In Lies! Lies!! Lies!!! Dr. Ford juggles with two hot potatoes: the validity of recovered memories of child sex abuse, and validity of the polygraph for the detection of lying. These burning issues are set in the context of a widespread review of human prevarication in which a large number of recent books and papers are digested and summarized for the reader.

Ford is a psychiatrist whose personal interest is mainly clinical. Many case histories are summarized here. The references suggest that he has been interested in the field since 1973 when he published a paper on the Munchausen syndrome, and in 1983 he wrote a book on somatizing disorders. In 1988 with two colleagues he published a review article on lying in the American Journal of Psychiatry, and that brought him not only a lot of publicity but also a considerable correspondence from those afflicted with the tendency to lie and also from their family members. In 1994, with M.D. Feldman, he published Patient or Pretender: Inside the Strange World of Factitious Disorders (John Wiley & Sons, Inc., New York).

In this volume Ford emphasizes the pervasiveness of lying and the paradoxical attitude of society toward it. A mother corrects her child for lying about stealing cookies, and in the next breath tells the child to lie to his teacher about the reason for missing school. The ability to lie, and to tell when a lie is needed, are fundamental human skills. Whereas those who lie too much are considered unreliable, those who lie too little are labeled tactless. Lies told in the context of the marital situation may damage the marriage, but so may the failure to tell a lie. Lies are expected from politicians and advertisers, and lies underlie the usual forms of politeness in many languages. It is only when lies bring no reward to the lying person or to others that they take on the character of pathology, and then they tend to occur in persons who suffer from what the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association calls Cluster B personality disorders, namely antisocial, histrionic, narcissistic and borderline personality disorders. These afflicted individuals also suffer from low or unrealistic self-esteem, impulsivity, a tendency to romance or dramatize themselves, a deficit in the formation of close personal relationships and a tendency to vary between idealization and contempt for their friends. All these problems are thought to be related to a failure to develop a sense of basic trust with a caregiver in early life, and to physical, emotional and sexual abuse during childhood. The tendency to tell pointless lies develops in the attempt to cope with these adverse circumstances.

The author devotes considerable space to the problem of detecting lies, and his conclusions came as a surprise to me. We are not good at detecting the liar, and even those who have had a lot of experience and training in the field such as customs officers and policemen are not much better than the rest of us, and the better they think they are, the worse they are in fact. Even successful poker players are better at lying than in detecting lies in their opponents, and to do so they make detailed lists of the habits of each individual player, suggesting that there are few valid generalizations to be made. Moreover, people cannot be trained to detect lies.

It is when Ford comes to the question of formal lie detection tests that he has an important positive recommendation to make. Detection tests are based on the fact that when people lie, they become emotionally aroused, and this causes various changes in the body such as a reduction in salivation, a rapid pulse, irregular breathing and an increase in sweating of the palms and soles. In ancient times falsehood was mainly detected by its effect in drying the mouth: an accused Bedouin was asked to lick a red hot iron bar, and if his mouth had been dried by a guilty conscience his tongue was burned and he was then convicted; any victim who managed to keep a good flow of saliva for any reason was less affected and was acquitted. In the Spanish Inquisition the accused was told to swallow bread and cheese, and those in whom the bolus stuck in the gullet were marked as guilty.

Present-day criminals and others whose veracity society wishes to determine do not need to worry about their salivary flow, but they need to have good control of their heart rate, breathing and sweating, the variables measured by the polygraph. An increase in arousal when answering sensitive questions is assumed to reflect the activation of guilt. However, Ford takes issue with the reliability and validity of such tests: there are too many false- positives, so that innocent people may be blamed unjustly. Some people get easily aroused, and even to be accused of something they have not done may be so upsetting that they give a positive test. Meanwhile, the true culprit, who may have an antisocial personality disorder, is so cool and unemotional by nature that he is not aroused by even the strongest guilt. No professional qualifications are required to become a polygrapher, and many current practitioners are poorly trained; moreover, they rarely get feedback on the correctness of their test results, so that there is little scope for trial-and-error learning. The author reports that in 1985 US Secretary of State George Schultz managed to prevent the widespread introduction of lie detection tests into the public service, saying “I have grave reservations about so-called lie-detector tests” and refused to take the test himself. I found the author convincing in his criticisms, and I would endorse his recommendation that the polygraphic procedure comes into the category of a psychological test and, therefore, should only be administered by, or under the supervision of, a qualified psychologist. More research needs to be done on the guilty knowledge test, which is based on the arousal reaction to information that can only be known by the guilty person.

The author is critical of psychotherapists who encourage patients to uncover memories of childhood sexual abuse while undergoing intensive procedures such as age-regressive hypnosis. He is also critical of self-help manuals that encourage readers to convince themselves that they have been sexually abused. While acknowledging the seriousness and widespread occurrence of real sexual abuse of children, he notes that there are 14,000 reports in the files of the False Memory Syndrome Foundation, and he takes the view that many cases of recovered memory are false. I share with him the experience of dealing with families in which there has been a false accusation of sexual abuse — a more destructive experience could hardly be imagined.

This is a learned and sensible book. Let me finish with three quotations, the first two from the book:
“My clinical experience as a psychotherapist has led me to believe that at the psychic core of each of us is the wish for perpetual life, gratification of our needs for nurturance and protection, and the belief that we are loved — a wish that can be fulfilled by finding the idealized parent substitute.” (page 261)

Alas! Our wish for perpetual life can only be fulfilled by some form of self- deception, which makes one less than optimistic about the admirable exhortation with which Ford concludes his book:
“If we are to avoid an apocalyptic fate, we must learn to modulate the instinctual forces of aggression and reproduction and the allied functions of deceit. In the final analysis, it is not lying but mutually reinforced self-deception that poses the greatest danger to the individual, society and humanity.”

Compare this with “. . . the same processes [shared deceptions] that favor cohesion within specific societies may exaggerate conflict with other societies, undermining the global cooperation needed for the human species to survive . . . .” (Beahrs, J.O. Ritual deception: A window to the hidden determinants of human politics. Politics and Life Sciences 15, 3–12; 1996).