A few weeks ago, I wrote an article called “Why Would You Lie to Your Therapist?” that appears to have hit a nerve with clients and therapists alike.
The article questioned why — when you’re paying good money for a therapist — you would spend any time lying to them. It was an honest question that psychotherapists sometimes grapple with, especially after seeing a client for awhile and then finding out some really big or important piece of information the client hadn’t previously mentioned. (In many cases, the word “lie” may be implying intent where none exists. Omitting certain information, or simply being unaware of its importance, does not mean a person is intentionally untruthful.)
The responses to that article were both amazing and insightful, providing a plethora of reasons people don’t always fully disclose everything to their therapist. I want to thank my readers for the enlightening conversation. After analyzing the responses, I’ve compiled a list of the ten most common reasons people are not always truthful with their therapists.
The Reasons
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1. Painful or embarrassing information. Perhaps the most frequently cited reason also is the most obvious: Discussing an issue that is extremely emotionally painful, embarrassing, or shameful is just plain difficult to talk to anyone about. Humans are not intrinsically good at talking about embarrassing things about ourselves or about the way we feel or behave. We hide our shame and our pain from others, and it takes time and effort to go against years of doing so just because we start a psychotherapy relationship.
2. Didn’t know it was important; denial. Another common theme was that it’s not really a lie if a person doesn’t know the information is important or valuable to their progress in therapy. An issue the client believes is irrelevant to therapy may, in fact, be very relevant and important when it’s finally revealed. This may be due to the client’s lack of insight, but it also can be part of the problem itself — denial, delusional or false beliefs, or a cognitive distortion, where our minds have convinced us a particular thought is true when it’s not. The person seeking therapy simply may not know or recognize what the “truth” really is, or may not be ready for such a truth to be revealed to them.
3. My therapist will judge me. I caught a lot of flak for suggesting that therapists somehow were above judging their clients. Perhaps I was lost in my idealistic world of therapy professionals, but I still believe that good professionals try not to judge their clients. The fact is, judgment does happen, and sometimes therapists don’t always handle their judgmental attitudes or beliefs in a positive, therapeutic manner.
Some therapists do judge clients for what they tell them in therapy, or dismiss their concerns or emotional responses, and that’s a reason many people hold back in baring their souls in psychotherapy. Some therapists don’t listen when that’s their primary responsibility. Such therapist behavior can lead a person to feeling a lot worse about themselves, when therapy is intended to help a person feel better about themselves. A client often will clam up and stop being truthful (”Everything’s fine!”) because they’ve learned their current therapist simply isn’t going to help them.
4. My therapist will report me. Another common fear was of therapists’ status in most states as “mandated reporters.” If people are in danger of harming themselves, others, a senior citizen or a child, therapists must report such behaviors (and, left more to the therapist’s discretion, thoughts) to the appropriate state agency. Such reports then may become part of a central database, meaning clients could be branded for life with a tag such as “suicide risk” or “child abuser” regardless of whether it is a permanent condition. Although such concerns are relatively rare in the context of most people’s reasons for seeking out psychotherapy, it is a legitimate concern.
5. Trust and rapport with your therapist. The therapy process makes for a complex relationship, and one that takes both parties’ time, effort and energy to build. Without a strong rapport and solid trust, people often feel defensive and on guard in psychotherapy and may not share all that they could or should. Trust must be earned, a process that takes time and patience. Clients might withhold information until they felt that trust was in place. If a person doesn’t trust his or her therapist, they’re not going to be willing to share everything with him or her.
6. Lying as coping mechanism. Often, people learn to lie skillfully in order to avoid continued abuse or trauma. Undoing the common use of that coping mechanism will take time, even with a skilled and trusted therapist.
7. It just takes time. Many people pointed out that building that trust and rapport with one’s therapist just takes time. As human, social beings, we’ve learned to wear certain masks that aren’t always easy to let drop just because we should. The therapeutic process is a messy and complex one. Both therapist and client must take the time and make the effort to dig out the truth.
For some people, trust and rapport may not be enough. It may take a long time to be able to talk to a therapist about years of struggle with an experience. There are layers and layers of “truth” and a psychotherapeutic relationship can be both dynamic and complex.
