PREVIOUS : LIES & LYING – Intro (Part 1)

 

 

Clients LYING in THERAPY 
People lie to their therapist more often than we think & most are lies of omission. It’s not easy to admit that we act against core beliefs from our upbringing, or opposed to how we see ourself (a ‘good person’). We resist confessing that we do & say things that shatter social moral codes, dishonor our values, & that we’re self-destructive or hurtful to others.
EXP : “I didn’t think it was relevant that I had a drug problem. That was two years ago!” // “Uh, did I forget to mention that I ‘m having an affair?”
People in therapy lie about all kinds of things, & these are just a few. ► It’s understandable that someone will leave out important facts about a part of their life = because it makes them feel ‘safer’, less humiliated. So they offer just enough information to get emotional supported or validation. They may think to themself about a serious issue : “That part is better kept secret. I’ll take care of it myself. I’ll tell them just so much, so they can still help me without spilling it all…..”

Anyone who lies to their therapist is wasting time & money. Clients may believe lying by omission is a form of self-preservation, but if they say they want to heal & grow – it’s a huge handicap. At best, it’s a distraction, & at worst a manipulative deception that prolongs their anxiety & self-sabotage. It either drastically postpones valuable progress, or totally derails the therapeutic process.

BUT – if you feel judged, criticized or ridiculed, you’re in the wrong place. Find a new therapist. (Modified article by Karen Kleiman)

Therapeutic Lying
a. DOCTORS
If “therapeutic” – means the healing or curative powers for treatment of disease or disability and
if “lying’ is making a false statement with the intention to deceive,
then lying is not therapeutic.
Roswell Park Cancer Institute states: “If there’s one thing sacred in the doctor-patient relationship, it’s trust. Open & honest dialogue on both sides is critical for effective care.

Patients have to be truthful to ensure diagnostic accuracy & an appropriate treatment plan, while doctors need to provide full disclosure about their patient’s health – the good & the bad – to help patients make informed decisions. Indeed, patient autonomy is the cornerstone of modern medicine & patient-centered care.”

Exceptions – Caring for dementia patients is complex. Lies that reduce suffering & stress in patients – unable to fully appreciate the cause of distress – can be beneficial. Clinicians sanction their use in these cases & see them as ethical & non-malfeasant.

EXP : A caregiver may tell an argumentative patient with Alzheimer & hypertension, who is worrying about where his wife is, that “she’s gone to the store”, rather than that “she died 7 years ago.” Here, the lie avoids a possible fight that may cause a rise in blood pressure.

Other options : Instead of lying to a dementia patient, it may be possible to validate the person’s concerns. OR by Redirection – diverting their attention to something pleasant. (much MORE…..)

b. PSYCHOLOGISTS
An under-researched topic is therapist dishonesty. Ideally, they have to use professional judgment in deciding what’s relevant, appropriate, & helpful to a client – regarding what to say or not. At times therapists also conceal, exaggerate, or explicitly mis-represent. Curtis & Hart (2015) found that 96% of canvassed practitioners reported intentionally keeping information from clients “in order to protect” them, & 81% reported directly lying.
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However, when looking at this list – we can see there are appropriate & legitimate situations where no disclosure is best.
And when necessary – information is communicated fairly, yet indirectly/partially, without burdening the client or without lying.

✍️ Traditionally, classic psychoanalysis means the therapist stays objective & anonymous, preventing them from any self-disclosing.🧡 But as the practice of treatment has evolved, therapist self-disclosure is now seen as a possible tool to help clinician normalize a client’s humanness. Admitting fallibility & modeling open expression – when used in moderation – may strengthen the therapeutic relationship thus encouraging client disclosures.

Naturally, not all therapist self-disclosure is beneficial. It’s imperative to maintain professional boundaries & keep the focus on the client. But many clients do respond positively to examples that reveal & clarify their issues, as long as those aren’t too private to the therapist, nor being used to elicit help & support from the client.

NEXT : Types of Lying , #1