The lies are unplanned, spontaneous. Once told, they generally stick (for years)-- but it's fair to say the pathological liar doesn't know what he's going to say until he says it. He is a bullshit artist who makes it up as he goes along, and who then believes his own crap.
And the lies aren't even useful lies. You ask him what he did last Saturday and he tells you he went to the museum; and maybe he says at the museum he saw a guy try to rob the gift shop, but he got caught by two off duty cops wearing blue hats. And later you learn he was really at a movie with his girlfriend and you think, why the hell did this freak make all that up?
That's why it's called pathological.
A pathological liar is like a 4 year old kid, who tells you what happened to him down by the lake. Meanwhile, there's no lake.
The important question here is this: does the pathological liar know he is lying? Or does he believe his stories? Is he lying, or is he delusional?
The answer is: both. Sort of.
He is not delusional, but he hovers in that half-world of the narcissist (oh, there's that tie-in), where the lies are believed until he gets caught, but then-- and this is the move that only a few can pull off-- he acknowledges that the "facts" are lies, but not the essence, the spirit. "Ok, look, I'm not really in the CIA."
But in his mind, he knows that if conditions were right-- if something big went down-- he could be exactly like a CIA agent, and that's close enough.
If he saw a suicide bomber, he'd be able to movie- kung fu him, grab the Sig Sauer and squeeze off a few rounds.
He also knows which wire to clip. How does he know? Because he's in the CIA.
If aliens actually did come and attack us, he knows he would actually be able to fly a spaceship.
Pathological lying is not "confabulation." In both cases, lies are told spontaneously and freely, without clear intent, purpose, or gain-- except that in confabulation, the reason the person lies is to fill in the deficits in his memory; he can't remember what actually happened. Hence confabulation is associated with dementia ("when I was 18 I went to Paris with my unit and I saw... 8 puppies get eaten by Chamberlain and de Gaulle-- hand to God I saw it"), and especially with alcoholic dementia/hallucinosis
("I don't know what happened to me-- six guys jumped me... yeah... six... Canadian guys, I think they were Satanists, no, wait, Stalinists, yeah, that's right, and they could read my mind...")
What about biological correlates? There aren't any, because this isn't a disease, it's a description.
Here's an example: an article entitled, "Prefrontal white matter in pathological liars" found massively (20%+) increased prefrontal white matter, and a 40% decrease grey/white matter ratio in pathological liars, as compared to both controls and antisocials. But before you crack an anatomy book to figure out what that means (more prefrontal white matter= more ability to think and reason),
you should know that the subjects they labeled "pathological liars" were really people who purposely and frequently lie to get a gain--
in other words, they were big fat evil scumbag liars, but not pathological liars. What this study found was that people who frequently lie develop a better brain for manipulating information, remembering stories, etc-- which is interesting, but not all that surprising.
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