The 10 Common Reasons People Deceive Their Therapists Continued
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8. Wanting to maintain a positive self-image. It’s hard to maintain our own sense of self or a positive self-image when we have to confront the more embarrassing or painful aspects of our life. There is research to suggest that sometimes clients hide information from therapists as attempts — sometimes unconscious — to construct desirable images for their therapist. Catharsis may be beneficial for clients in many instances, but the things that keep one’s self-image intact are even more important, even if it means not always sharing everything with our therapist. Sometimes we don’t see ourselves as the people we really are, and may be shocked at behaviors we can’t acknowledge to the therapist because we can’t even acknowledge them to ourselves.
- Fear of how others will perceive us
- Fear of what others will think of us
- Fear of what will be done with the information we share, or how it might someday be used against us
- Fear of what the therapist will think of us
- Fear of how others will judge us
- Fear of having our feelings or thoughts dismissed, of not being believed
- Fear of being in therapy for the first time and not really knowing what to expect
- Fear of being told we’re “crazy” or worthless, of being unloved and unlovable
- Fear of rejection
- Fear of the unknown
- Fear of change.
9. Transference and countertransference issues. Transference occurs when a client unconsciously redirects, or transfers, onto their therapist the feelings they have toward one or more important figures in their life. For instance, a client who grew up with an emotionally unavailable father may get angry at his or her older, male therapist for always being quiet and not saying much.
A client may lie to his or her therapist because the therapist represents another important individual to whom he or she also lies (usually for very good reasons, such as protecting him- or herself emotionally). He or she also may seek to impress the therapist as part of transference.
Countertransference is the same issue, except it’s the therapist who is unconsciously redirecting his or her feelings onto the client. Therapists who begin to act in an unexpected manner toward their clients may damage the foundation of therapeutic trust and rapport. Clients may stop being forthcoming with their own feelings in order to return to the previous therapist-client relationship.
10. Fear. A lot of the previous reasons can be boiled down to one big reason — Fear.
These are all legitimate and valid reasons for “lying” to your therapist. Others — such as intentional manipulation in order to obtain a specific diagnosis for disability reasons or prescription medication for pain relief reasons — are not covered here.
The truth is that psychotherapy is complex and challenges both the psychotherapist and the client to work outside their comfort zone. Change and progress takes effort, and that sometimes means not always being entirely truthful with a professional. But it also means challenging ourselves to try, even when it doesn’t feel natural or easy.
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Links to This Article
From Psych Central's World of Psychology:
Why Would You Lie to Your Therapist? - World of Psychology (2/6/2008)
Webbtips: Därför ljuger människor för sin terapeut « WeMind (2/12/2008)
10 Reasons We Lie to Our Therapists — Anxiety, Panic & Health (8/18/2008)
Honesty in Therapy « sanity is knocking (5/2/2009)
26 Comments to
“10 Common Reasons to Lie to Your Therapist”
I definately agree that the reason one lies or leaves out pertinent information is to maintain a good image of oneself to the therapist. It’s hard to say, “Guess what other horible thing I did, or my significant other did to me and put up with it… etc.”
If you ever have to get a government security clearance, you might want to lie to your therapist. To get the clearance, you need to disclose all your medical records. I don’t want uncle Sam knowing I smoked a little kief in college. Some folks don’t want uncle to know they’re sexual orientation either. These shouldn’t disqualify you, but it makes for a drawn-out senseless issue. But, then again, uncle Sam just wants to know if you lie.
Why does our past have to haunt us for so long? That alone is psychologically damaging.
“Your therapist won’t judge you, …”
You’ve obviously haven’t dealt with having a personality disorder on your record.
“All they will do is use it to find a way to better help you and help you move forward.”
It’s more moving you back to the waiting list. There are more deserving patients.
Holding back certain information is necessary at times just to get care for a larger and more immediate problem.
I am very glad that you did this follow up article as I find it still very useful. I think lying is just a natural part to who we are. We all will and in a sense have to with hold certain information. If we all walked around an open book, well nothing would be the same. While a therapist is someone you are supposed to be an open book to, it still takes time to turn and read the pages. They key is time (then when you feel it won’t work switch) but with holding/lying will all resolve its self in time.
