Summary: In its wonderfully clear presentation of characteristics this case classically represents the type. A woman of 27 years (usually claiming to be 17), during a career of 7 or 8 years has engaged in an excessive amount of misrepresentation, often to the extent of swindling. Alleging herself to be merely a girl and without a family, she has repeatedly gained protection, sometimes for a year or more, in homes where her prevaricating tendencies, appearing with ever new details, have sooner or later thwarted her own interests. By extraordinary methods she has often simulated illnesses which have demanded hospital treatment. For long she was lost to her family, traveling about under different names, making her way by her remarkable abilities and unusual presence.
This case illustrates, again, two points we have often made, namely, that the difficulty of getting safe data concerning genetics increases rapidly with age, and that the chance of altering tendencies after years of character formation vastly diminishes. These features appear strongly here, yet our long knowledge of the person and of the many details of her career gives the history great interest.
A young woman, whom we will call Inez B., a name she once assumed for a time, arrived at a girls' boarding home in Chicago with merely a small traveling bag and money sufficient only for a few days. In appearance and conversation she gave distinct evidences of refinement. She showed indecision and confessed she knew no one in the city.
Just at this time a wealthy eastern girl, Agnes W., was missing from her home, and the police everywhere were on the lookout for her. A detective who was ordered to visit the boarding club showed a picture of Agnes W. to the matron, who instantly discerned a likeness to Inez and informed him of her recent arrival. Inez was questioned, but could or would give no satisfactory response concerning her own home. She maintained she was just 17 and had come to Chicago to make her own way in the world. After some account of herself, the details of which were somewhat contradictory, it was inferred that she might be Agnes W. She vehemently denied it, but being the same age and some likeness being discerned, the questioning was continued. Various matters of Agnes W.'s antecedents were gone into and after a time Inez burst out with, ``Well, if you must have it so, I am Agnes W.'' The girl was thereupon taken in charge by the police authorities, and she herself registered several times as Agnes W. After the family of the latter had been communicated with, however, it was ascertained that Inez was not the lost heiress.
She now said that anyhow she really was a runaway girl. She had left her adopted parents because they were cruel and immoral. It was her unhappy brooding over her own affairs that led her to lie about being the other girl. She insisted she was sorry for the many lies she had told various officers, but felt, after all, they were to blame because their obvious desire to have her tell that she was Agnes W. led her on. They deceived her first because they misrepresented themselves and did not say they were police officials. Nevertheless, she makes much of how she hates her false position, being registered under a false name and figuring as a deceiver.
The significant points in the long story of Inez, as told to us in the days of our first acquaintance with her, are worth giving. (At this period she was with us thoroughly consistent; at all times she has appeared self-possessed and coherent.) Inez states she is 17 and has just come from a town in Tennessee where she has been living for a couple of years with some people by the name of B. who adopted her. At first they were very good to her and she loved them dearly. She was quite unsophisticated when she went to them and did not realize then that they were not good people. She met them at an employment agency in St. Louis where she had gone after leaving the Smiths, the people who had brought her up. At that time the B.'s appeared fairly well-to-do, but Mr. B. had been running up debts that later carried him into bankruptcy. Inez was sick and exhausted now from having worked so hard for them. She finally ran away from that town because the B.'s wanted to go elsewhere, leaving her in a compromising position with a young man who rented their house. She first tried boarding in two places, however, before she ventured to go.
The Smiths were the people she lived with until she was 14. She remembers first living with them, but faintly recalls bearing the name of Mary Johnson before that. Who the Johnsons were she does not know, but she feels sure of the fact that she was born in New Orleans. However, Inez does not worry about her parentage even though it is unknown. Mrs. Smith was an elderly woman of wealth who was very good to her, and by the time she was 14 she had studied German and French, algebra and trigonometry. She had a French tutor and took lessons on the piano. Always did well in school and loved her work there. The Smith children, who were much older, were very angry with their mother for all the money she spent on Inez—they would have preferred its being expended on their children. The son grew quite abusive and Mrs. S. was made to suffer so much that the girl came to feel that she was largely the cause of the old lady's unhappiness. After one particularly deplorable scene she slipped away from their home in New Orleans, traveled to St. Louis and went to an employment agency where she found the B.'s. At the present time, above all things, she does not want the Smiths to know about her when she is temporarily a failure. She will never go back to them until she can help the old lady who was so good to her.
Inez tells us she is now suffering from a wound still open as the result of an operation for appendicitis performed two years previously. She also suffered from tuberculosis a few years ago. (She was found to be running a slight temperature, and some slight hemorrhages in the sputum were observed.)
