The Elephant in the Zendo -- Books about Denial and Self-Deception

Wanted to recommend a few books:

The Elephant in the Room: Silence and Denial in Everyday Life by Eviatar Zerubavel - sheds new light on the social and political underpinnings of silence and denial -- the keeping of "open secrets. The author shows that conspiracies of silence exist at every level of society, ranging from small groups to large corporations, from personal friendships to politics.

The Folly of Fools: The Logic of Deceit and Self-Deception in Human Life by Robert Trivers
New book from a professor at Rutgers University

Here is a recent book review / article that addresses deliberate self-deception that occurred when there was a deep need to promote a "story" and to ignore reality -- showing how emotional dependence, grandiosity, and the need to believe overwhelmed common sense, evidence and basic truth:

Multiple Personality Deception
The famous patient who inspired the panic was more the victim of her psychiatrist than of mental illness
By Carol Tavris

One of the most foolish and devastating episodes of social hysteria in America was the rise of "multiple personality disorder" in the era between, roughly, 1980 and 2000. Before 1980, only a handful of cases had ever existed world-wide, and the "multiples" came in pairs. In the 1950s, "The Three Faces of Eve" added one more personality to the mix. MPD then languished, as a rare psychiatric curiosity, until "Sybil" was published in 1973. The title patient produced 16 personalities before she was through, and became a national phenomenon. Flora Rheta Schreiber's book sold more than six million copies, and 40 million Americans watched the 1976 two-part television special starring Joanne Woodward and Sally Field.
Sybil Exposed

If Helen's face launched a thousand ships, Sybil's faces launched tens of thousands. In her wake, people began coming out of therapy claiming that they had dozens, even hundreds, of "alters"—human, animal, mechanical and vegetable. By 1980 so many psychiatrists had begun looking for sensational cases of MPD in their own troubled clients—and finding them—that for the first time it became an official diagnosis in the "Diagnostic and Statistical Manual of Mental Disorders." MPD was a growth industry; eminent hospitals, notably Rush Presbyterian in Chicago, opened MPD treatment centers. By the mid-1990s, according to some estimates, as many as 40,000 cases had been reported.

Yet Sybil's story, which started it all, was a complete fabrication. Sybil, whose real name was Shirley Mason, did not have a childhood trauma that caused her personality to fragment, and her "personalities" were largely generated in response to pressures, subtle and coercive, by her psychiatrist, Cornelia (Connnie) Wilbur, whom she wanted desperately to please.

The true story of Sybil has found its ideal historian in Debbie Nathan, whose earlier book, "Satan's Silence" (with Michael Snedeker), debunked the "ritual sex abuse" panic that swept across the United States at the same time as MPD. Ms. Nathan's indefatigable detective work in "Sybil Exposed" has produced a major contribution to the history of psychiatric fads and the social manufacture of mental disorders. This is the book that should be a made-for-TV movie.

Sybil was a fake, but not entirely a fraud. Self-deception, Ms. Nathan shows, was the motivation for all three principals involved in the creation of her persona: the patient, the psychiatrist and the writer. Each faced a choice when confronted with the evidence that Sybil was not a multiple personality: Accept the truth or press forward with a story they knew was a lie. Ms. Nathan deftly shows how emotional dependence, grandiose ambition and financial incentives from need to greed tilted their decisions.

Ms. Nathan begins with the early lives of the three: Shirley, who grew up in a tiny Minnesota town, the only child of Seventh-day Adventists; Connie, who saw wealth and professional glory if she could get a good story out of her distressed, dependent patient; and Flora, a New York magazine writer whom Connie commissioned to turn Shirley's story into a book with a "happy ending." Each of these women, who came of age in the 1920s and 1930s, yearned to break out of the confines imposed on them by religion, region or gender: Shirley, to become an art teacher; Connie, to prove wrong her father's claim that she was "too stupid" to be a doctor or chemist; Flora, to become a great writer.

Shirley, who suffered from various physical and emotional ailments for most of her life, began psychoanalytic treatment with Connie in 1955. Before long, the two women struck a deal: Shirley would allow Connie to publish her story of being a multiple personality, and the cost of her treatment would be taken out of the book's royalties.