Thank you for the follow-up article.
I have a follow-up question: under what circumstances might a therapist lie to a client?
I agree with Katherine Kruska. I think part of the process from the point of view of the patient is also the need for approval. Much concealing or outright lying could be done for selfsteem reasons, even when there’s no unconcious denial.
adrivahni, I don’t know… That’s a good question though. Some ideas that come to mind might be to (a) protect the client from an insight or information they have that they believe the client may not yet be ready to hear (e.g., will likely cause the client more harm than benefit); (b) about aspects of their personal life (some therapists may find it easier to lie, omit, or give a generalization about some aspect of their life rather than give truthful details, which is what some therapists have been trained to do).
I’m sure there are others…
I like this follow up article a lot. I think one of the most important aspects of trust in the therapy relationship is the personality of both client and therapist.
The second most important is the therapist’s ego. Can he/she refer someone out when they really don’t have the skills to help them? Sometimes I think psychologists who are traditionally CBT and short term therapists see a challenging ‘case’ and take it on (ego talking)…they can do more harm than good in this respect.
Can he/she discuss counter-transference responses as part of therapy? One of the big reasons that I couldn’t fully trust my therapist is because I would experience reactions from him sometimes.
I felt both the positive and negative reactions. When it was positive he would validate my thoughts when it was negative, about 99.9% of the time he tells me I have it wrong or he would say perhaps he was having a bad day etc.
He is getting better at this. It has hurt my progress at times and I am getting better at calling him on it so we can talk about it.
Lastly, I think therapists often think they are providing a safe environment but some who have personality issues etc. need more than one session per week or other contact here and there.
I have been amazed at the blatant abandonment of some therapists. You see this when there is a suicide attempt or hospitalization that could’ve been avoided if the T took the darn phone call or called back.
There is a way to construct ‘contact’ so that it is appropriate and helpful to both therapist and client. Many are so stuck in their theoretical orientation/ego or counter-transference that they hurt their clients.
Lie to my so-called “therapist”? Of course I lied to her. Twenty-nine years ago I was involuntarily committed to a psychiatric hospital after a suicide attempt which resulted in a cardiac arrest. I was assigned to a psychiatric nurse for one-on-one therapy. Being a naive 25 year-old I innocently began to describe the isolation, poverty, and post traumatic stress syndrome which made my life a nightmare. She responded by shouting, “BULLSHIT, BULLSHIT, BULLSHIT! Realizing I wasn’t going to be released unless I fulfilled her needs I made up a story about having a boyfriend who died of Hodgkin’s Disease after I encouraged him to delay seeking treatment so we could go on vacation together. What else could I do? She was the therapist and I was the psychiatric patient. Who would take my word over hers? As mentioned, this was twenty-nine years ago. If I ran into her today and she was choking I would say to her, “I know how to do a heminlich maneuver but I’m not doing one on you. The world would be a better place without you. I’m going to savor your death.” And then I would.
Elizabeth’s is a fantastic posting.
Doing pseudo-therapy to escape an abusive therapist is called LaChancing.
I was a secretary on an inpatient psychiatric unit and there was a psychiatric social worker whom I could hear through the thin partition separating our office screaming insults at patients. The patients described her as an “emotional rapist.” Eventually they got together and began warning new patients to the floor that this woman was out-of-control and abusive. They told the new patients what to say to her so they wouldn’t set her off and so they could get released as quickly as possible. Eventually one patient smuggled a small tape recorder into a session, recorded the abuse, and got her fired. I wish I’d had to courage to speak up, but I needed the job.
I have lied to my therapist about suicidal thoughts. But I didn’t have a plan or intent. Then if I did, I might not tell her because I work in the field and wouldn’t want to be an in-patient in this county. I would tell my best friend though.
Why do people lie to their therapists?
Therapists!!!
How about dental hygenists?
The joke in the office for decades and recently on TV goes as follows: “I go to an out-of-town dentist to have my teeth cleaned before I go for my scheduled appointment with my dentist’s hygenist. I can’t stand her disapproving question, ‘Have you been flossing regularly?’”