It may strengthen the portraiture so far sketched to give our impressions as stated after our first study covering a week or two; nor will it lessen the reader's interest to remark that it was not for lack of acquaintance with the pathological liar type that we failed to correctly size up this individual. Indeed, we had already studied nearly all the other cases cited in this monograph. Our statement ran as follows: ``This girl is very frank and talkative with us. With her strong, but refined features and cultivated voice she is a good deal of a personality. She is sanguine and independent. Very likely she does not exaggerate the hard times she has had in going from one home to another. One cannot but respect this unusual young woman for wanting to keep her early history secret. It would be fortunate if some one would care for the girl and get her ailments cured. With her very good ability she might easily then be self-supporting.''
A woman of strength and judgment undertook to look after Inez. The girl's personality commanded interest. In a few days she complained more vigorously of her abdominal trouble; an operation seemed imperative and was performed. (An account of this will be given later.) Later the girl was taken to a convalescent home and then to a beautiful lake resort. While here she suddenly was stricken desperately ill. Her friend was telegraphed for, a special boat was commissioned, and the girl was taken to a neighboring sanitarium. The doctors readily agreed that the case was one of simulation or hysteria. She was brought back to Chicago and warned that this sort of performance would not pay. After being given further opportunity to rest, although under less favorable circumstances, in a few weeks she was offered work in several homes, but in each instance the connection was soon severed. Then without letting her guardian-friend know, Inez suddenly left the city.
Inquiries had brought by this time responses telling something of the career of Inez in the past two years, but nothing earlier. She was the ``mystery girl'' in the Tennessee town, as she was in Chicago. The B.'s kept a boarding-house and took Inez as a waitress, knowing her first by still another alias. She worked for them about a year and then went to Memphis, where she was sick in a hospital. She had now taken the B.'s name. They were regarded as her guardians (on the girl's authority) and they finally sent for her again out of pity, although they felt she had a questionable past, and they knew she had lied tremendously while with them.
Then the B.'s moved away and turned Inez over to a respectable family. While with the B.'s Inez had been regarded as a partial invalid; their physician diagnosed the case as diabetes and found it incurable. In fact, the B.'s went into debt for her prolonged treatment. Another physician, who was called in after the B.'s left, said the trouble was Bright's disease. At any rate, all regarded her as suffering from some chronic disorder. Except for her extraordinary lying, of which she made exhibitions to many, and some little tendencies to dishonesty mixed with her lying, Inez was regarded as being quite normal. The two other families with whom she lived for a time found it impossible to tolerate the girl on account of her lying. Finally, obtaining money by false representation, telling the story of a rich uncle in Chicago to whom she was going, Inez departed, taking with her a trunk containing valuables belonging to the B.'s.
Dropping our chronological account of this case we may from this time deal with it as a whole, putting together the facts as they developed by further study of Inez herself and by the receipt of information from many sources.
Since we have known her, Inez has been under the observation of several skilled medical specialists. She all along has been in good general physical condition. Having been treated previously for diabetes, special examinations were repeatedly made, but never a trace of this trouble was discernible. Her own story of having had tuberculosis, and the traces of blood in the sputum, which she presented on handkerchiefs, etc., led to repeated tests for tuberculosis. These also proved absolutely negative. Before all this, there was found on the left side of the abdomen a mass which, from the history the girl gave, was surmised to be a tubercular abscess.
At this time she was running a little temperature. An operation was performed and an encysted hairpin was removed from the peritoneal cavity. This had undoubtedly found entrance through the old appendicitis wound; the hairpin had evidently been straightened for the purpose. Both wounds now speedily closed. Gynecological examination showed no disease and established the fact of virginity. Thorough neurological examination showed that the girl was not of nervous type and that there was no evidence whatever of organic disease. There was complaint of frequent headaches, but no signs of acute suffering from these were ever witnessed and by this time no reports of subjective symptoms could be credited. No sensory defects of any importance. It was always easy to get a little variation upon visual tests and the like, however. Weight 130; height 5 ft. 1 in. Color good. Head notably well shaped with broad high forehead. Strength good. Very normal development in all ways.
Most important to note as bearing on her social career was the fact that Inez was possessed of markedly strong, regular, pleasant features, including a good set of teeth well cared for, and an unusually firm chin. In attitude and expression she seemed to give complete proof of great strength of will and character. Her face suggested both frankness and firmness. When with quiet force and dignity asserting her desire for education and a place in the world, Inez presented a most convincing picture. Perhaps even more significant is the fact that Inez possesses a speaking voice of power and charm, well modulated and of general qualities which could belong apparently to no other than a highly cultivated person.
During a year there has been no variation in the general well-being of Inez, although she has been taken to hospitals in at least two more towns and has figured again as a sufferer from tuberculosis and appendicitis, and has written several times to friends that she was about to be operated on.