Connie began injecting Shirley with sodium pentothal (falsely called "truth serum," more properly "fanciful imaginings serum") and recording whatever Shirley said under its influence. Most of it was dreamlike garble, with an occasional alarming "memory" thrown in: Once Shirley recalled being forced onto a table, knocked out by medication and seeing a man looming above her. Connie assumed Shirley had been raped. Much later Shirley admitted it was a memory of her tonsillectomy.

Connie turned Shirley into an addict, giving her nearly a dozen drugs, including barbiturates, tranquilizers and anti-psychotics (such as Thorazine). Even with this "help," Ms. Nathan writes, "Shirley's new 'trauma' memories were pathetically trivial." But if Shirley couldn't produce a traumatic secret that was the reason for all her alters, there could be no resolution and no book. And so, in 1958, after four years of therapy, Connie simply withheld the sodium pentothal that Shirley was addicted to. Shirley was devastated. She wrote a long letter to Connie, admitting she was "none of the things I have pretended to be . . . I do not have any multiple personalities. . . . I do not even have a 'double.' . . . I am all of them. I have been essentially lying."

Connie had a choice. She could give up the most important case of her career, or she could justify her misdiagnosis and failure to help her patient in familiar psychoanalytic jargon. Shirley, she explained, was experiencing massive denial and resistance—evidence that the therapy was working. Now Shirley had a choice. She could continue being a "multiple" and keep Connie and drugs in her life, or leave therapy, owing Connie a fortune she could never repay. Shirley went home and wrote Connie a second letter. It must have been another alter, she said, who wrote the first one. Connie upped Shirley's sessions to five a week and resumed the sodium pentothal.

In 1965, almost 11 years after their first psychotherapy session, Connie announced that she was moving to a new job in West Virginia. She told Shirley that she was welcome to come along, but she would have to integrate her multiple personalities right away so that the book could finally be written. Shirley immediately produced a new identity as herself and never again dissociated.

Flora faced her own choice about Sybil after finally getting a contract from a small publisher in 1969. Doing some investigative legwork for the book, she discovered huge discrepancies between Shirley's memories and what Shirley herself had written in her diaries at the time the alleged events occurred. If her mother went on lesbian orgies in the woods and defecated on neighbors' lawns, the young Shirley didn't say a word about it. No one in Shirley's hometown corroborated Shirley's memories, nor did her childhood medical records. And then Flora found Shirley's letter saying that she never had multiple personalities. Flora had to decide whether to give up this luscious project, which she was already fantasizing might be as successful as Truman Capote's "In Cold Blood," or to believe Connie and Shirley.

When Ms. Nathan, as part of her own investigation, persuaded forensic experts to examine some of Shirley's key diaries, she learned that entries marked "1941" were written in ballpoint pen, which was not used in the United States until 1945. Ms. Nathan suspects Shirley wrote these entries years later, probably at Connie's urging, to support the MPD story and persuade Flora to stay with the project.

What, then, did Sybil suffer from? Is MPD "real"? Yes and no. MPD is what some psychiatrists call a culture-bound syndrome, a culturally permitted expression of extreme psychological distress, similar to an ataque de nervios (an episode of screaming, crying and agitation) in Hispanic cultures and "running amok" in Malaysia. As Ms. Nathan suggests, "the Sybil craze erupted during a fractured moment in history, when women pushed to go forward, even as the culture pulled back in fear."

The disorder seems real to clinicians and their patients who believe in it, but it results from suggestion, sometimes bordering on intimidation, by clinicians. One eminent MPD proponent actually told his colleagues that they might need to interview a patient for up to eight hours nonstop before an alter appears! Once that happens, the therapist rewards the patient with attention and praise for revealing more and more personalities, as Connie did to Sybil.

Flora Rheta Schreiber died in 1988, age 72. Her papers, including Sybil's therapy records, went to John Jay College in New York City, where they were sealed from public view to protect Sybil's identity. A decade later, when two diligent investigators discovered her real name, the box was opened to the public.

