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.
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
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.
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.
- 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.
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.