A bestselling author faked having cancer, but he’s not the first. Why do people do it?

Dan Mallory, known as writer A.J. Finn, poses during the presentation of his debut novel 'The Woman in the Window' in Barcelona, Spain, on April 9, 2018. EPA/ALEJANDRO GARCIA

Dan Mallory, known best for writing The Woman in the Window under the pen name A.J. Finn, admitted in a New Yorker exposé this week that he faked having an inoperable brain tumour.

Per the magazine, Mallory’s fabrications were plentiful: he said his mother slowly died from cancer (she had cancer but is still alive), and that he “survived earlier bouts with cancer” only to be told he had a brain tumour that would kill him by his 40th birthday (he did not).

When the New Yorker unravelled the truth, Mallory offered an apology via a PR firm, saying he had “no recollection” of many of the falsehoods, and attributing them to bipolar disorder.

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“It is the case that on numerous occasions in the past, I have stated, implied or allowed others to believe that I was afflicted with a physical malady instead of a psychological one.”

With that, Mallory joins a select group of people around the world who’ve either fessed up or been forced to fess up to faking illnesses – be it for sympathy, monetary gain, or some combination of the two. What motivates them is not always simple to untangle.

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“Many who experience mental-health struggles legitimately experience a range of physical symptoms,” says Brenda Lee, who has a doctorate in clinical psychology and works as a therapist and clinical associate in Winnipeg — think stomachaches and headaches for anxiety.

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Others with mental-health issues may “find it easier to explain their struggles to others using the language of physical illness, which our culture tends to better understand and validate.” (This seems to be what Mallory’s statement indicates drove him).

Then, Lee says, there is factitious disorder. That’s when people falsify signs and symptoms in either themselves or other people even when there doesn’t seem to be any clear reward for doing so.

It’s pretty uncommon, she says, with research indicating that roughly one per cent of patients in the hospital meets the requirements for a diagnosis. A 2014 article in The Lancet noted it’s “likely to be underdiagnosed” and that prevalence probably hovers somewhere between 0.5 per cent and two per cent.

Some indicators that a person might be fabricating their illness: they’ve sought help at a number of clinics and hospitals, they’ve given selective or misleading information, their illness doesn’t seem to be following the typical progression, a “remarkable” number of tests and consultations have been done with few results, and they’re opposed to a psychiatric assessment.

While a 2010 article in The Lancet said health-care workers will likely “encounter at least one case” of factitious disorder during the course of their careers, that likelihood goes up for paediatricians.

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A 2013 study out of Canada actually warned doctors to keep an eye out for “caregiver-fabricated illness,” meaning the parent says the child has symptoms they don’t actually have (it’s considered a psychiatric disorder).

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In 2017, a Texas mother was arrested and charged with serious bodily harm to her child after records showed she took her eight-year-old boy to hospitals and health facilities more than 320 times. Over a seven-year period, the boy had 13 major surgeries.

Those headline-grabbing cases aren’t the ones Lee is typically called in to treat.

For the most part, she cares for those who are experiencing physical symptoms for psychological issues and those who borrow physical illness terms to describe their mental distress.

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“Providing an empathetic and understanding therapeutic relationship may help someone who believes that they would not be taken seriously unless they described their distress in physical terms.”

Part of the problem is likely isolation and loneliness fueled by the rise of social media, says Nafissa Ismail, a psychology professor at the University of Ottawa, as well as its research chair in stress and mental health.

“We get this feeling of being more isolated,” Ismail says. “This feeling of not having achieved maybe what other people have achieved or not living a life that other people are portraying [themselves] to be living.”

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In that environment, she says, faking an illness is a way of seeking attention and not intended for malicious purposes.

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“It’s a way of feeling like people care about you, that they’re interested in what’s happening in your life.”

A Calgary woman who faked having cancer and being a victim of the Fort McMurray wildfire wasn’t trying to be greedy, the Crown said, but was looking for attention and support.

Jennifer Halford, 35, pleaded guilty to seven counts of fraud in 2016, and received a two-year suspended sentence. The judge said public outrage would play no part in her sentencing decision and suggested Halford might be struggling with mental health issues. Halford’s five-year-old died in January 2011 after a four-year battle with Mitochondrial Disease.

Not every cancer-faking case is motivated by their mental-health needs. One woman who faked having cancer in Baltimore in 2010 had a history of scamming, including bad checks and a mortgage scam. Before that, Howard Richman, a former executive at a biotech company, faked being “gravely ill with colon cancer” in an attempt to avoid a lawsuit from the Securities and Exchange Commission.

More recently, an Australian cookbook author falsely said healthy eating cured her brain cancer. In 2017, Belle Gibson – who was described by a judge as being “cavalier about the truth” – was also found guilty of falsely claiming most of her income went to charity.

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That there are a range of reasons why people fake cancer and other illnesses is further complicated by the fact people “frequently engage in a range of deceptive behaviours,” wrote the psychologists in The Lancet paper in 2014.

While factitious disorders are “clinically significant, deception is a pervasive, normal and ubiquitous social behaviour of human nature.”

– with files from the Associated Press

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