Insurance companies have the right to read notes taken by our doctors. Refusal by therapists to let insurers read our records could lead to denial of claims or could cause difficulty in obtaining life insurance or car insurance, security clearances and etc. It is safer to leave somethings unsaid. I do not want an insurer knowing things about me that only my therapist needs to know. The insurer’s concern is not my good but their profit. Thanks for writing the articles.
There’s another reason I don’t seem to ever hear much about: withholding significant information for fear that your therapist can’t handle it. It’s almost like trying to protect your therapist. I know it sounds really strange. What do you call that?
Good article!
Some of the readers’ comments are understandable about the legitimacy of needing to lie regarding certain things in order to protect themselves (such as sexual/gender issues and government jobs, Axis 2 issues, and abusive therapists).
My only beef would be to suggest instead of, “These are all legitimate and valid reasons for “lying” to your therapist.” to say “These are UNDERSTANDABLE reasons…” Some of the reasons cited would actually be goals/targets to be addressed in therapy such as building rapport and addressing maladaptive coping strategies such as denial, habitual lying, etc. Thus, they would not, by definition, legitimate or valid reasons in the long run.
Therapists are human and often very flawed, which may be the main reason they studied psychology in the first place. Psychiatrists (also therapists) are trained to drug patients and often do not “listen” for the truth which patients may be entirely oblivious to. Emotional honesty is not alwyas available to the patient or the therapist. Simply because someone has a degree and is called a therapist does not mean they are paragons on mental health themselves and often can be very abusive, dishonest and have hidden agenda’s regarding the manner in which they treat their patients.
Transference goes two ways and sadly, more often than not, the therapist reacts (or over-reacts) to their patients as often as the patient has transference issues with the therapist.
Back in teh 1970’s I was a student of pshychoanalysis and attended the 27th International Psychoanalytic Congress in Vienna where I was priveleged to meet many of the worlds top psyhoanalysts and with the exception of Anna Freud (sigmund’s daughter) and Erick Erickson (who was in fact an artist and only inadvertently fell into the role of psychoanalyst as contemporary with Freud, Jung and Adler) the mind set of most of the others was frighteningly void of emotional honesty and lacking the ability to see the trust, even when it was presented to them.
The result of that conference was that I returned to the states and hastily changed direction and became a journalist instead, where truth telling was also revered but more often a fact.
People’s lives have been virtually destroyed by mis-diagnoses, improper and hastily given lables which follow them their entire lives and are virtually impossible to expunge from the medical records even in the face of retrospective evidence of the impropriety of the diagnostic label.
One patient I interviewed had been diagnosed as paranoid and schizoid at the age of 16 by a “therapist” who was being paid by her parents. One of her parents had a hidden agenda and lied to the therapist to use that therapist to create dissidence between father and daughter, because of her own need to have an exclusive relationship with her new husband, absent interference from her new husband’s daughter, who was more easily able to see through this woman’s manipulative and saccharine nature.
There result was that the daughter was drugged, labeled and for the next 20 years bounced in and out of therapists offices, mental hospitals and virtually lost most (of not all of her life) to these misdiagnoses; suffered from life long iatrogenic disorders (those created by improper medical treatment, inasmuch as the psychotropic drugs destroyed her liver, kidneys and digestive tract) and only after finally divorcing herself from the therapists and pshyciatric profession, began to recover.
30 years later, this same step mother tried to have the daughter declared mentally incompetent in a probate court in order to take off with her husbands estate and deprive the daughter (who was named as principal beneficiary of her father’s estate) of her inheritance. At this time she was examined by an impartial psychiatric team . The Step mother was found to have had “early dimentia” (in other words it was the step mother who was nuts) and the daughter was found devoid of any evidence of paranoia or schizoid features (which only get worse with age, if they are present at all).
No amount of letters and dianostic test results were able to convince the original “therapist” to change his diagnosis and clear this poor daughter’s medical record so she would not have to be burdened with this incorrect label for the rest of her life.
WHY SHOULD THERAPISTS BE TRUSTED WHEN THE ROUTINELY ABUSE THEIR POWER? …should be the titled of your next article.
There is a book called TOXIC PSYCHIATRY, a must read for anyone who is contemplating getting psychiatric treatment or engaging in any contract with a therapist.
Talking to a complete stranger is safer!
