The middle-aged man lived a solitary life, working as a security guard on the night shift in the Pacific Northwest. Never married and with no children, for a time he lived in a van parked outside his ailing mother’s house. He occasionally heard voices in crowds, he said. The product of a dysfunctional childhood, he was a recovering alcoholic from his time as a war hero in the military, he told the young woman interviewing him.

“Did you ever kill anyone?” she asked.

“During the military, or after the military?” he responded.

The question and answer led to the depraved admissions of stalking, rape and murder of Mr. S. – who told the young psychology intern he had been a serial killer of women for about 20 years. But there was one catch: none of it was true. Despite the fearful reaction of the intern, which touched off Mr. S’s lengthy hospitalization and an intensive police investigation, he had made up the entire story because he had simply “wanted attention” from her, as reported in the latest Journal of Forensic Sciences.

“We present a patient who fabricated an elaborate history of being a sexually sadistic serial killer with homicidal ideation with the intention of obtaining personal attention, nurturance, and empathy from his psychotherapist,” write the authors. “However, given the nature of his feigned condition, the patient frightened the very person whom he sought to engage in caretaking.”

Mr. S. had a full explanation of his apparently-fictional modus operandi. He would follow a female target for months. In his van he kept two sets of identical clothes, along with supplies like lengths of strong rope. That rope would be used for strangulation.

At the time he was talking to the intern, he was pursuing a woman he had first seen at the local public library, he said. His only friend’s girlfriend was another target for abduction and murder years earlier – since she had effectively taken away his sole human contact.

Mr. S would not say how many he had killed, who they were, or where their remains were, according to the case history. The intern’s terror prompted her to turn the case over to one of her superiors.

“The patient’s therapist, feeling frightened and threatened by these disclosures, transferred his case to her supervisor, who then saw the patient for a few therapy sessions,” they write.

Mr. S’s story grew. He indicated the voices in his head were getting worse, and that he was considering amputating his own leg. The threat of self-harm allowed an involuntary commitment to a local psychiatric hospital – by which time a team of specialists were assessing the self-proclaimed sadistic serial killer.

In the psych ward, Mr. S. claimed the sounds he heard had grown to include Italian opera during the otherwise-quiet nights in the hospital. Nevertheless, he was calm and cooperative – and actually appeared “pleasant” to other people within his confines, the authors add. The police combed through any possible killings or unsolved crimes which could be linked to Mr. S. They found none.

In the meantime, the psychiatrists contacted the local District Attorney’s office. Together they sought – and obtained – an order for an involuntary 180-day commitment of Mr. S. With that document in hand, they confronted their patient.

Mr. S came clean. He “had made the whole thing up...about the killings...all of it” because he “wanted attention,” he admitted.

Initially, he had wanted to be “more interesting” to the young female intern. Once the story had grown, he had felt too embarrassed to backtrack, he told them.

But the possibility of spending six months in an involuntary civil commitment in the psychiatric hospital had changed his mind, he said.

Nevertheless, Mr. S spent those months confined in that hospital. During that time, his antidepressants were at first increased, so that his reported hallucinations disappeared. But eventually he was taken off all medications for several months. All homicidal ideation – including mentions of killing – disappeared completely.

A Rorschach evaluation eventually determined there was no psychosis involved in the man’s thinking. Instead, he had tendencies toward narcissism, dependency, and borderline personality disorder.

But the main diagnosis was the “factitious disorder,” they concluded. Mr. S. simply wanted to appear more interesting than he really was. Even the “war hero” military honors were false – his time in the military had been strictly non-combat. He could not understand why the intern had been so fearful of him and his stories of butchering women, according to the paper.

The case history, written by Christopher Fischer, Mace Beckson, and the well-known forensic psychiatrist Park Dietz, found that what Mr. S said and did simply did not line up with the actions of real-life sadistic killers.

“Mr. S did not exhibit common characteristics observed in sexually sadistic serial killers. He provided no detail of torture or ritualistic fantasies or behaviors,” they write. “Although claiming to rape his victims, he did not describe the typical sexual arousal from their subjugation, torture, and killing. Indeed, the detail of rape appeared to be an afterthought to the story of abduction and homicide, as if attempting to complete the picture of a ‘sexually sadistic serial killer.’”

Mr. S was released shortly after completing his involuntary commitment. His whereabouts are reportedly unknown.