Not all forms of deception are alike. Unlike pathological lying or frank antisocial behavior, moral hypocrisy reflects the deceptive pursuit of self-interest in which the individual uniquely violates his or her own moral standards. Four hypotheses relevant to this concept are identified in a critical review of the psychoanalytic literature. These hypotheses are evaluated logically and in light of findings from contemporary research. The author argues that explanations resting on the concepts of superego weakness, impulse strength, and/or narcissism fail to provide an adequate account of the complex intentions betokened by hypocrisy. By contrast, the mechanism of disavowal enjoys strong, broad-based support once it is freed from the narrow confines of perception and reality testing. Rather than a attenuation of reality testing, hypocrisy represents a mode of perception in which contradictory moral imperatives coexist without conflict. Authentic engagement and empathy with patients is facilitated by a nonjudg-mental appreciation of the human capacity for moral disengagement.