The diagnoses of several competent medical men are that the girl is a simulator or is an hysterical, and their findings show that she has lied tremendously about her past. (There were never any positive signs of hysteria, and our own opinion is that the case is much better called one of extreme simulation and misrepresentation, as in the diabetes and sputum affairs, etc., and of self-mutilation, as with the hairpin.)
We have had ample opportunity to become acquainted with Inez's mental qualities. She has repeatedly been given tests for mental ability. As judged by the average of those seen in our court work we are forced to regard her as having ability clearly above the normal. Her perceptions are keen and quick. She works planfully and rapidly with our concrete problems and shows good powers of mental representation. It is notable that she is very keen to do her best on tests and takes much delight in a good record. Her psychomotor control is astonishingly good. In a certain tapping test, which we consider well done if the individual has succeeded in tapping in 90 squares in 30 seconds, she did 117 and 129 at two successive trials with only one error in each. This is next to the best record we have ever seen.
Our puzzle box, which is seldom opened in less than 2 minutes, she planfully attacked and conquered in 52 seconds. She also rapidly put it together again, which is an unusual performance. Reaction times on the antonym test, giving the opposites to words, were very low; average 1.4 seconds. Her immediate memory for words was normal, but nothing extraordinary. She gave correctly, although not quite in logical order, 18 out of 20 items on a passage which she read herself. On a passage read four times to her she gave 11 out of 12 items in correct sequence. The Kent-Rosanoff association test showed, to our surprise, nothing peculiar. Notwithstanding her known social characteristics, there were very few egocentric or subjective reactions.
Nor did the ``Aussage'' test show great peculiarity. On free recital she gave 17 items, two of which were incorrect. They were misinterpretations rather than inventions, however. On questioning she added 15 items. She was incorrect on 5 more details, but all of these were denials of objects actually to be seen in the picture. Not one was a fictitious addition. She rejected all the 6 suggestions proffered.
Our psychological observations were important beyond the giving of formal tests. We found her to be a fluent and remarkably logical and coherent conversationalist. Her choice of words was unusually good. Questioned about this she said she had always made it a point to cultivate a vocabulary and was particularly fond of the use of correct English. (This was all the more interesting because we later knew that she had been living recently with somewhat illiterate people and that her original home offered her very little in the way of educational advantages.) Inez told us that she had earlier carried her desire for self-expression in language to the point of writing stories and plays, but we were never able to get her to do anything of the kind for us. One of her constant pleas was that she might get the chance to become a well-trained teacher of English. Her letters never showed the same skill with English that her conversation denoted, but her meagre education probably accounted for this.
Characteristic of Inez, also, is her intense egoism and her abundant self-assertion under all circumstances. It often seemed to us as if for her the world revolved, with passing show, around a pivot from which she regarded it as existing only for what it meant for her career. These qualities have led to her statements, and perhaps to the actual feelings, that she was the aggrieved one, and had been badly treated on many occasions. This seemed to reach almost paranoidal heights at times, and yet, before passing judgment on this, one should be in position to know, what probably will never be known, namely, the actual facts of her earliest treatment. Occasionally Inez showed most unreasonable bad temper and obstinacy. This only came out when she was asked to do things which she considered occupationally beneath her. In general she felt herself much above the ordinary run of people. When she could be patronizing, as with children, she acted quite the grand lady. Indeed, in asserting herself on numerous occasions she has assumed just this attitude, which is all the more strange because our further information shows that it was not justified by any social station which her family ever held.
Going further with psychological considerations it is to be asserted that Inez showed marked lack of normal apperceptive ability in not appreciating the necessarily unfavorable results of her own lying. For that matter, she also fails to learn by experience, for very frequently she has suffered from her own prevarications. It might, however, be argued that to Inez the thought of a possible hum-drum future in which there was no adventure, no roving, and no playing the part of a successful personality, was a worse choice than that of lying, which might and, indeed, often did serve the purpose of making friends with people, who otherwise would not have entertained her. So one could hardly judge her deficient even in this particular. (Of the character of her lying and the special observations on that point more later.)
We found Inez, then, neither mentally defective nor insane. To even say that she was without moral sense would be beyond the mark, for in many ways she showed great appreciation of the best types of behavior. Her peculiarities verging on the abnormal are, however, undoubted; they render her a socially pernicious person. They are to be summed up in terms of what we have discussed above, namely, her excessive egoism, her faulty judgment or apperceptions, her astounding tendency to falsification.
Inez was next heard from in Iowa where she wrote that two doctors had pronounced upon her case and said an operation was again imperative. She asked her recently made friend for permission to have this done, and also for $150 to cover expenses. Neither, of course, was forthcoming, on the grounds of there being no guardianship. (Her age was then unknown.) Inez wrote, ``I just thought I was compelled by law to let you know of my whereabouts, for I understood I could do nothing without your consent.'' In the same letter, replete with other lies, Inez asks, ``Please forgive me now for all my willfulness and wrongdoing. I will do my best never to do it again, and Oh! I do so want to be good so that you may feel proud of me some day in the near future.''
