Malingering and psychopathy: a likely connection

By:  Linda Hartoonian Almas, M.S. Ed

There may be a correlation between psychopathy and malingering.  Some studies support that increased PCL-R (psychopathy checklist) scores correspond with an increased potential for malingering, while others are less conclusive.  Regardless, if psychopathic individuals, or those with such features, seek to gain or avoid something through manipulations, they are good at bringing their intentions to fruition.

What is malingering?

Malingering is defined as intentionally making up or exaggerating medical or mental symptoms in an attempt to avoid one or a variety of responsibilities.  It is an intentional misrepresentation of facts in an effort to appear unable to work, or to fulfill other obligations.  Additionally, with this avoidance, comes an external reward or some form of perceived personal gain.  Often, malingerers see no other ways to achieve their avoidance goals.

Why do they do it?

This external payoff may come in the form of “getting something for nothing,” through unemployment or disability benefits, avoiding punishments in some circumstances, or getting out of having to perform what they consider to be undesirable tasks, and more.

The specific reasons and presentations may be as numerous, but the motivations are relatively consistent.  Mainly, there’s something they must do, but don’t want to or feel they need to.

How do they malinger?

It is common for malingerers to feign mental or psychiatric conditions over physical maladies. They may feel that these are easier to fake, since diagnostic methods may be more difficult to quantify.

If malingerers claimed broken arms, for example,  x-rays could quickly negate any false claims.  The same is true for many other physical ailments.

However, it is easier to claim stress or distress, or a variety of other mental afflictions, that may render malingerers “unable” to work or make good on their obligations.  In fact, they may even blame us for their “illnesses.”

Pathological lying and manipulation

With a primary element of malingering being intentional deception, it makes sense then that psychopathic individuals, or those with psychopathic traits, may be likely to engage in successful malingering.  Two prominent traits psychopaths exhibit are pathological lying and manipulative and deceptive behaviors.  Both are necessary in order to malinger successfully.

Most of what psychopaths say is false, or laced only with grains of truth that are usually seriously distorted.  Since they lie and distort with ease, and manipulate people and circumstances to achieve what they want, it is easy to see how they are able to manage malingering successfully.

Parasitic lifestyle

Furthermore, it is common for individuals with psychopathic traits to live parasitic lifestyles.  They are often careless, putting us in situations that cause us distress for their own gain or pleasure.  Initially, they may look like our soul mates, wonderful long lost relatives, or saviors.  They may come bearing gifts and making promises.

However, we quickly learn that most of what they offered came with conditions.  The promises failed to materialize, and that they, in fact, arrived on the scene to live off of us.

They may even put us in positions to pity them, fight for them, or defend them.  Eventually, we realize that they view life to be about their needs, rather than those they are obligated to.  Parasitic.

Why is this relevant?

When we unknowingly become close with psychopaths, we are going to be touched by this in some way, at some point in time.  “The right thing” may be something they spend a lot of time addressing, but very little time actually doing.

Since it is common for individuals with psychopathic traits to fail to make good on their obligations and responsibilities, it is worth understanding.

When they find themselves in too deep, and it is impossible for them to shirk their responsibilities in any other fashion, they may simply choose to take themselves out of commission.

Practical application

Although malingering can take place for a variety of purposes and in a variety of different ways, let us examine the possibility of a parent doing so to escape paying child support.  Many readers have probably experienced this, as it is a common challenge among those dealing with individuals exhibiting such traits.  The motivations for attempting to eliminate the support may be numerous, but are less significant than the actual act.

It is true that many good people, who genuinely care deeply, are simply sometimes unable to adequately provide.  However, in cases where we suspect malingering, it is critical to assess the big picture.

What is the history?  What are some of their attitudes displayed prior to the malingering?  Were there inconsistencies in stories or statements?  Was it clear that elusive measures were being contemplated?  Were the actions and the words, again, failing to match over time?

Are other bills going unpaid?  Is there a telling history regarding who they are choosing to pay and who they are choosing not to?  Is there a history of bankruptcies?  Do most of the “explanations” begin with blame and end with lack of ownership and reasonable solutions?

Well intended individuals are typically not be satisfied with offering next to nothing significant for support, regardless of circumstances.  Additionally, those who have genuinely lost the capacity to perform in their chosen careers often acquire new and different skills or do whatever it takes to contribute similarly and meaningfully.

Further, they do not lie about their intentions, indicating that they will provide in one respect and then not follow through when the opportunities present themselves.
When malingering is present, attitudes of complacency, or even satisfaction with the situations they have created may be present.   

Is malingering possible to prove?

It is possible that medical professionals or evaluators can prove malingering?  Like many other behaviors psychopaths display, the malingering is no different, in that they tend to lack the consistency that  individuals who are truly suffering exhibit.  Those too ill to work or perform duties, for example, may also be unable to recreate or participate in activities that would otherwise bring them joy.

However, successful malingerers may continue on with other activities, or even engage in things they would not otherwise participate in.  In essence, out of work may translate into on vacation.

Actual symptoms of certain conditions they are faking often look much different, as well.  They may go through the motions of doing what needs to be done in order to appear “ill” or to “recover,” but their actions still tend to look different than those who are legitimate.

Again, while assessing, it is important to examine the circumstances collectively.  Does the individual have something to gain by malingering?  If it appears that they may, that is a good indicator that they are malingering.

All the while, it is important to remember that a normal person’s interpretation of something to gain, and theirs, may look very different.  Thus, making their intentions easier to conceal, unless reminded of the need for this awareness.

It may be necessary for providers and employers to ask probing questions, observe carefully, and gather pertinent outside information.  The words cannot be trusted and taken at face value.

If clinicians consider all of the circumstances, and do even a small amount of research, they may come to know that further investigation may be necessary.  Unfortunately, this is not always a priority until the issue comes into the forefront, somehow.

Who would do this?

It may seem odd that there are individuals who choose to engage in these behaviors.  Aren’t they  coincidentally harming themselves?

While that depends on individual circumstances, in many cases, they are.  Nonetheless, the payoff that they are attempting to achieve may override logic and reasoning.  Their eyes are on the prize, so to speak.  Yes, that sometimes defies logic, which is another reason this may seem unbelievable.

Remember, we are not discussing a portion of the population that typically acts with anyone’s  best interests in mind.  Strangely enough, although they mainly act selfishly, sometimes, this even extends to mean their own.

As it is becoming my mantra, I will close with the suggestion that we take comfort in the understanding.  It will allow for peace amongst disorder.