Why Do Patients Lie to Their Therapists?
The therapist must build a trusting relationship with the client, provide a safe space for the client to share their thoughts and feelings, and assist the client in their emotional and cognitive remediation in a non-judgmental way.
For the client, they must show up to appointments, communicate honestly with their therapist what is going on, and maintain an open mind when their therapist gives them suggestions and strategies to apply.
Fear of “What Others Will Think”
Therapy is a scary process as people have to come to terms with painful and embarrassing truths and experiences. The thought of sharing these experiences with someone else could be social suicide. Many people struggle to tell the truth when an event is incriminating in some sort of way.
A client may interpret when a therapist brings into a light a personal issue as being judgmental. For example, a client enacts the same destructive behavior in their work life. They often have hostile relationships with coworkers. They tell you about a situation at work with a coworker, where they appear to be at fault. Consciously or subconsciously, they know they are at fault. You start to bring into light their contribution to the problem, but your client feels like you are blaming them. They feel guilty, and start to avoid discussing work relationships all together.
A way to address the topic of shame with your client is to reassure them that your office is a safe space: they can share their emotions and thoughts with you without fear of judgment. This reassurance may work faster with some clients than others. Continuing to make the client aware that they are free to share what they wish with you and that they are in a safe space can help maintain honesty.
Facing Denial or Lying to Oneself
Have you ever had a problem and pretended it wasn’t there? Many people have.
Sometimes, a life situation can be too painful to acknowledge. As a protective mechanism, people can create an alternate truth that is easier to digest rather than face the reality of a situation. As a therapist, hearing your patient experience denial can be quite frustrating. Remember that this is a coping mechanism: it may take time for your patient to really acknowledge what is happening.
They Can’t Connect the Dots
Processing and synthesizing information from devastating experiences takes time and skill. Clients may not have fully processed an event, which can cause them not to share or to give disconnected details. Time is the biggest aid with this problem, but taking detailed notes and looking for patterns may help address scattered or lost pieces of information.
What Do You Do?
If you have been working with your patient and notice some inconsistent trends, it may be wise to lightly tap into them. You can bring up examples from your notes, and ask more questions about an experience or situation your patient has told you about that you feel is related to your current session. Never use language that can be interpreted as shameful. Assure your patient you want to understand them so you can offer the best help. Always ensure that the therapeutic environment you create is a safe place for them to share their life struggles and confide in you.