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Lying plays an obviously objectionable role in everyday life, yet so-called white lies can be a part of the tactfulness which makes civilized human contact possible. The analytic situation rests on the unique professional ideal of the truthfulness of the patient being reciprocated by the analyst's honesty. Freud knew, however, about the elusiveness of human truth, and as Friedrich Nietzsche once wrote, anticipating psychoanalysis's concern with self-deception, “the most common lie is that with which one lies to oneself; lying to others is, relatively, an exception” (Nietzsche, 1954; Anderson, 1980).
Pathological lying is a special matter, and Helene Deutsch's hitherto untranslated 1921 paper (Deutsch, 1922) can be instructive for several reasons. She had been analyzed by Freud in 1918-1919, and then entered what in old age she considered to have been her most creative period as a psychoanalyst. Unlike most members of the Vienna Psychoanalytic Society at the time, Helene Deutsch was well trained in academic psychiatry. She got her M.D. at the University of Vienna in 1913, and then spent five years more at Julius Wagner von Jauregg's clinic; it was the stronghold of psychiatry in the Austro-Hungarian Empire, and in 1927 Wagner-Jauregg became the first and only psychiatrist to win a Nobel Prize. With his encouragement she had gone to Munich for a few months in 1914 to learn the investigative techniques of Emil