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dered 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 17all 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 metaphysicsit 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。
CASE 4
Summary： A girl of 16 had been engaged in an extraordinary amount of clever shoplifting under the influence of her ‘‘mother。'' In the courts