A month or so later this friend was called up by the director of a religious home for girls in Chicago, who stated that Inez had just come to them and had been taken seriously ill. Advice was given to discount her symptoms, but she was sent once more to a hospital. Here she produced more blood as if from a pulmonary hemorrhage and more symptoms were recounted, but the doctors decided after careful examination that she was falsifying. Her illness ceased the minute she was told to leave the hospital. Matters were serious, for Inez was now without home, money, or relatives. She was once more taken under protection and greater effort was made to trace her family. They were discovered through letters containing remittances sent by Inez herself from Iowa, after years of silence. Much of her career was soon brought to light. By this time, we may note, several observers had insisted that from a commonsense standpoint the girl certainly was insane.
While affairs were being looked up, Inez conferred with us from time to time. She started by telling a thoroughly good story, the general import of which was the same as she told months previously, but there were differences in many details. In the first place she still insisted she was 17 years old and gave us an exact date as her birthday— this was in response to the mild suggestion that she might be considerably older. Since her letters, although showing very good choice of words, were incorrectly punctuated, we inquired further about her education. She said she had received 18 credits in a noted girls' seminary in the south, but later reversed this and stated she had very little education.
She told us her experiences of the last few months when she had been introducing literary works in the towns of Iowa. She had done well for a beginner at this, we found from other sources, but had made misrepresentations and had talked too freely, against her employers' wishes and advice. Finally she had sent in forged orders. This was quite unnecessary, for her salary was assured and sufficient, and her employers had regarded her as an extremely promising representative. In Iowa she was receiving mail under two different names; she still found it convenient to represent herself sometimes as Agnes W. In her peregrinations she had again made close friends with some substantial people, who found out, however, in short order that she was untruthful, and her chances with them were at once spoiled.
In the next weeks, when under observation, Inez varied her story from time to time even with the same persons. She was now 17 and now 19 years old. She had an operation first in one town and then it was in another. Her antecedents in many particulars varied from time to time. Inez seemed to have lost her desire or ability to be consistent, and in particular appeared to have no conception of the effect upon the adjustment of her own case which her continual lying was likely to have. (At this time again some non-professional observers insisted strenuously that Inez was insane. They based their opinion upon the fact that she showed so little apperceptive ability, so little judgment in relating the results of her continual lying to its necessary effect upon her career.) It requires too much space to go over the complicated details of her many stories, but some of her expressions and behavior are worth noting.
We always found Inez most friendly, sometimes voluble, and she ever dealt with us in a lady-like manner. Again we noted that many a society woman would give much for her well modulated voice and powers of verbal expression. Without any suggestion of melodrama she would rise to strong passages in giving vent to her feelings of indignation and ambition. At this time we were still wondering where she could have obtained her education; it was not until later that we comprehended that her abilities represented sheer native traits.
She first came to us much hurt because a certain official had warned her, after one of her simulating episodes in a hospital, never to deceive again. ``My trying to get sympathy! I don't want any sympathy. I told her I was independent and always wanted to make my own way in the world. If they thought I wasn't sick in the hospital why didn't they say so. The doctor told me to stay in bed.
``Doctor, yes, I did lie to you about my age before; why shouldn't I? I have been deceived on all sides and have found that people are against me. If they want to leave me alone, they can get the truth, but when one is deceived one has to tell lies sometimes. I've had many troubles. Oh, doctor, if you knew what I've been through and what's in my heart you'd think I do pretty well. I would rather starve than have it cast up to me that I had asked for any body's help or sympathy. I want to make my own way. I must have an education. In September I plan to go to the M. Academy and work my way through. I am just past 18 now.
``The B.'s are ashamed of me I suppose. I ran away from them. They are refined people. But I can't be treated in that way. They adopted me. They said that I got some money dishonestly, but, doctor, it is not in me to be bad. I feel that through and through.
``Well, I know that I'm a Yankee by birth, on both sides. My people came from Mayflower stock. I will make my way in the world, I will succeed, and you'll see, doctor. I will have an education. As to going back to the Johnsons, I would commit suicide rather than do that. It was not true that I had a good education as I told you. They did not treat me well. They can write as they please and talk about forgiveness for what I have done, but it is they who were cruel and abusive. Suppose they do say I'm their child. I know I am not because I was not treated the same as the others. I was 12 or 13 when I ran away from them. How could I belong to the family? They are all so much older than I am.''
Inez now gave us, most curiously, some addresses which opened up knowledge of her career over several years. But what she told us about these new people was directly denied by return mail. At one interview her first words were, ``Do you know now, doctor, that I was in a State hospital?'' Having made this challenging statement she went no further, merely involved herself in contradictions as to the place, and would say nothing more than that she had once suffered from an attack of nervous prostration. She absolutely denied items of information about herself which we had gradually accumulated, and this type of reaction obtained all the way through our last period of acquaintance with Inez, even after we had the detailed facts about her early life from her parents.
