The first time I heard a patient mention a relative who died in the World Trade Center attacks on 9/11, I felt the expected hushed sadness, the sore sorrow of what we were all still recovering from a couple months prior. I was a little perplexed, though, at the person’s lack of emotion and matter-of-factness, but dismissed it. I knew, even as a fledgling psychiatric trainee in Manhattan, that everyone grieved in their own style, and I jotted down the information for his file. The second time a patient told me about a 9/11 death, and then the third, with similar blankness, often accompanied by other major problems, such as homelessness, drug abuse or depression, I started to wonder. I can recall at least 10 similar instances of people saying they had a sibling, a son, a cousin or parents who had died in the attack.
Yes it was a historic, cataclysmic mass murder that claimed 3,000 lives, but New York was a huge city with millions of people. I could understand people saying they lived near the buildings, witnessed the horrible collapse, inhaled the burning chemical toxic smoke afterward or even that they knew survivors. I went on a date with a guy who had just missed being on the flight that crashed in Pennsylvania. So coincidences weren’t impossible.
But oftentimes the stories didn’t hold up. One had a tale about a grown child recovering in a burn unit, but the hospital he was at kept changing each time she told it. When I called the most recent hospital she’d mentioned, they had no record of her son. Another patient claimed to have had parents on one of the planes that crashed, but later admitted it wasn’t true. My cynicism started to creep forth. I began calling it to myself the “9/11 sign” — anyone with a report of a 9/11 death in their history was likely seeking some sort of secondary gain, at best in the form of greater sympathy in the face of a multitude of other tough psychosocial stressors in their lives, or at worst, to get controlled substances or even to apply for special 9/11 benefits.
So I was not shocked to hear comedian and actor Steve Rannazzisi reveal he lied about having escaped the twin towers that day. I also wasn’t shocked by the otherwise outrageous tale of Tania (Alicia Esteve) Head, the former president of the World Trade Center Survivors Network who wasn’t even in United States during the attacks but maintains she was one of the few who had escaped above the floor directly hit by a plane.
We can’t know Rannazzisi’s exact motive for lying (indeed, he claims to not know either), but his lie does seem to have helped jump-start his career, if only by setting him apart. In psychiatry, we classify the older concept of “pathological lying” into two main camps: conscious vs. unconscious motivation for lying. Patients are clearly aware of the lying itself and highly manipulative in their actions, but their motivations for doing so can vary.
Conscious lying, termed “malingering” in psychiatry, is known more commonly as “con man” behavior and is sometimes related to antisocial personality disorder. It’s done for clear and conscious secondary gain, usually monetary, such as disability payments, drugs or “three hots and a cot”— for homeless people who in desperation lie about being suicidal to get admitted to a hospital. Rannazzisi seems to fall into this category, since his claims helped get attention to spark his budding acting and comedic career after he moved to Los Angeles shortly after the attacks. He continued to make claims about escaping the towers in interviews as recently as 2009.
You also have the “unconsciously” motivated liars suffering from factitious disorders, in which people feign symptoms, either mental or physical, in order to play “the sick role.” One extreme form of this disorder is Munchausen’s Syndrome, in which a person, sometimes with some education or training in health sciences, intentionally falsifies medical illness in themselves, or worse, in their children, in order to receive care and attention. Milder forms of factitious disorder include people who develop pseudoseizures, paralyzed limbs or other somatic issues, often manifesting from underlying hidden trauma or unspeakable emotions. There is also “pseudologia fantastica,” literally fantasy fake words, where people feel compelled to rattle off extremely detailed, fantastical stories about themselves that are untrue.
The “unconscious” motivation usually is related to strong unmet needs during childhood development, such as neglect or abuse, leading to an ongoing drive to seek forms of care and affection even in self-destructive or manipulative ways. It seems Tania Head might fall into this category, since she reportedly came from a very wealthy and noted family in Spain; she had no real need for money when she advocated for survivors. She developed a close cadre of fellow survivor friends. But there is the issue of fame.
9/11 was a game-changer for the American psyche and as such, might have become a lightning rod for the particular “sympathy” lies it garnered. No other event has inspired so many false claims among my patients. And people of all stripes and socioeconomic classes seemed to sense the power lurking behind that type of attention, that kind of historic relevancy. It’s the power of infamy.
For the true victims of the attacks and their bereaved, the reverence and awe is, to me, fully justified. There was also something elegiac and beautiful about the way Americans came together those shocked and mournful weeks after the attacks, something in our character we didn’t know we had.
But the dark side of that awe and reverence are people who wish to ride the coattails of that sympathy, and the ennobling force of people’s generosity. We shouldn’t necessarily just feel enraged by these individuals (although it certainly is tempting.) These are usually ultimately sad, lonely, empty people who capitalize on this unprecedented capacity for charity. And maybe there is something to be said for how our individualistic society does leave many neglected souls to grow up unsupported and desperate, in emotionally and financially broken families and environments. That our period of momentary closeness quickly dissipated into our regular grumbling, busy, self-centered ways, leaving these lost souls at the edges to clamor for these scraps of love and support. Fame, as found by Head and Rannazzisi, is a quick, powerful way to garner that love and support.
To his credit, Rannazzisi has come clean at great cost to his reputation and appears in his statements to exhibit remorse. Typically malingering and factitious lying, either from outright sociopaths or from factitious patients who exhibit the classic symptom of “la belle indifference,” do not come with much insight or regret. “For many years, more than anything,” Rannazzisi said in a statement, “I have wished that, with silence, I could somehow erase a story told by an immature young man. It only made me more ashamed.” For him, perhaps the pull of fame was too much for a young guy looking for his big break. 9/11 was the sure thing.