Cornelia Wilbur died in 1992, age 86, when MPD was at its height of popularity with her colleagues. Her executor, a former patient, destroyed her papers.

Shirley Mason died in 1998, at age 75, alone with a framed photo of Connie and the doll collection she had kept with her since childhood. In exchange for a life in Connie's orbit, she gave up close friends, enjoyable work as an art teacher and an offer of marriage to a man she loved.

The MPD bubble burst in 1995, when several patients sued a St. Paul psychiatrist for malpractice, alleging that she had used punitive methods to induce their "multiple personalities." They were awarded millions of dollars, and the psychiatrist eventually lost her medical license. More malpractice suits followed; hospitals closed their inpatient MPD units; and the epidemic subsided. Psychological researchers went on to scientifically discredit virtually all the assumptions underlying MPD, such as the belief that trauma is commonly repressed and causes "dissociation" of personality. Harvard psychologist Richard McNally calls this notion "a piece of psychiatric folklore devoid of convincing empirical support."

Yet the promulgators of MPD do not seem to have learned anything. They changed the label to "Dissociative Identity Disorder," but a skunk by any other name is still a skunk. The International Society for the Study of Trauma and Dissociation continues to give its Cornelia B. Wilbur Award "for outstanding clinical contributions to the treatment of dissociative disorders." When Ms. Nathan told the society's president, Kathy Steele, about "the extensive evidence of Connie's ignorance, arrogance, and ethical misconduct" that she had unearthed, that Sybil was "a performance based on fiction," Ms. Steele replied: "So what? I don't know what difference it makes."

What difference does a correct diagnosis make? At a professional meeting in 1989, in response to a question from the audience about how Sybil was doing, Connie announced casually that Shirley suffered from pernicious anemia, a disease that causes an inability to process vitamin B-12. Discovering that Connie knew this fact about her patient may be Ms. Nathan's greatest scoop, for symptoms of pernicious anemia include just about everything that plagued Shirley Mason throughout her life: fatigue, social withdrawal, anxiety, hallucinations, muscle pains, confusion about identity, distorted memories and changes in personality. No one in Connie's audience of psychiatrists, Ms. Nathan writes, took note.

Thanks, Josh, for bringing the MPD story to us.

Elizabeth Loftus has done some excellent work on so-called "repressed memories." Lives have been ruined over the hysteric responses to repressed memories. There are two prominent cases in Washington -- one, a father of several girls who lived in Olympia, was falsely accused of sexual assaults on his daughters based solely on the girls' recovered "memories." His life and career and family were ruined even though the girls later recanted their stories. In another case in Wenatchee, a police detective inspired a number of girls to recover their (false) repressed "memories" of Satanic rituals involving sexual abuse in a church. In the Wenatchee case, the lives of a fundamentalist preacher and his wife were destroyed.

Carol--I have an aunt and uncle who (I strongly believe) were the victims of false "repressed memories" that were unearthed by a psychologist or counselor when their daughter underwent therapy. Hypnosis was used. The inference I make is that suggestive quality of the hypnosis created new images in the daughter's memory that weren't there previously. I have no reason to suspect any malicious intent on the part of the psychologist, daughter/patient, or parents.

Yet there lies a family in ruins.

I don't really understand why psychologists and psychiatrists are allowed to claim that these therapies are safe and effective by their certifying professional organizations. We don't allow drugs to be declared safe by the FDA without that crucial two-pronged test in clinical trials.

Scientists, and those who people naturally trust are using scientifically-approved methods, should be especially on guard against their certainties outpacing their evidence. The general public needs to beware of those who don't.

Back to the general category of self-deception and willful blindness:

November 14, 2011 - New York Times - Column
Let’s All Feel Superior
By DAVID BROOKS

First came the atrocity, then came the vanity. The atrocity is what Jerry Sandusky has been accused of doing at Penn State. The vanity is the outraged reaction of a zillion commentators over the past week, whose indignation is based on the assumption that if they had been in Joe Paterno’s shoes, or assistant coach Mike McQueary’s shoes, they would have behaved better. They would have taken action and stopped any sexual assaults.

