What I noticed in her email exchange with Patrick was Mayer's incredible lack of shame or remorse at her deliberate, bald-faced lie:
If I understand what’s going on here, you’re not a doctor, but you play one at town hall meetings.
Is that about it?
And she replied:
Do you mean play a doctor like you play a journalist? Then the answer is no. But who knows, that was only my first town hall meeting–even though I was a delegate. If I go to another one, which I seriously doubt because my husband is already extremely annoyed, then maybe I’ll play a plumber.
Notice how she neatly turns the tables on the person exposing her? She plays a doctor, like he plays a journalist; and even suggests that next time she'll play a plumber (thereby showing her hostility and envy toward a real person who asked a real question of candidate Obama and neatly attacking Joe the Plumber--who incidentally happens to really be a plumber).
This turn-about attacking strategy is a hallmark of the way a typical psychopath deals with exposure of his (or her) psychopathy. They are not remorseful; not at all. In truth, they believe that everyone else is just like them and find it impossible to appreciate that other people are not the lying and manipulating con artist that they are.
There have been many famous imposters throughout history. They falsify their identity and either borrow someone else's identity or make up an imaginary person with a different name or pretend to have a different profession. Their success with the new identity or profession often depends on the complicity of others in the lie and the web of lies they create. In Roxana Mayer's case, both Congresswoman Lee and the Houston media were complicit--probably because Mayer met their psychological needs with her impersonation.
If we delve into psychoanalytic literature regarding imposters, the prevailing thinking is that the imposture is often part of a compulsion to enact the family romance:
The family romance is a conscious fantasy, later repressed, in which a child imagines that their birth parents are not actual but adoptive parents, or that their birth was the outcome of maternal infidelity. Typically, the fantasy parents are of noble lineage, or at least of a higher social class than the real parents.
The family romance (Freud, 1909c) differs from children's sexual theories in that it does not address general questions about the origins of life but rather the question, "Who am I?"—where "I" denotes not an agency of the mind (or ego) but the result of an effort to place oneself in a history, and hence the attempt to form the basis of a knowledge.
The family romance fantasy has several possible aims and sources: revenge against frustrating parents; rivalry with the parent of the same sex; separation from idealized parents by means of their transformation into fantasy parents; and the elimination of brothers and sisters for competitive or incestuous purposes.
Now, you may think that Freud is full of it, but he and other analysts have postulated that the defect involved in becoming an imposter relates to a defective superego (a sort of "parental" structure in the psyche); and that this defect leads to the psychopathology exhibited in specific cases. Imposters suffer from a type of psychological perversion, and they are desperately searching for those idealized parent(s)( that they believe they have lost and at the same time enacting revenge against the ordinary and woefully imperfect parents they were stuck with in the real world.
In Mayer's case, perhaps the specific motive was trying to cover up for the idealized parent she adopted by pretending to be an expert in a field that could lend him some credibility (as his credibility sinks). Note her statement that, "I also went to lend support to the reform effort. It’s easier to be against something especially since anger is such a great motivator."
Unresolved neurotic/personality conflicts are also very strong motivators.
My guess is that Mayer would have continued the impersonation and played the concerned doctor to the hilt if she had not been outed by a little bit of fact-checking done by a blogger who happens to be more of a journalist than most professional journalists these days. She would undoubtedly have had a lot of complicit neurotics--trying to salvage their idealized relationship with the Obamessiah--who would have been willing to play along with her.
There are often many layers of complexity in this particular type of psychopathology, but to cut to the chase: imposters are liars, manipulators, and con artists.
And, they are much more common that you would think.
UPDATE: Oh, and btw, there will always be those who, as Wretchard points out, can be counted upon to remain the bihag ng pagibig; the slave to love; and will continue to love and cover for the liar, the deceiver; the manipulator--no matter what evidence is provided or how many times reality hits them over the head.