Inez never lost an opportunity to impress upon people whom she did not regard as her equals that she considered herself much of a lady and quite above housework. On one occasion, when held as a runaway girl, she had a terrible outbreak of temper simply because she was asked to clear the dinner table. This was no momentary affair. Her recalcitrancy was kept up the larger part of one day, and she made the place almost unbearable that night by screaming and moaning. Telling me about the incident, she said it was because she would not allow herself to cater to such people. ``If a person asks me, I may do things, but nobody can tell me to. I would not give in. I would not do it.''
To some of us it has seemed highly significant that at moments which would ordinarily be expected to bring out great emotion Inez showed almost none. For instance, when going to an important interview about the disposition of her case, she first plaintively said she did not know what to say, and then immediately began to dwell with evident pleasure upon the costume of the person addressing her. Many normal emotions were seen expressed, however, and many moral sentiments were undoubtedly held, but there seemed to be curious displacements upon these levels of her mental life; there was faulty mental stratification. Probably the force which caused this is egocentrism.
In relating what we now know of the past history of this case we shall put together that which we have heard from many different sources. There is no question about all the important facts—correspondents largely corroborate each other.
Inez came from a family of French extraction, apparently stable and normal tradespeople. The old mother at 74 years wrote us an unusually well-thought-out, detailed account of her daughter's early life. The paternal grandfather was insane and an aunt had epilepsy. Defective heredity in other respects is denied. We get no history of convulsions in the immediate family, nor of any other neurotic manifestation, except that one sister is ``very excitable.''
Inez came when the mother was unusually advanced in life, and the brothers and sisters, of whom there were five, had long since been born. There was a difference of 10 years between Inez and the next older. In telling the facts, the mother dwells much on this and the bearing which her chagrin during pregnancy may have had upon the girl's physical and mental development. She was born, then, after a troubled pregnancy, a weak and sickly child, ``almost like a skeleton.''
Inez was rather slow at walking, but at one year spoke her first words. We do not know with accuracy about the earliest factors in the mental environment. (Inez has told various stories about early family friction, and even about contracting an infection at home, much of which seems highly conjectural.) Between the ages of 7 and 10 several sicknesses, diphtheria, measles with some cardiac complication, etc., kept her much out of school. Part of the time she lived in New Orleans, and part of the time in a country district. She only went to school until she was 14, and was somewhat retarded on account of changing about and illnesses. However, it is said she always liked her school and showed fair aptitude for study. At 14 she returned to New Orleans and, desiring to be a dressmaker, started in that trade. She worked in several places, but finally went back to her home.
At the age of 18 Inez met with what, according to her family, was a decisive event in her life. She was in a trolley car accident; after being knocked down she was unconscious for some time. No definite injury was recorded. Her family marked an entire change of character from that time. They say she then began lying in the minutest detail about people and seemed to believe in her own falsifications. Besides this she started the roving tendency which she has shown ever since.
The extensive information which we have received concerning the later history of this remarkable case we can only take space to give in summary. We know definitely that Inez has received attention, during periods varying from a few days to six months, in no less than 18 different hospitals. Besides this she has been under the care of physicians at least a score of times. Her swindling in this matter was so flagrant in one eastern city to which she had journeyed that she was handled through the police court and was sentenced to a state hospital for the insane for a term of 6 months. The charge was that she was an idle person and a beggar, and she was regarded as perhaps being unbalanced. The report from this town is that she would be taken with ``spells of apparent violent illness on the street, in the trolley cars, at railroad stations, and so be carried to various hospitals and doctors' homes.'' She has visited numerous cities, getting her sustenance largely through hospitals and physicians.
After being admitted into one famous hospital and showing some of her curious manifestations she was transferred to a state institution in the vicinity to be studied for insanity. Correspondence with one physician tells the story of how five years ago he was called from a medical meeting to attend this ``girl'' who had been taken from a trolley car into his home. She was apparently suffering great pain in the region of the old appendicitis scar and she was conveyed in an ambulance to a hospital. After investigation for a few days, it was decided she was hysterical or a simulator.
On numerous occasions her feigned illness has been so apparently overcoming that she has had to be transferred in an ambulance to a hospital. One of her usual performances has been to get into some home or institution and then keep others awake all night with her signs of distress. It is interesting that she has used the same methods over and over again, but has been adroit enough to vary the illnesses which she has simulated. At one time investigation in a hospital seemed to show that she was neurasthenic. She has been given chances in homes for convalescents, but has never maintained herself in such a place for long. We note she was sent back from one of these to the main hospital on account of having vomited the medicine she had been given. In fact, she has repeatedly been found resisting the treatment which had been prescribed.
