sort to the imagination and fantasy, a
subterfuge rendered easy by those inherent defects enumerated in
connection with the preceding case.

All the frankly psychotic manifestations, such as his delusional ideas
and his grave affection of the lower extremity which served to put him
in a hospital for the insane, were, of course, entirely malingered.

This brings us to the subject of malingering proper.

III

In malingering we see the application of deceit and lying to a definite
situation. That which is a habitual type of reaction in some
individuals, as was illustrated in the foregoing cases, comes to the
fore in others only under certain stressful situations of life. While in
the habitual fabricator the most prominent motives are those of an
egotistic nature, a craving for self-esteem as compensation for an
inherent defect, in the malingerer we see a resort to this form of
reaction as a means of self-preservation, as a means of escape from a
particularly painful situation.

There was a time in the history of psychiatry when malingering was a
frequent subject of discussion in psychiatric literature. This was due
not so much to any inherent practical importance of the phenomenon of
malingering as such as to the faulty conception that this phenomenon was
something which by its very existence ruled out the existence of mental
disease. More scientific studies of personality which led to a direction
of our attention to the malingerer rather than to malingering as an
isolated mental phenomenon brought with it a complete change of attitude
towards the entire subject.

Today, far from harboring the notion that malingering and mental disease
are mutually exclusive, we are beginning to look upon malingering itself
as the expression of an abnormal psychic make-up. Furthermore, far from
believing, as of old, that the proverbially insane is supposed to be
totally devoid of discretion in his conduct, we know that there may be a
good deal of method in madness, and that even the frankly insane
malinger mental symptoms when the occasion requires it. No experienced
psychiatrist would today, for instance, consider the oft-quoted story of
the alleged madness of Ulysses as evidence of malingering.

The story is told that Ulysses, in order to escape the Trojan war,
feigned insanity. He yoked a bull and a horse together, plowed the
seashore, and sowed salt instead of grain. Palamedes detected this
deception by placing the infant son