Dear Dr. Wes & Kelly: My 14-year-old daughter lies constantly about everything and has since age 2. She would lie about little things like taking candy, and when caught with 10 empty wrappers under her pillow, she would say someone else put them there. She lies to everyone — parents, grandparents, etc., and it has cost her most of her friendships. She’s told others her dad has health problems, that we are divorcing (we’re not), and that she has anorexia and bulimia (she doesn’t). She also takes things and then denies it. I’ve have had her in counseling twice for this. Things improved slightly for a very short time, but counseling is no longer possible as our health care plan won’t pay for it. We aren’t overly punitive, but she does get consequences. We’ve taken her cell phone and computer. She knows lying is not acceptable, and yet it is always the path she chooses even though she knows it makes things harder for her. She got loads of attention as a child and has a loving, caring family and extended family. She is a strong student in school, is loved by her teachers and has many gifts. Only the constant lying gets in her way. I am at the end of my rope … so discouraged and so scared as to what her future holds for her.

— Canadian Reader

Wes: I doubt you’re over-reading or reacting to this situation. What you describe goes well beyond our recent column about teenage lying and into the realm of the pathological. The main clue is that your daughter’s behavior causes her more trouble than it resolves. She’s always getting caught and punished by specific consequences, rejection of friends or the misery of general mistrust. Time and again her lying denies her exactly what she (presumably) wants — the attention of others. There’s an old saying that insanity is doing the same thing over and over again and expecting a different result. I’m not declaring her insane, but it’s clear that your daughter is struggling with a self-destructive, habitual behavior.

What I don’t know from your letter is how much she cares about her problem, and therefore whether she’s vested in changing it. Is she horrified by her own behavior but can’t seem to stop? Or is it just a lot easier to lie than to face the immediate consequence — essentially procrastinating the inevitable? Does she ever expect a payoff, or the lie itself is so thrilling that she can’t resist? Is she puzzled when she keeps failing at this, or does she expect it? Does she feel compelled to lie even if she doesn’t want to? What we’re really looking for here is what her lying means to her and what it represents in her personality. If her previous therapists didn’t figure this out, then any intervention is bound to fail. If, for example, you are treating this as bad behavior and it’s really deeply psychological, then you won’t get anywhere until you deal with the psychology — and vice versa. Worse, the psychiatric diagnoses that can underlie this behavior include everything from attention deficit to conduct disorder to problems of attachment to the early stages of an eventual personality disorder.

I’ve had a number of these cases over the course of my career, and I know how frustrating they are. I’ve used many approaches to address the problem — some pretty dramatic. However, in each I got to an understanding the young person and family using interview, testing and general relationship building. Unfortunately, without a sustainable evaluation and therapy process it will be hard to know which path to take. I’d urge you to find charity organizations or government clinics that could try to tackle this problem. If it continues past adolescence, your daughter has a difficult path ahead.

Kelly: Throughout childhood and adolescence, kids seem to be constantly testing the limits, trying to see how far they can go before they reach the deep end. Most can distinguish the very thin line between a small lie and a big lie. Your daughter seems to have that line blurred. Perhaps she’s having difficulty differentiating between fantasy and reality. If this has been reoccurring since age 2, that is definitely a red flag for concern.

You seem like a caring individual who only wants what is best for your child. Although you may be fed up with your daughter’s constant lying, don’t give up on her just yet. Let her know she is not alone — and you and your family are there to help her through it. No matter how much you try to fix the situation, you can’t do it all on your own. For actual change to happen your daughter must realize what she doing is wrong, and she must want to change her ways. You can only push so much before she falls off the edge. As Wes notes, in these extreme cases where lying has continued and has affected nearly everyone psychological evaluation and help seems highly necessary.

I have a few questions of my own. When your daughter is caught in a lie, who ends up with the brunt of the consequences? Do you find yourself correcting her mistakes? Have you or her friends covered for her lies? Or do you allow her to publicly claim her mistakes and correct them? Does she own up to what she does?

Your daughter’s punishment for lying should not only include taking away material possessions but requiring her to clean up the messes she creates. Sometimes humiliation can be the best incentive for change. Your daughter will learn the consequences of dishonesty firsthand and hopefully learn to uphold the truth.

Your daughter will hopefully soon realize that she is losing everything and everyone around her. During this time, things may spin out of control. The only thing you can offer up to that point is love, support and a reminder of how she got here.

Next week: My parents filter everything good on the Internet.

— Dr. Wes Crenshaw is a board-certified family psychologist and director of the Family Therapy Institute Midwest. Kelly Kelin is a senior at Free State High School. Opinions and advice given here are not meant as a substitute for psychological evaluation or therapy services. Send your questions about adolescent issues (limited to 200 words) to doubletake@ljworld.com. All correspondence is strictly confidential.