The record of admission and treatment given in one hospital is of peculiar interest. She was received there four years ago and evidently had been unable just previously to take care of herself properly on account of roaming. Her clothing was dirty and her head unclean. She was found to have the old appendicitis scar, which contained a small sinus. She remained in bed after admission, complaining of much pain in her abdomen, not well localized however, and would lie moaning, crying, and rolling across the bed. She was then running a slight temperature. After a time an operation was decided upon and a hairpin was found in the abdominal wall, undoubtedly inserted through the scar by the patient herself. (The findings of the surgeon in Chicago, then, revealed a repeated performance.)
At another place the patient maintained she was unable to urinate, but at the same time strongly resisted catheterization. From the variability of her complaint it was found it could not be caused by a local condition, and examination showed no reason for the difficulty. Analysis of her symptoms undertaken at this time led to several stories, one about urethritis, which Inez claimed to have contracted from her brother at 3 years; an episode when she had received a great fright during micturition; an incident when she had seen a man exposed when she went to the toilet. (Of course, our experience with this type of case leads us to appreciate the difficulties of psychological analysis with extreme liars.)
On one occasion she entered a hospital, claiming to have been recently injured; she had been taken in a supposed fainting condition from a car. Then it was she maintained that she had been struck by an iron bar and that a spike had entered her back. She also claimed at this time to have had her toes frozen. Study of the case here, too, showed no signs of injury or frost bite. On another occasion she told of having been dropped by a nurse while being lifted from a bed. Altogether her stories and her simulations have been convincing enough to get for her on many occasions good attention during at least a few days.
We can get no account of true hysterical signs being discovered by any one. There has been no showing of anything but that she is a liar and a simulator. In the hospital records the portions devoted to previous history are thoroughly vitiated by her untruthfulness, and they contain statements which offer great contradictions, one to the other.
Inez has been observed, then, for two long periods by psychiatrists. While at the end of neither period were the observers willing to state that the young woman was compos mentis, still their verdict in this matter had to be made up from considerations of her social behavior rather than from what they were able to discern by direct observation of her mental processes. From one case-record we read that ``The patient was quiet, pleasant, and agreeable, replied promptly and intelligently to questions, and talked spontaneously of her affairs. She was quite clear as to the environment, had apparently a satisfactory memory, with the exception of a recent period preceding admission. Her statements, too, were probably not altogether truthful, but frequently a reason for the untruthfulness was made out. She thought that her mind was all right, but complained of having occasional difficulty in thinking.''
Another prolonged study of her mental status was made four years ago. From the record we learn that there were no apparent reactions to hallucinations. Consciousness was clear and the patient was completely oriented for time, place, and persons. The train of thought was coherent and relevant. Questions were readily answered and attention easily held. Memory was fair for most events. School knowledge was reasonably well retained. Judgment, to this observer, seemed impaired, although no definite delusions could be elicited. Emotionally she was found more or less irritable, fault finding, and at times a trifle despondent. (Certainly the latter would be a natural reaction under the circumstances.) Often, however, she was found cheerful and contented. No special volitional disturbances were noted. Was found to act in an hysterical manner when she felt ill. She was neat, tidy, and cleanly in her habits. Appetite was good and she slept well. Such was the report from the institution where she was held for six months. There was no material change in her condition during this time; she showed herself very proficient with the needle; she was discharged when her sentence expired.
We note a statement from one hospital that this ``girl'' gave no evidence of having had any direct sexual experience, or that she had ruminated much over these matters. Her story about frequent fainting attacks given at this time was not corroborated by observation. The diagnosis from one hospital was neurasthenia, but investigation of her case in most places seems to have led merely to the conclusion that she was a tremendous liar.
Notwithstanding our long record of this case and the accounts which have been handed in to us of experiences with her in other localities, we do not presume to know a tithe of the places Inez has been to or lived in during the last eight years. It is more than likely that she herself would find it difficult to give any accurate account of her rovings. At the time we first saw Inez her parents had not heard from her for about three years. Shortly after this we found that she had renewed correspondence with them and had sent them money as if she were now prosperous. Her family have all along, in spite of her stories, been poor.
At one period she visited several cities in the southeastern states and was at a hospital in one of them. In Charleston there is a family by the name of B. (spelled the same as the name of the people she was with in Tennessee). These were the people Inez asked us to write to in an appeal, because they had long known her and were wealthy, for a chance to get an education. She stated they were immediate relatives of the B.'s in Tennessee, and that she had visited them once at their fine home in Charleston for three or four months. These people replied to us that they had been receiving letters for years from associations and organizations in regard to this girl whom they had never seen. They were convinced she had assumed their name because she had understood they were well-to-do and liberal. ``We know nothing about her education, but judge she has enough to dupe people with; posing as poor at one time, sick at another, and anxious for an education at another, as you inform us.''