Unfortunately, none of us can safely make that assumption. Over the course of history — during the Holocaust, the Rwandan genocide or the street beatings that happen in American neighborhoods — the same pattern has emerged. Many people do not intervene. Very often they see but they don’t see.

Some people simply can’t process the horror in front of them. Some people suffer from what the psychologists call Normalcy Bias. When they find themselves in some unsettling circumstance, they shut down and pretend everything is normal.

Some people suffer from Motivated Blindness; they don’t see what is not in their interest to see. Some people don’t look at the things that make them uncomfortable. In one experiment, people were shown pictures, some of which contained sexual imagery. Machines tracked their eye movements. The people who were uncomfortable with sex never let their eyes dart over to the uncomfortable parts of the pictures.

As Daniel Goleman wrote in his book “Vital Lies, Simple Truths,” “In order to avoid looking, some element of the mind must have known first what the picture contained, so that it knew what to avoid. The mind somehow grasps what is going on and rushes a protective filter into place, thus steering awareness away from what threatens.”

Even in cases where people consciously register some offense, they still often don’t intervene. In research done at Penn State and published in 1999, students were asked if they would make a stink if someone made a sexist remark in their presence. Half said yes. When researchers arranged for that to happen, only 16 percent protested.

In another experiment at a different school, 68 percent of students insisted they would refuse to answer if they were asked offensive questions during a job interview. But none actually objected when asked questions like, “Do you think it is appropriate for women to wear bras to work?”

So many people do nothing while witnessing ongoing crimes, psychologists have a name for it: the Bystander Effect. The more people are around to witness the crime, the less likely they are to intervene.

Online you can find videos of savage beatings, with dozens of people watching blandly. The Kitty Genovese case from the ’60s is mostly apocryphal, but hundreds of other cases are not. A woman was recently murdered at a yoga clothing store in Maryland while employees at the Apple Store next door heard the disturbing noises but did not investigate. Ilan Halimi, a French Jew, was tortured for 24 days by 20 Moroccan kidnappers, with the full knowledge of neighbors. Nobody did anything, and Halimi eventually was murdered.

People are really good at self-deception. We attend to the facts we like and suppress the ones we don’t. We inflate our own virtues and predict we will behave more nobly than we actually do. As Max H. Bazerman and Ann E. Tenbrunsel write in their book, “Blind Spots,” “When it comes time to make a decision, our thoughts are dominated by thoughts of how we want to behave; thoughts of how we should behave disappear.”

In centuries past, people built moral systems that acknowledged this weakness. These systems emphasized our sinfulness. They reminded people of the evil within themselves. Life was seen as an inner struggle against the selfish forces inside. These vocabularies made people aware of how their weaknesses manifested themselves and how to exercise discipline over them. These systems gave people categories with which to process savagery and scripts to follow when they confronted it. They helped people make moral judgments and hold people responsible amidst our frailties.

But we’re not Puritans anymore. We live in a society oriented around our inner wonderfulness. So when something atrocious happens, people look for some artificial, outside force that must have caused it — like the culture of college football, or some other favorite bogey. People look for laws that can be changed so it never happens again.

Commentators ruthlessly vilify all involved from the island of their own innocence. Everyone gets to proudly ask: “How could they have let this happen?”

The proper question is: How can we ourselves overcome our natural tendency to evade and self-deceive. That was the proper question after Abu Ghraib, Madoff, the Wall Street follies and a thousand other scandals. But it’s a question this society has a hard time asking because the most seductive evasion is the one that leads us to deny the underside of our own nature.

Thanks again, Josh, for another thought provoking article.

December 23, 2011 - New York Times Book Review

Why We Lie
By JOHN HORGAN

THE FOLLY OF FOOLS: The Logic of Deceit and Self-Deception in Human Life by Robert Trivers - 397 pp. Basic Books. $28.

In 1995 I traveled to the University of California, Santa Barbara, for the annual meeting of the Human Behavior and Evolution Society, which turned out to be a pep rally for psychologists, anthropologists and others who view humanity through the lens of evolutionary theory. Attendees heard Darwinian takes on lust, love, infidelity, status-seeking, mental illness, violence, patriotism, politics, economics and religion, as well as keynote addresses from such luminaries as Richard Dawkins and Steven Pinker.

