways that make me look even more important and accomplished. Never enough. Never lovable. I have asked my friends to stop me when they hear something fantastical or weird come out of my mouth. I am even looking at what I want to say before I utter the words, to discern what is not so in the initial way I thought up a sentence. There are therapies, there is Neuro Linguistic Programming, there are many roads to improvement. For me the keys are meditation, the support of friends who truly believe in the person that has always been there under the lies, and a commitment to greater discernment and healing. The task is formidable. But we CAN and do change, with determination, hope, and compassion for ourselves. One day at a time. One sentence at a time.

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Carola, It looks like you've come such a long way! Way to go. I'm sure life is rewarding you for being strong. I have just read the tread and I am worried. I have meet the love of my life and I'm messing it up. I have built a wall of protection built by the things I believed people wanted to believe. I have come to understand that I have been building an identity to please others to make life easy for my self. I have hit the bottom as I am about to lose the first person I have been able to trust. I meet a man by chance, but I lied from the start telling him what I though he needed to hear to find me attractive. after a year of falling in love I had to confess because of the panic attacks. guilt was driving me mad for the first time, in 32 years of living I have began to assess my ego and the fact that I was destroy something good because I don't believe I am worth it. My mum and dad have a long term marriage but build on lies. its part of their game. Being tomboy to please my dad as he wanted a son taught me to be ruff and tough but as soon as I hit sexual activity and behaved like a man. It has only been through meeting the love of my live that I have started to address the imbalance in my id/ego. how can I expect him to support me as he is the one that has given me the love to open up to my lying. When I confessed in one big go that I have being plain old conning him he gave me another chance. From that moment on everything changed it was like clockwork orange as soon as I told a lie I have strong panic attacks. the feeling that I was gonna go mad unless I told the truth. Even when I was given too much change in Sainburys I gave it back and received no thank you but had to do it because I had already made the change. That hit home to me that I believed I should be reward for telling the truth. The truth should have been second nature but for me it was a question. I had to seek medical help for the panic attacks but after a month of beta blockers I wanted to get off. I have been reading N.L.P. to find ways of training my behavior. But so far it has been on my own. my biggest concern is hurting an amazing man that should have better than me right now. I know I make him so happy in every way expect my passed. I tried to do the right thing by sending a letter to an old pal of ten years ago whom I have stayed in contact with as we traveled together and had a sexual experience once as I want to commit to my partner and get rid of any old ties. the day I posted a letter to say hello and goodbye my old friend he calls from abroad by chance, I have to tell my boyfriend the truth or as my central nervous system kicks off. at first I cover up as that is natural for me but I have nothing to cover up as I have tried to do the right thing and politely say good buy to an old male friend so I would be free of my passed by posting a letter that morning by chance but I did not tell my partner in the moment. As soon as I walked out the door to go to the shops the panic hit me and I had to tell him that I had already sent a letter say good luck and that I wanted to focus on my partner. I could have not said any thing as that could have cost less harm but I am so impulsed to tell the truth now that I can't cope with the littlest lie. even if telling the truth after lying cost me the love of my life I will accept it with grace as I have made my bed, and I must lie in it. he has given me the gift of love and trust for the first time in my life and I have been destroying it by reflecting my past problems on to a true human being. I have been studying N.L.P to try and rebuild my self. I have studied mental health in the past but it is not helping at the moment I have a second appointment with a counselor and have got myself off the beta blockers. My partner does not like the idea of me talking to someone else or getting medical help and taking pills to cope and I understand but I believe that I need a professional to help me. I don't think it will matter as when he wakes up tomorrow he will want me out of his life as I am to much hassle for a man so wonderful as him. I hate to say it but the man who has shown me the light and given me the chance to trust has had enough of me. it hurts so deep as I have opened up to him with all my heart and when I have said wrong I have confess because I love him like no other, so much so that if I don't tell the truth my body attacks me so I have no choice but to tell the truth even if it destroys everything which it has tonight. it is better to have loved and lost than to never have loved at all. I will thank him every day of my life you showing me true love is possible, even if I'm not worthy of receiving it. I hope one day I will have the time and the chance to teach this to others before it is to late for them. I believe this is a tough path but without taking the right steps for myself you or I will never be ready to find a true soul. I know life will give me another chance but what scares me deeply is I will always wish I had got it right with the man I am about to lose. I believe love is the only thing that can help. But when you destroy love because you feel you are not worthy you blame yourself. I am asking too much of my partner he has a life of his own and a company to run and I am not helping him but putting my head problem on him. Do I walk away because I love him so much and feel he is going to do better with out me. Or do I believe in the love that it so strong to me and fight to be with him. I just want him to happy with or without me. I don't care for me because he has already given me more that I have had before. In fact I believe I should feel pain in relation to all the pain I have been party to causing over the years. He will go far and be a total success. I will love him till the day I die. The soul mate I always wanted in my dreams will have to go back into to my dreams. I hope that one day I will be worthy of my dreams... one day.

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In my experience it seemed the person truly meant what he was saying.... but.... nothing ever changed or improved.... turned out to be more lies! Be careful of yourself! Take good care of yourself! Protect your self, the adult and the child parts of yourself! It is hard to know when one is lying and your trust is sacred and special.... when it is repeatedly squashed, you might become squashed also!

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I believe it is possible to recover from compulsive lying. I am not a liar, but a drug addict. I believe I suffered from what I believe most liars suffer from. LOW SELF-ESTEEM. To all those that need to know this. You must love yourself before you can truly love another. Material goods are nothing but shallow distractions. Truly love yourself and you can live with next to nothing and be truly happy! Once, before I came to my self-realization, I found myself with all the money and toys that I thought would make me happy. I couldn't figure out why I wasn't happy. Then one day I lost everything I had. I realized that I hadn't faced the truth. I hated myself. I dropped the hate. I work to improve where I am not pleased with myself (where I reasonably can) instead of escaping with drugs or like with other people here, LYING. I am still view myself at the bottom of the pile as far as true accomplishments but it doesn't depress me like it used to. Why? I am finally making positive progress, even if its just a little at a time. I am facing my demons instead of running scared! I feel happier than I have in 25 years! Lying, like drugs, is just delaying your recovery! Delaying your true happiness! Of course compulsive liars can be cured! They just have to know what it feels like to be truly happy! As cheezy as it may sound, I give my love to all. I hope you can see and love your true self for what it is. For better or worse. Ugly or pretty. Fat or skinny. Smart or stupid. Perfect or imperfect. Love yourself and good things will happen to you. Trust me.

I didn't understand your question very well, but there's a sleep disorder where you rock back and forth the entire night so much that you can't sleep. I don't remember what it's called. You might want to search for that on www.webmd.com or through the DSM-IV (it's a really big book that lists every known psychological disorder.) I hope I helped! ^_^