From another correspondent with whom Inez had lived in Alabama for a few weeks we had a marvelous tale which they heard from her. She had told them she formerly lived in the most beautiful part of New Orleans and when 5 years old was placed in a convent, and then taken to a boarding-school, from which she was kidnapped and taken to a small town in Georgia. She was later placed in another boarding-school and there met the wealthy B.'s of Charleston who took her home with them. While there she had to go to a hospital on account of some infection. One day she was thrust into a taxicab, taken on a boat, landed at another city, etc. The B.'s of Charleston have thus figured long in her story, and we learned from several correspondents that this kidnapping has figured over and over as a big event in her life.
Once, years ago, Inez was taken into a private home accompanied by a trunk, we hear, which was found to contain a considerable amount of jewelry. This was pawned in the name of the people with whom she then lived and was redeemed later by some one else. Inez laid claim to the jewelry after a time, but apparently was unable to produce anybody who could vouch that it was really hers. Its ownership has remained unknown.
When she went to St. Louis at one time she had stated she was to meet a relative there, but the person, we have come to know, was a certain very decent young man who had become acquainted with her through a correspondence bureau. He had thought well of her and warned her not to come to that city, but when she did so he met her and took her at once to his own home where the womenfolk looked after her until she was found a place elsewhere. The deliberate attempt to throw herself upon his protection was thus frustrated by his relatives. Many other reports of the misrepresentations of Inez have been given us. She has discovered that borrowing money on the strength of invented statements is sometimes possible, particularly for her with her good presence and convincing manner. The B.'s complained that when she left Tennessee there were in her trunk many dollars' worth of articles that belonged to them.
Throughout our long experience with Inez we have never been able to make up our mind whether or not she remembered all of her past. Her lying always stood in the way of getting at anything like the real facts. On no occasion has she truthfully dealt with her career as we know it. She has professed absolute lack of knowledge of her accident, and of the time and place of its occurrence. It is interesting that none of her acquaintances mention this. Although Inez has told long stories of her past to many people, and with some inclusion of truth, she never seems to have mentioned this important event of which we learned from her family. We cannot, then, decide about possible amnesia for this occurrence.
On occasion Inez has expressed the same desire for religious experience as for education, and has written to friends that she had become imbued with the Spirit. Her story of her religious upbringing is altogether unreliable and contradictory, but while in one hospital she professed belief, took communion, and was baptized in a certain faith. Her behavior was not, however, in the least modified by this.
One serious minded woman took Inez at her word when she said she wanted to study algebra and offered her a good opportunity which was never accepted. This demonstrated clearly that the desire was a matter of words only. Inez' constant assertion of independence has been one of her main sources of temporary success. Kindly people have speedily taken up with her. Sympathy is undoubtedly, in spite of her statements to the contrary, one of the strongest needs of her nature. In one of her letters we note her expression of satisfaction in a certain situation where she found herself much ``mothered'' by kind nurses. All her chances, however, have been spoiled by her indulgence in lies.
Inez has remained adamant to every plea and suggestion made by many well-wishing friends that she reform and begin again. After her parents and other relatives were found and communicated with, her career partly known, and her mother's need of sympathy shown to her, she still refused to change her story in many particulars—even when she knew that we had discovered about her writing home within recent months. She steadily refused to acknowledge her true age. When the evidence was complete, showing that she could not be held as a runaway girl, but must be treated under the law as a woman, she went forth to begin, as we heard from many other sources, her old misrepresentations of herself, which speedily got her into further trouble.
We were not astonished, even after we had accumulated almost the entire knowledge of the career which we have outlined above, and Inez knew that we had done so, to be visited by two fine philanthropic women who wanted to consult with us about an unfortunate girl who had won their sympathy, and who had been placed by them in a leading hospital after having shown some signs of acute bronchitis. In fact, she was in such a bad condition that she had to be transferred in an ambulance. But her illness had rapidly cleared up and now after ten days of observation an eminent diagnostician had thoroughly scolded her for simulation, and the girl was once more on their hands. Indirectly they learned that we knew of the case of this ``girl of 16.''
They realized that they had been taken in, but it had been done so cleverly, and, as they expressed it, Inez showed herself such a splendid actress, that they wondered if she had not extraordinary histrionic abilities which could be utilized. (It remains to be seen whether anything constructive can be done by following this lead. We feel that previous psychiatrists who gave earlier an unfavorable prognosis in this case were perhaps quite right. But perhaps we should not let our opinions in this be swayed by the fact that my associate, Dr. Bronner, who went to this last hospital was met by an absolute denial on the part of Inez of the essentials of the above career, by her insistence that she was not the same person as the daughter of the Smiths, and that she was only 17—all this in spite of her knowledge of our correspondence with her family and others, and her own previous acknowledgments of lying.)
