The great fake off
The strange case of the white woman who passed herself off as black has put a spotlight on identity fraud - and the ease with which people can pass themselves as something they are not.
The curious saga of Rachel Dolezal, the prominent African-American advocate outed as white, acquired an extra element of farce this week, with Dolezal appearing to insist, in the face of a media firestorm, that it was plausible for a Caucasian to identify as black.
As Dolezal, until recently a senior figure within the National Association for the Advancement of Coloured People, was condemned as a fraud and a fantasist, the woman at the centre of the controversy came out punching hard.
In interview after interview she went on the offensive, insisting she legitimately perceived herself as black and was qualified to advocate on behalf of minorities. She might not have been born African-American but, culturally, that is how she had come to regard herself. Who were we to stand in judgement?
"One of my sons yesterday (told me), 'Mom, racially you're human and culturally you're black.' I do know that they support the way I identify. And they support me," she said.
At one level, her story has an aspect of absurdity: the white middle-class woman who convinced the world - and, herself - she belonged to another ethnicity.
However, it may also be viewed in the wider context of individuals passing themselves off as something other than who and what they truly are.
Indeed, there has lately been a deluge of high-profile cases of people shamelessly faking an aspect of their identity. In some instances, it is possible they suffer from a certifiable psychological condition, variously dubbed "factitious disorder" or Münchhausen syndrome.
In other instances, they may have simply been engaged in an elaborate hoodwinking. The difficulty lies in distinguishing one from the other.
One of the most notorious examples of identity hoax was that of 9/11 survivor Tania Head, who claimed to have barely escaped with her life in the 2001 attack on New York's Twin Towers.
By her telling, she was one of only 19 to survive above the point of impact in the World Trade Centre's south tower and had lost her finance in the strike. Articulate and emotional, she gained a media profile and eventually became president of the World Trade Centre Survivors' Network.
"I looked around, it was like a horror movie, people were mounted on each other, the smell of burnt skin and people's insides was gagging," she said in one interview.
"I kept thinking about my fiancé, about our wedding, I wanted to wear that white dress and swear my love for him. Something gave me the strength to get up. I believe today that it was my fiancé on his way to heaven."
But with fame came scrutiny, and in 2007, Head was unmasked as a liar. She'd been nowhere near the World Trade Centre - in fact, at the time of the attacks, she was studying in Spain.
There is, of course, an important distinction between Head and Rachel Dolezal - the former appeared to be spinning a deliberate mistruth, the latter seems at some level to believe race is a matter of perception and that it is defensible for her to view herself as African-American.
Far more common than either example is the phenomenon of people faking cancer. The ease with which this may be achieved was underlined recently with the case of Belle Gibson, an Australian New Age guru who convinced the world - or, at least, the internet - that she had been struck down with terminal illness and stumbled upon a miraculous cure.
By her telling, aged 20, she was diagnosed with a brain tumour. In her emotive blog, she wrote about undergoing chemotherapy only to reject conventional treatment after eight weeks. Instead, she turned to "alternative" therapies: colonic irrigation, a dairy/gluten-free diet.
On the back of her "recovery", in 2013, Gibson launched a lucrative mobile application, the Whole Pantry, crammed with eating and lifestyle tips. The $3.79 app was downloaded 300,000 times, earning Gibson a tidy income and bringing her to the attention of Cosmopolitan and Elle magazine, which dubbed her "the most inspiriting woman you've met this year".
Then in April, with Apple having flown her to California to publicise the pre-installation of The Whole Pantry on its new smartwatch, she had a sudden change of heart. Everything - her illness, her miracle recovery - had been a lie, she confessed.
"No. None of it's true," Belle wrote in her blog. "I am still jumping between what I think I know and what is reality. I have lived it and I'm not really there yet."
Was this a shameless fraud? (She is under investigation for $300,000 in promised charity donations). Or something more complex?
Some have theorised that she suffered from the aforementioned "factitious disorder" - the feigning of illness in order to assume the identity of a sick person.
"Patients with factitious disorder and Münchhausen syndrome simulate disease when the pay-off for appearing sick is not obvious," writes Dr Marc Feldman in Playing Sick: Untangling the Web of Münchhausen Syndrome, Münchhausen by Proxy, Malingering and Factitious Disorder.
"The internet is a ripe setting for factitious disorders," consultant neurologist Jules Montague wrote in the Guardian recently. "Evidence is easier to falsify, medical knowledge is easy to source. A 'professional patient' can convincingly inhabit the sick role within hours.
Adopting new personae is afforded by the invisible cloak of a computer screen. During a coma, a non-existent mother posts on the sufferer's behalf. A fake grieving friend informs the community of a tragic death."
She cited a 2011 study suggesting 9pc of individuals receiving "complex medical and surgical" treatment suffered from "some form" of the disorder - a huge drain on resources.
"It is reasonable to assume that factitious illness behaviour results in personal and financial costs that are comparable to medical problems that are regarded as serious public health problems," writes professor of psychology James Hamilton in the introduction to Playing Sick.
"The estimates of cost, for example, would place factitious illness behaviour problems in the same league as medical problems like Parkinson's disease, multiple sclerosis, liver disease, ovarian and cervical cancer and epilepsy."
Nobody has suggested Rachel Dolezal is afflicted with factitious disorder. She appears to sincerely believe she is a legitimate member of the African-American community and an appropriate advocate on its behalf.
Perhaps the most straightforward explanation, then, is that she is a person with delusions but that, unlike most in her situation, has been required to face up to her fantasy with the entire world watching.