The most influential thinker there, arguably, was a scruffily bearded fellow, wearing sunglasses and a knitted cap, who never gave a talk. He lurked around the margins of the conference; at one point I spotted him puffing a joint outside a meeting hall. This, at any rate, is how I remember Robert Trivers, although as he points out in “The Folly of Fools,” memory often tricks us. He also confesses to being a pothead, so I’m pretty sure my recollection is accurate.

As a Harvard graduate student in the 1970s, Trivers wrote a handful of papers showing how our genes’ relentless drive to self-replicate underpins even our most apparently magnanimous impulses. According to his theory of reciprocal altruism, we occasionally act kindly toward strangers because our ancestors — over time and in the aggregate — received a quid pro quo benefit from acts of generosity. In other papers, Trivers proposed that families roil with conflict because parents share no genes with each other and only half of their genes with children, who unless they are identical twins also have divergent genetic interests.

These concepts were popularized by others, notably Edward O. Wilson in “Sociobiology,” Dawkins in “The Selfish Gene” and Pinker in “How the Mind Works.” All have credited Trivers, whom Pinker has called “an underappreciated genius, and one of history’s greatest thinkers in the analysis of behavior and emotion.” If Trivers is not better known, that may be because he has struggled with bipolar disorder since his youth. He is also, by his own admission, an irascible anti-authoritarian, whose sharp tongue often gets him into trouble. He left Harvard in the late 1970s, eventually ending up at Rutgers. He also has a home in Jamaica.

No doubt tired of seeing others crank out well-received elaborations of his work, Trivers has finally produced a popularization of his own. His topic is deceit, with which by his own admission he has wrestled — on a personal as well as professional level — throughout his adult life. Trivers’s scope is vast, ranging from the fibs parents and children tell to manipulate one another to the “false historical narratives” political leaders foist on their citizens and the rest of the world.

Trivers calls deceit a “deep feature” of life, even a necessity, given genes’ brutal struggle to prevail. Anglerfish lure prey by dangling “bait” in front of their jaws, edible butterflies deter predators by adopting the coloring of poisonous species. Possums play possum, cowbirds and cuckoos avoid the hassle of raising offspring by laying their eggs in other birds’ nests. Even viruses and bacteria employ subterfuge to sneak past a host’s immune systems. The complexity of organisms, Trivers suggests, stems at least in part from a primordial arms race between deceit and deceit-detection.

Our big brains and communication skills make us master dissemblers. Even before we can speak, Trivers notes, we learn to cry insincerely to manipulate our caregivers. As adults, we engage in “confirmation bias,” which makes us seize on facts that bolster our preconceptions and overlook contradictory data. We wittingly and unwittingly inflate the qualities of ourselves and others in our religious, political or ethnic group. We denigrate those outside our in-group as well as sexual and economic rivals.

Fooling others yields obvious benefits, but why do we so often fool ourselves? Trivers provides a couple of answers. First, believing that we’re smarter, sexier and more righteous than we really are — or than others consider us to be — can help us seduce and persuade others and even improve our health, via the placebo effect, for example. And the more we believe our own lies, the more sincerely, and hence effectively, we can lie to others. “We hide reality from our conscious minds the better to hide it from onlookers,” Trivers explains. But our illusions can have devastating consequences, from the dissolution of a marriage to stock-market collapses and world wars.

One intriguing theme running through “The Folly of Fools” is that self-­deception can affect our susceptibility to disease, for ill or good. Trivers speculates that some illusions — for example, a daughter’s insistence that her alcoholic, abusive father is a good man — require so much effort to maintain that they drain energy away from our immune systems. Conversely, religious fundamentalism, which often restricts mating or even interactions with outsiders, may help protect the faithful from parasites carried by infidels. According to Trivers, religions are more likely to split into rival factions in regions with high rates of infectious disease.