One other woman I interviewed was having trouble sleeping and her primary care physician prescrived AMBIEN (the same drug that sent Patrick Kennedy off “sleep driving”.
This woman had the same reaction to Ambien. Was never counselled not to drink after taking it. Had gone to a christmas party and had a few sips of wine and then went home and tok her AMBIEN, only to find herself committed to a psychiatric ward a few days later when she awaoke from a coma, and labeled with a BORDERLINE PERSONALITY DISORDER and counselled to got AA meetings, when this woman was not a substance abuser, rarely drank, never used street drugs and had the “therapists” and psyciatrists believed her when she was telling the truth, they might have discovered the truth 9which is not known), that AMBIEN causes certain people to have very weird reactions and should never be taken before or after ingesting any alcohol.
There are many natural treatment for those symptoms labeled as psychiatric disorders. Some involve dramatic change of diet, use of supplements and use of homeopathic treatment.
Many labeled as manic depressive; or who suffer from depression, auditory hallucinations, or Obscessive compulsive disorders can divest themselves of all symptoms within weeks or months of homeopathic treatment and some dietary changes.
Sugar Blues was the title of a book written years ago, and documented that ingestion of too much sugar (refined carbohydrate) can cause major depression. It has also bee documented that food coloring and additives can cause “psyhciatric” symptoms.
Advers reactions to vaccines can and do cused OCD symptoms which can be relived by homeopathic remedies that are used to treat “vaccinosis”, which is a condition that results from impure vaccines and adverse reactions to them.
In short, the entire field of PSYCHO-THERAPY and PSYCHIATRY need to be seriously revamped, more closely monitored so that people who naively seek help and treatment for conditions that cause extreme psychic distress and human suffering of the worst kind, are not abused by the profession.
After what I have seen (having worked in several psychiatric hospitals), if I were forced to seek therapy or put in any of those institutions, I would lie in a NY minute.
If you are troubled, talk to a friend; learn about the effects that certain foods have on your moods; get counselling by a minister or priest; seek homeopathic or naturopathic treatment first and start to take responsibility for your own mental health. Copping out to empowering a “therapist” to make you get honest with yourself, can be a devestating and losing battle.
If you don’t have any friends, talk to a complete stranager, it’s a lot safer.
My inner child wishes to post this comment:
The Chronicles of Narnia are not just great fiction stories, but filled with symbolism of an initiatory experience, a spiritual evolution that takes place within those of Indo-European origin. This is part of their heritage, their birthright, part of who they are. How long will the field of Psychiatry rob these complex, gifted individuals of their Narnia experiences by doping them up and labeling them as Schitzophrenics?
I don’t lie to my therapist or one I saw when I was really sick. there have been some that I have withheld info from and some I quit seeing because they were frauds who just wanted me to change my spiritual beliefs. I resent that I was labeled BPD, when I needed help to cope with fear, legit fear; to talk about where it came from. I had a pastor who helped with that and many other issues. I was accused of being a hypochondriac because I followed the nurse’s orders to tell about side effects of my meds. I was accused of being disruptive when I came to the defense of another in-patient, and of having a bad attitude. I was just trying to get well.
In the past, I have lied to my therapist at times when we were getting close to issues that felt too scary to deal with. I would often admit that I lied later in the session, usually when there was less than five minutes left and I knew I wouldn’t have to deal with the emotions. Of course at the beginning of the next session he’d bring up the topic so my lying was really just a delaying tactic. This terrific man knew that and never accused me of anything, just used his gentle, persistent questions to make me think about what I was doing, why I was lying, and better alternatives. Today, I can just say whether talking about something makes me uncomfortable, uneasy, or even scared, which now I know that for me this is a signal that something needs to be dealt with rather than avoided.
Reading this article has been extremely painful for me. After 10 years of Therapist/psychiatrists I am at the point of weaning myself slowly from all meds. From working two jobs to becoming an anxiety/depressed ridden SAHM mom from the effects of past/present treatment. My first doctor was aloofed,abusive,made fun of me when I was losing weight(looked anorexic) and he joked if I was lifting weights,called him for emergencies when I was pregnant and depressed no referral for a doctor what so ever. He responded a month later after my son was born and denied receiving my phone messages. later on he started to comment on the fact that I was going to get plastic surgery and I asked a basic question in terms of medical interaction and his response was that “I love breasts”. A week later I confronted him and asked for a referral and he gave a piece a paper he began to play with my wedding ring and got up sat next to me and unzipped his pants then he moved against the wall and he did the same thing. I walked out and reported this to the hospital and their response was It was my fault and that I needed to seek help.
