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The Many Things People Lie to Therapists About

Denying how badly they feel, lying about sexual desires, and more.

Key points

  • The vast majority of therapy clients—as many as 93 percent, according to one study—lie to their therapist at least occasionally, research finds.
  • Common lies include minimizing the severity of problems, pretending to be more positive or hopeful than was accurate, or concealing past regrets.
  • Sexual thoughts or problems were often the subject of long-term, ongoing deception.
Source: Fizkes/Shutterstock

Before I turned my attention to the study of single people, I did research on the psychology of lying and detecting lies. In a pair of studies, my colleagues and I asked 77 college students and 70 people from the community to keep track of every lie they told every day for a week. They also kept a record of all of their social interactions, because each social interaction represented an opportunity to lie.

The first report from that research was published in 1996. Untold numbers of scholars from many different disciplines had written about lying before then, but these studies provided some of the first, and by far the most extensive, data up to that point on some of the most fundamental questions about liars and their lies. The questions included, for example: Does everyone lie? How often do people lie? What do they lie about?

We found that lying was utterly commonplace. Over the course of the week, 99 percent of the college students and 91 percent of the people from the community told at least one lie.

Our studies were about lying in everyday life, where perhaps a certain amount of deceit is to be expected. But there is one context in which honesty and openness are supposed to prevail. It should be a safe place where people can be totally truthful, even about their most shameful secrets, and still feel accepted. Their honesty should provide their path to healing.

I’m talking, of course, about psychotherapy. What I described is the ideal. But is it really true? How honest are people, really, in what they say—or don’t say—to their therapists?

In their new book, Secrets and Lies in Psychotherapy, Barry A. Farber, Matt Blanchard, and Melanie Love provide the most comprehensive answers to those kinds of questions that we have ever seen. Across two studies, 1,345 psychotherapy clients described the lies they've told to their therapists. In one of the studies, they also came clean about the topics they systematically avoided during therapy.

How the Studies Were Conducted and Who Participated

In the first study, 547 psychotherapy clients were shown a list of 58 topics and asked, for each one, if they had ever lied about it to their therapist.

In the second study, the researchers wanted to go beyond lies that may have been told just once and look at deception that occurred more routinely. They asked 798 therapy clients if they had ever discussed any of 33 topics. If they said yes, they were asked how honest they are when discussing those topics. The clients who reported being not at all honest or just a little honest were categorized as engaging in ongoing dishonesty. If they said no, they had not discussed the topic with their therapist and explained that they tried to avoid that topic, they were also categorized as engaging in ongoing dishonesty, but in a more passive way.

All clients answered the questions online. Study 1 participants were recruited from 13 large metropolitan areas in the U.S., using Craigslist volunteer opportunity sites. For Study 2, 28 smaller cities and rural areas were added. Across both studies, participants ranged in age from 18 to 80. As is generally true for people who use mental health services, the clients in the two studies were disproportionately female (78 percent), white (76 percent), and well-educated (57 percent had a college degree).

The Findings

How many clients lie to their therapist?

Asked whether they had ever lied to their therapist about each of 58 topics, the vast majority of the 547 Study 1 participants admitted to lying about at least one of the topics. The percentage was similar to what my colleagues and I found in our studies of lying in everyday life: 93 percent of the clients told at least one lie to their therapist. Six percent lied about 20 or more of the 58 topics. The biggest liar lied about 39 of the 58 topics.

Study 2 was about ongoing lying and avoidance, rather than just one-time lies, so it would make sense to find lower rates of deception. But they weren’t that much lower. Eighty-four percent of the clients, on an ongoing basis, lied or avoided discussing at least one topic.

What topics did clients lie about most often? (Study 1)

Of the 58 topics that clients were asked about in Study 1, only one of them was a topic that more than half of the clients lied about at least once. Fifty-four percent of them lied about how bad they really felt—and they minimized those feelings. People presumably go into therapy because they are feeling bad, and they want to feel better, yet more than half of therapy clients downplay just how bad they are feeling.

The topic that clients lied about second most often was similar: 39 percent minimized the severity of their symptoms.

Were you expecting lies about sex to top the list? “My sexual history” only ranks as #12, with 22 percent lying about that at least once. Sexual fantasies and desires come in at #16, with 17 percent of the clients lying about those.

Here are the topics about which at least 15 percent of the clients told lies:

  1. How badly I feel—I minimized, 54 percent
  2. The severity of my symptoms—I minimized, 39 percent
  3. My thoughts about suicide, 31 percent
  4. My insecurities and doubts about myself, 31 percent
  5. Pretending to like my therapist’s comments or suggestions, 29 percent
  6. My use of drugs or alcohol, 29 percent
  7. Why I missed appointments or was late, 29 percent
  8. Pretending to find therapy more effective than I do, 29 percent
  9. Pretending to be more hopeful than I really am, 27 percent
  10. Things I have done that I regret, 26 percent
  11. Pretending I did homework or took other actions suggested by my therapist, 26 percent
  12. My sexual history, 22 percent
  13. My eating habits, 21 percent
  14. My real opinion of my therapist, 18 percent
  15. My feelings about my body, 18 percent
  16. My sexual fantasies or desires, 17 percent
  17. Not saying that I want to end therapy, 16 percent
  18. Self-harm I have done (cutting, etc.), 16 percent
  19. What I really want for myself, 15 percent
  20. Things I have done that were illegal, 15 percent
  21. Things my parents did that affected me, 15 percent

Ongoing deception: What topics did clients lie about more routinely? (Study 2)

When it comes to matters of ongoing deception, the topic of sex moves to the top of the list. More clients routinely deceived their therapists about their sexual desires or fantasies (34 percent) than about any other topic. Thirty of the 34 percent deliberately avoided the topic.

The other topic about sex, “details of my sex life,” came in a very close second. Thirty-three percent routinely deceived their therapists about that. Again, most of them (26 percent) purposefully evaded the topic.

Here are the topics about which at least 15 percent of the clients engaged in ongoing deception:

  1. My sexual desires or fantasies, 34 percent
  2. Details of my sex life, 33 percent
  3. Suicidal thoughts, 21 percent
  4. My real reactions to my therapist’s comments, 20 percent
  5. My sexual orientation, 17 percent
  6. Times I treated others poorly, 16 percent
  7. Secrets in my family, 16 percent
  8. Whether therapy is helping me, 16 percent
  9. Trauma or abuse experience, 15 percent

What I’ve shared here is just a taste of what Secrets and Lies in Psychotherapy has to offer. You can also read about clients’ motives for lying, how the clients felt about their lies, whether they thought their therapists realized they were lying, and what it would take for them to be more honest. There is also a chapter on therapists and the lies they tell to their clients. Secrets and Lies is an academic book, but you don’t have to be a scholar to find it fascinating.

Check Psychology Today's directory of therapists to find a professional near you.

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