NBC anchor Brian Williams is really under fire now -- for seemingly making up details or whole story elements about, among other things, coming under enemy fire by Hezbollah, being in a helicopter hit by enemy fire in Iraq, rescuing puppies while working as a volunteer firefighter and reporting from New Orleans after Hurricane Katrina.  

Williams is a talented man.  He has one of the most coveted positions in all of journalism. Whether he was in a chopper that was actually hit by enemy fire, or close to one hit by enemy fire, or simply in the same general vicinity as one hit by enemy fire, he had gone into a war zone to report on a bloody conflict. Whether he rescued one or two puppies from a blaze, or simply volunteered to help put out a blaze, he was doing something commendable. Whether gangs attacked the French Quarter hotel he was staying in or there was simply chaos in the streets -- streets he had elected to walk -- he was putting himself in harm’s way.  

I have never evaluated Brian Williams, but this question could be asked:  Why wasn’t the truth about each of the stories that Williams seems to have embellished enough?  What leads a man to make him look even more courageous than the courage he displayed?  What leads a man to cast himself as the leading man in dramas that course through even greater dangers than the very real perils that unfolded?

One potential answer is that some people must do everything they can to camouflage deep feelings of weakness and unworthiness.  If you were a bullied kid who suspects himself of cowardice, or an abused kid who suspects himself of being unlovable, or a short or asthmatic kid who suspects himself of being weak, and if you never deal with those underlying fears, then you can end up trying to camouflage them with one tall tale after another.  

People very often cast themselves as one thing to avoid being seen as the opposite.

Casting oneself as heroic and powerful and fearless, when it is done to stave off buried feelings of being vulnerable and frightened, is no different than using any other drug. A person can become just as addicted to praise and the admiration in someone’s eyes as he can to cocaine or heroin.  

I know this is hard to believe, but it is true.  And just like any other drug of abuse, mainlining the ill-gotten respect of others is never enough to really quell the internal sadness and anxiety a damaged person carries inside.  You need more and more praise, however you can get it, to keep the negative feelings at bay.

And if praise and attention and awe are your drugs (rather than a nice byproduct of your work) as an anchorman, then being in front of the camera reading the headlines may not be enough.  You might chase the camera everywhere you can, as Williams seems to have done -- to one talk show, after another, to one celebrity cameo, after another.

Telling tall tales isn’t a skill that you’re born with, or that you develop at age 50.  It’s acquired.  And that’s why it is important for anyone addicted to that drug to figure out when he first mainlined it.  

What was it used to cover up?  If you had an alcoholic father who beat you (and I am not implying in the least that this or any other example I generate describes Mr. Williams), and you want to believe he was a good father, then you could be off to the races, as a confabulator.  If you had a sister who confronted a deadly illness as a child, and your family wanted you to believe it was the flu that kept coming back, then you could be on your way to being expert at generating cover-ups.

The truth always wins. Ask anyone who uses any drug to try to distance himself from any reality. It never, ever works. And so, now, Mr. Williams would be wise to do the work of uncovering just why the real facts of his very real willingness to be in harm’s way just weren’t gritty enough.  

The real admiration of colleagues for his real skills just wasn’t flattering enough.  The real success he enjoyed at the top of his profession just wasn’t rich enough.

The psyche or God or one’s self (maybe all the same thing) has a way of bringing you to your knees in an instant, and making you confront the very things you have been running from. Brian Williams may find himself at that very moment.  

And, as strange as it sounds, and as painful as it could be, it could be a transformational one.

Dr. Keith Ablow is a psychiatrist and member of the Fox News Medical A-Team.