ABSTRACT
Somatoform conditions can be conceptualized as "self-deception," that is, at a nonconscious level, the individual has "tricked" himself or herself into believing that physical symptoms are present. In contrast, malingering/factitious presentations involve "other" deception; that is, the individual is aware that the symptoms are not real, but is trying to deceive others into believing that they are real. Before delving into how consciously versus nonconsciously created symptoms might be differentiated, it may be useful to examine the genesis of self-deception regarding illness. For self-deception to have been retained through evolution, it must have conveyed particular value. The importance of this self-deception mechanism to humankind is perhaps illustrated by the respect and adulation one give to "actors" whom they view to be particularly skilled at their craft. Each year the Academy Awards and other accolades are given to those actors whom they judge to have best "tricked" into believing the stories they portray on screen and stage.