Trivers will no doubt alienate many readers when he turns his attention to politics. Although he indicts many nations for denying their sins, he is especially incensed by Israel’s treatment of Palestinians and the United States’ treatment of American Indians, blacks, the Vietnamese, Iraqis, Afghans and other groups. I found Trivers too shrill in these sections, even though my political views overlap with his. Also questionable are his put-downs of cultural anthropologists, whom he accuses of denying — for ideological rather than scientific reasons — biological research that can deepen our understanding of human behavior. In my experience, evolutionary scholars are at least as driven by ideology as cultural anthropologists are.

But I cut Trivers slack for his denunciations of others because he is so hard on himself. Throughout the book, he recalls instances in which he lied — to girlfriends (he has apparently had many), wives (two), children (five) and colleagues. In one especially poignant passage, Trivers recalls walking down a city street with an attractive young woman, “trying to amuse her,” when he spots “an old man on the other side of her, white hair, ugly, face falling apart, walking poorly, indeed shambling.” Trivers abruptly realizes he is seeing his reflection in a store window: “Real me is seen as ugly me by self-­deceived me.”

Trivers is not an elegant stylist like Dawkins, Wilson or Pinker. His technical explanations can be murky, his political rants cartoonishly crude. But Trivers’s blunt, unpolished manner — which I assume is not feigned — makes me trust him more than some slicker writers. “The Folly of Fools” reminds me of other irreducibly odd classics by scientific iconoclasts like “The Fractal Geometry of Nature,” by the mathematician Benoit Mandelbrot, and “The Society of Mind,” by the artificial-­intelligence pioneer Marvin Minsky.

Only in one passage does Trivers strike me as insincere, when he notes how prone academics are to self-importance; one survey found that 94 percent considered themselves to be above average in their fields. “I plead guilty,” Trivers adds. That, surely, is false modesty. May his new book give him the attention he so richly deserves.

Essential Secrets of Psychotherapy: Truth, Lies and Self-Deception
None of us are beyond deceiving ourselves.
Published on November 30, 2008 by Stephen A. Diamond, Ph.D. in Evil Deeds

Folie a deux is an idiomatic French expression meaning "craziness of two." This fascinating syndrome is referred to diagnostically in the American Psychiatric Association's DSM-IV-TR as Shared Psychotic Disorder, one of several types of psychosis. How common is this condition, what causes it, and what can it teach us about the nature and perils of self-deception?

A delusion is, by definition, a psychotic symptom: a fixed, false, irrational conviction not comporting with objective reality but clung to vehemently nonetheless. Shared Psychotic Disorder refers to the onset of such a delusional state of mind in someone as a consequence of close relationship with another person already suffering from psychosis. Yes, in this sense, psychosis can be communicable. This relatively rare mental disorder illustrates two vital truths: Psychosis--contrary to the conventional mainstream view--is most often not merely the manifestation of biochemical aberration or a "broken brain," but a fundamentally psychological phenomenon. And, as such, it demonstrates the dangerous degree to which the human mind is capable of massive self-deception. It proves the awesome power of psychology.

None of us are beyond deceiving ourselves. Such self-deception, which in its most extreme and pathological forms we deem delusional, is much more pervasive than most imagine. Consider the ordinary example of some heated conflict with a spouse, lover, relative or close friend. How is it that after the fact, each participant can have a completely contradictory version of what happened? Objectively speaking, first A happened, then B occurred, then C was said, D followed, etc. But what if the objective facts or our own behavior don't comport well with how we see ourselves? We distort the facts to support our particular point of view and to sustain our beliefs about the kind of person we are or want to be. When the objective facts threaten the ego and its integrity, we experience what social psychologists call "confirmation bias," a kind of cognitive dissonance known more recently as "Morton's Demon." We dismiss certain facts incompatible with our myth of ourselves in favor of other less threatening and more corroborative ones. We twist the truth. And we become convinced of the veracity of this twisted truth. And we do all this unconsciously. We don't even know we're doing it. This goes beyond mere "cognitive distortion," resulting in a radical rewriting of history and reality for the purpose of preserving our precious self-image or persona. In its most extreme form, such self-deception can lead to certain delusional beliefs symptomatic of psychosis. This illustrates clearly the powerful unconscious cognitive component of psychotic disorders of various kinds.