I asked for a copy of my medical records which took three years to get a response a sheet of paper(harmful for me to see it) god know what kind of garbage in it.
following doctors.
2-one would let the receptionist just the whole pile of Pt. files.
3-spent an hour of consultation was trying to charge for 2 sessions. got only one.
4-Was okay until I told her that I wasn’t feeling well on wellbutrin and instead of reducing it she told me to off of it completely. I became very sick and told her “goodbye”.
5-recent doctor on vacation and don’t have 11 days of klonopin to get me through.
I studied to become a CASAC but my experiences have totally discouraged me from MH field.
i agree these r resonz 2 lie 2 ur therapist. . like my therapist 4 instantz he iz older an male. . wich scares the shit outta me. . .cuzz of sumthing that im trying 2 get ovr. an he turnz my wordz. if i were 2 say im ahppy then he wud ask me how i feel bout my parentz an id say im angry with them then he wud say didnt u just say ur happy. . .itz annoying. an i try 2 hide all my secretz an feelingz from him i dnt trust him an i dnt no wat wud hapen if he evr new. . O.O my dirty secretz.
Yes, lie to my therapist? Always I’ve never had a therapist I thought i could trust.
The purpose of therapy is to get help with one’s problems. Without full disclosure of what is bothering you, the therapist doesn’t have a complete picture of you and cannot possibly offer any relevant help.
I have always trusted my therapists, especially the last one I had. I couldn’t imagine lying because, how would that help ME?
I guess I have faith in their descretion. If they are to help me, I have to trust them as much as they have to trust me.
If you don’t have an open mindset, then you’re doomed to fail from the get-go.
Glad I read the recent commenting box to see what people commented on, or else I doubt I would have found this post.
One important point: in the end, if you as the patient lie to the therapist, you only diminish the value of the treatment. I respect trust is earned and truth can be incredibly painful to face and share, BUT, in the end, honesty and directness are the cornerstones to healthy choices and goals.
We all have lied. But, can we live with them?
Here are 2 more reasons that patients might lie to you:
1. A minor might omit things because they have a significantly reduced right to privacy and confidentiality which they are required to be informed of at the start of therapy (if you’re a danger to yourself or others, or someone is hurting you, then we need to tell your mom).
2. Fear of not being taken seriously, being dismissed or being mocked-particularly if this person has a history of negative relationships with medical doctors.
It sounds like most of you need to get a damn good therapist ! It is entirely counter-productive to lie or omit anything with your therapist, not to mention a total waste of money.
I can honestly say I have NEVER lied to my therapist(s) and I tell them that up-front, so that they won’t be surprised with the stuff I come out with which is often ‘inappropriate’. And believe me there is a whole lot of nasty, criminal and distasteful stuff in my past that comes out.
Interview your therapist on the first visit - if they are not smarter than you, it may be tempting to run rings around them - this even happens unconsciously. My partner even brags about the fact that he manipulates his therapist at will ! What a waste of everyone’s time and money.
If your find your therapist judging you or trying to change your beliefs, MOVE ON !
My therapist, whatever weird (to him) stuff I come out with, says “I respect your personal choice to live this way…” before suggesting ways to improve things, get out of that cycle or whatever it may be. He has never criticized me or judged me - it is not their job.
If my therapist was like most people’s that I am reading here - judgmental, can’t handle it, unable to provide adequate help, dismissive of my problems - I would ditch him in a heartbeat.
I am sorry so many people cannot find a good therapist. I feel lucky to have mine. I wish you all the benefit of a great therapist in the future.
PS. I pay privately for my therapy so 1. my insurance co don’t slap a mental health label on me 2. I can give whatever name I like and Uncle Sam is none the wiser (for those of you who fear having to submit all medical records).
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Last reviewed: By John M. Grohol, Psy.D. on 6 Feb 2008