Summary: In summarizing the characteristics of this woman we may first insist that she has ambition, push, and energy in high degree. Her personality as expressed in general bearing, features, and facial action is remarkably strong and convincing. Her ambition was shown in her work on our tests as well as in her social behavior. (We have wondered if it was not her desire to shine which prevented the typical performance of the pathological liar on the ``Aussage'' test.) Her self-confidence as expressed on numerous occasions is no less striking. ``I tell you, doctor, that I have told lies, but you will see that I will come out on top.''
Inez has been free from the overt problems of sex life. We have repeatedly been informed that she has been a girl of good character in this respect. ``I ran away from home for a good cause. I'm not one of those girls who is crazy about the boys.'' Usually Inez shows a very even temper. It is only when her own personality is trod upon that she grows angry, and obstinacy is then her leading reaction. Some pathological liars may be weak in character, but not Inez. She is the firmest of persons. On occasions her attitude is entirely that of the grand lady. Her type of lying is clearly pathological. It would often be very hard to discern a purpose in it, and over and over again she has defeated her own ends by further indulgence in prevarications. To her the utterance of lies comes just as quickly and naturally as speaking the truth comes to other people. Even in interviews with us when she was voluntarily acknowledging her shortcomings in this direction she went on in the same breath to further falsifications.
The medical aspects of the case come under the same category as the lying. The dysuria, the spitting of blood, the sugar in the urine, the hairpins found twice in the abdomen, the simulated pains, neurasthenia, and bronchial attacks, together with her stories of accidents and fainting spells illustrate her general tendency. This behavior, like her lying, serves to feed her egocentrism, her craving for sympathy and for being the center of action. As with the lying, repetition of this type of conduct probably is largely a matter of habit.
The bearing of this case on the problems of testimony is interesting. As shown in our account of tests done, when objective concrete material was considered by this woman she reported it well. It is only when her egocentrism is brought into play that she becomes so definitely unreliable. This is a line of demarcation that students of this subject would do well to recognize.
Causative Factors: Our study of causation in this case, as we intimated at first, is necessarily incomplete. But some things, probably explanatory, stand out very clearly. Heredity is moderately defective. Inez was the outcome of an unfortunate pregnancy and was a poorly developed infant. She suffered early from a number of illnesses, which, however, left no perceptible physical defects. Her unusual relationship to the other children, based on the difference in age, was perhaps a starting point for the development of her inventional theories of her own origin. She has given us many hints of this in speaking of her earliest remembrances of hearing the Smiths whispering something about adoption, and of her feeling that the other children were too old for her to belong to their family.
Then we insist on the positive bearing which this woman's native traits have had in the production of her career. Her facility with language marks her as possessing one of the chief characteristics of the pathological liar. Added to this she showed the other personal traits which we have described in detail, leading to her success in misrepresenting herself. Her strongly developed physiognomy has caused many people to believe her older than she stated, but still one has seen such lineaments belonging to girls of 17.
The bearing which the accident at 18 had upon the case it is impossible for us to estimate. Her family are very clear on this point; they maintain that all her bad conduct has developed since then. Through unwillingness, or barely possibly real amnesia for the injury, Inez has not helped us to know the facts. Dr. Augusta Bronner, who has studied this case with me, cleverly suggests that just as anyone becomes confused in distinguishing really remembered experiences from what has been told by others was one's experience, so Inez gets confused between what has really happened and what she herself has told as having happened. This finally involves a pathological liar in a network which is difficult to untangle. Part of the causation of the present lying, then, is the extensive lying which has been done previously.
Psychological analysis in such a case is most difficult because of the unreliability of the individual's own statements about her life, inner and outer. Psychoanalysts will be delighted, in the light of what we long afterward found out, at the pregnant opening sentence of an interview, recorded above, when Inez blurted out that she was once in a State hospital. However, from what we ascertained, we may see clearly that here is an individual with a past that she desires to cover up. Much more delinquency may be involved of which we know nothing. As the result of circumstances and traits she finds herself, despite her very good ability, inadequately meeting the world. Her forceful personality carries her into situations which she is incompetent to live up to. The immediate way out is by creating a new complication, and this may be through lies or the simulation of illness, at which she has become an adept. Altogether, Inez must be thought of as one who is trying to satisfy certain wishes and ambitions which are too much for her resources. Towards the goal to which her nature urges her she follows the path of least resistance. Being the personality that she is, the social world offers her stimulation which does not come to others.
To discuss the problem of her responsibility would be to introduce metaphysics—it is sure that in the ordinary sense she is not insane. The cause of her career is not a psychosis, although we readily grant that out of the materials of her mental experience she may ultimately build up definite delusions.