Take the current Casey Anthony case (see my previous post). Casey Anthony is charged with the first-degree murder of her missing two-year-old daughter, Caylee. From the start, Casey has denied any culpability, claiming steadfastly that her daughter was abducted by her babysitter. Is this the objective truth? Or is it a lie? If it is a lie, is it a conscious lie or an unconscious one? In other words, does Casey know she's lying? Or does she actually believe the lie? If she turns out to be completely convinced that the lie is true, is she really lying? Or is she telling the truth as she sees it? If the latter turns out to be the case, then Casey could be considered delusional. From a forensic psychology perspective, this could conceivably become a key component of her legal defense.

But what of Casey's parents, especially her mother, Cindy Anthony? Both seem convinced that Casey did not harm their granddaughter and is telling authorities the truth. Is this a conscious show of support and solidarity for their daughter, an effort to protect her from abandonment and prosecution? Are they lying? Do they speak of Casey's innocence outwardly but inwardly believe in her guilt? Or are they lying to themselves? Denial is a potent form of self-deception, an unconscious psychological defense mechanism designed to ward off unacceptable or inconvenient truths. Could Casey Anthony's parents be, perhaps like her, so deeply in denial that they have introjected their daughter's delusional belief about what happened, becoming enmeshed in a folie a trois?

While such cases are extreme, this sort of symbiotic dynamic is present in most relationships to some extent, with partners regularly entering into and supporting the subjective reality of the other. Even when that necessitates deceiving themselves to do it. Evidence of this can be commonly seen in co-dependent relationships in which the severity of abusive behavior or substance abuse or mental illness in one person is minimized by the other. This insidious self-deception occurs not only in couples, but in families, friendships, groups, religious cults, political parties and entire countries. Cognitive dissonance leads us to disregard or negate all that could contradict our cherished self-image or insult our personal or collective narcissism. So the truth we see is highly selective, serving to reinforce primarily our experience of ourselves as good, kind, honest, religious, spiritual, loving, etc. Or, in some cases, confirmation bias or Morton's Demon can even lead to the rejection of positive qualities which seem incompatible with one's deeply entrenched negative view of oneself, thus destructively perpetuating it.

Interestingly, when the individuals in a folie a deux are eventually separated, the person who adopted the other's delusional beliefs typically no longer exhibits psychotic symptoms, while the original and more dominant delusional partner (the "inducer" or "primary case") remains psychotic. Why is that? It is due partially to the fact that the person who takes on another's delusional system is somewhat more psychologically intact compared to the inducer to begin with. Therefore, when removed from the delusional inducer's direct influence, they no longer fully partake in nor endorse his or her distorted subjective reality. Indeed, they may have passively or even lovingly joined with the other for the sake of solidarity and support in his or her delusional version of reality precisely so as not to abandon or be abandoned by the other. A concrete illustration of this dynamic can be seen in cults of various kinds, in which passive followers fanatically internalize the charismatic leader's grandiose and paranoid delusions. Think Charles Manson, Jim Jones, David Koresh, Adolf Hitler, Osama bin Laden and others. If and when susceptible followers leave the cult, these symptoms tend to diminish over time.

In truth, we deceive ourselves about a great many matters, from bad behavior, to how we feel, to the ever present existential fact of death. Such self-deception is fundamentally related to Freud's broad conception of the unconscious--the unknown aspects of our psyche--and specifically to Jung's notion of the shadow: those unacceptable traits and tendencies in ourselves we hide from both others and ourselves. This very capacity to deny our own selfishness, fears, cruelty and complicity in evil-- unconsciousness-- is itself a treacherous sort of self-deception. Which is why growing gradually more conscious during the course of psychotherapy can be a shocking, painful and sobering process. C. G. Jung noted the therapeutic importance of consciously tolerating the "tension of opposites" we today term "cognitive dissonance," and that such unadulterated confrontation with the truth about oneself is almost always initially experienced as an insult to the ego--a devastating blow to our narcissism. No wonder we so fervently resist this process. It takes considerable courage and commitment to be brutally honest with oneself. But it is precisely this willingness to stop our chronic self-deception and face the truth that finally sets us free.