People lie while lying on the couch. It happens all the time. You’ve done it. I’ve done it. Nearly everyone has some sofa subterfuge on their therapy resume.
You spend money, time, and emotional energy on therapy. So why lie? Doesn't deception or omission mean that you’re avoiding your issues, which prevents you from reaching your goals? Why lie about the very problems you’re trying to treat? Would you take your car to a mechanic and lie about the banging noises coming from the engine? No; you'd talk about the problem because you know that leads to the cure.
Therapists are professional secret keepers, legally bound (in most cases) to keep your information confidential, and they should have the training and personal therapy to keep their personal judgments in check. Therapists work to create a “safe space” for clients to talk about whatever they want. And regardless of what the therapist thinks or does, you want to get help for your issues, right? Doesn’t it make sense to be completely honest with your therapist? Isn't a lie a waste of your time and money?
Yes, but we still lie. I thought about writing a “stop lying to your therapist” post, but that's been done before, and it’s also common sense. Instead, I want to dive into why we do it. Researchers actually study this topic, including Matt Blanchard, Barry Farber and their “Lying Lab” at Teachers College, Columbia University. Yes, there's a lying lab. And there's a crew of Ivy League doctoral researchers thinking about why you lie in therapy: Look for their book Lies and Secrets in Psychotherapy (written with Melanie Love) sometime next year. They’ve broken down the Freudian Fib to an exacting degree, with surprising findings.
Blanchard, the lead author, shared some of his findings with us.
RH: We know that lying is common in therapy, but how common is it?
MB: Our results suggest it is very common. Our first study of 547 therapy clients found 93 percent could recall specific topics about which they have lied to their therapist in the past. This might involve denying suicidal thoughts, hiding drug use, concealing criminal acts, or downplaying the extent of their emotional suffering. We found it particularly interesting that 72.6 percent reported lying about therapy itself: Pretending to like their therapist’s comments, or pretending to find therapy more helpful than they really do.
To replicate these results, we launched a second study, flipping the wording to ask how “honest” clients felt they were in their current therapy. In this condition, 84 percent of around 800 respondents reported current dishonesty on a relevant topic.
RH: That’s a lot more than I thought. There are many different types of lying, from white lies to major deception—how did you define lying?
MB: There has been great work on specific types of lies (e.g. secrets), but we felt strongly that the techniques of dishonesty—from total concealment to outright fabrication—were less interesting than the underlying decision to be dishonest. Our definition of lying is pinned to the client’s felt sense of having been deceptive. We stick to simple terms like “lying” and “honesty” in our research in order to tap into that felt sense of deception.
With that in mind, we did find trends in the techniques used to be dishonest. Omission is about 3.5 times more likely than fabrication. Similarly, clients report minimizing the truth about 6 times more commonly than they report exaggerating.
RH: Were there any factors that seemed to make some clients more likely to lie than others?
MB: We were interested to see that most demographic factors—gender, ethnicity, education, income—had no relationship to dishonesty in therapy. Nor did the same factors in the therapist, or the client-therapist match. Only two significant predictors stood out—age and alliance. In both studies, younger clients reported more lying. Those who lied about one or more topics were on average 4-to-7 years younger than those who reported total honesty. This finding matches findings about lying in everyday life outside of therapy, too. A second factor was therapeutic alliance, with more dishonesty happening when the bond between client and clinician is felt to be weaker.
RH: If people come to therapy to seek help, why would they lie?
MB: Most commonly, clients lie to avoid the shame and embarrassment they feel even in the confidential, protected space of the therapy room. Clients also report lying to avoid a distracting topic they believe will take the therapy off track. But we find that motive varies dramatically by topic. For example, when clients lie about therapy, it’s generally to avoid upsetting the therapist. When they lie about suicidal thoughts, it is almost universally to avoid tangible repercussions, like being sent to a psychiatric hospital.
RH: If lying is so common and yet people still seem to get better with therapy, do we really need to address this?
MB: Good question. And the answer is yes. We study dishonesty not in order to end dishonesty, but in order to learn how to better foster honesty for our clients. We find that clients want to discuss the important, shameful secrets of their lives, but they need our help. This can be quite simple. For example, clients concealing suicidality report exaggerated fears of being locked up the moment they mention it. In this case, a simple explanation of the real triggers for hospitalization could free up the client to honestly discuss these painful feelings.
RH: How might therapists begin to work on this issue with their clients?
MB: One of the last questions we ask clients is: “How could your therapist help you be more honest?” We imagined that clients would want more warmth or skill from their therapist, or to know their therapist shared their problems, or understood their culture or class. On the contrary, the dominant response was, “If my therapist asked me directly.” So one simple takeaway from our work is: Just ask.
There you have it. Lying happens all the time in therapy, and therapists can help thwart it by asking direct questions. You can probably do some of the work yourself by asking yourself, “What do I really need to talk about today?” Then commit to talking about it. You could lie or hide—that's your choice—but then don't expect a major transformation. If you need some extra help, take a look at "21 Tips for Clients in Therapy."