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This article has been reviewed for accuracy by John Cottrell, Ph.D. in Clinical Psychology. Medical Disclaimer: The information and recommendations on our site do not constitute a medical consultation. See a certified medical professional for diagnosis.
Have you ever noticed yourself leaving a therapy session with certain things left unsaid or straight-up avoided? As it turns out, lying or omitting details to a therapist is more common than you may think. Does that mean your therapist is seeing through them?
A therapist cannot always tell if you are lying. Recent psychological studies suggest that most patient lies are unnoticed by therapists. Furthermore, these same studies indicate that patients often lie to their therapists, especially about therapy-related topics.
Read on to learn more about fabrications and omissions in therapy and what to do about them.
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- 1 Can Therapists Discern Lies From Truth?
- 2 How Often Do Patients Lie to Their Therapists?
- 3 Why Patients Lie
- 4 What To Do When You Find Yourself Lying to Your Therapist
- 5 Final Thoughts
- 6 Sources
Can Therapists Discern Lies From Truth?
Considering their background and training, one might assume that a therapist can easily catch a lie. However, that is not the case. Telling a lie from the truth is hard for pretty much anyone, even trained professionals.
For example, Gregory K. Moffatt, Ph.D., cites past studies that suggest that US Customs officers cannot detect low-stake lies unrelated to their profession. These kinds of lies include white lies like ‘having an ace in your pocket.’
Low-stake lies are harder to detect in general. After all, if one tells a lie at a low cost to themselves, the lack of urgency will prevent any clues in one’s body language. Let’s follow up with those US Customs officers. The lies they encounter cover up significant crimes, like drug-trafficking, that could lead to jail time. These kinds of lies are much harder to maintain.
However, how does this relate to therapy? Like any facet of human interaction, lying can occur in psychological treatment. However, the scale of these lies varies greatly. Some lies patients tell are lies of commission, otherwise known as straight-up fabrications. More often, patients lie by omission, leaving out essential details. Furthermore, the reasons patients lie vary in stakes.
All of these intricate details complicate how therapists handle lies, even when they notice them. For example, it is common for new patients to omit details because they do not feel comfortable sharing private information with someone they just met.
A therapist may overlook these lies and wait to address the topic until more trust gets established with the client. On the other hand, a patient’s lie may hide vital information that reveals imminent danger to themselves or others.
Considering how often patients lie in therapy, which we will address later on, and how much these lies vary, it is no surprise that many of them go over therapists’ heads.
Barry Farber, Ph.D., a professor at Columbia University, has studied the subject ostensibly. In his research, he found that 73% of respondents who have reported lying in therapy never had their lie addressed by their therapist. In other words, therapists are not great at detecting lies.
How Often Do Patients Lie to Their Therapists?
So, we know that lying in therapy is relatively ubiquitous, but just how standard is it? According to Farber’s study, 93% of respondents reported lying to their therapists.
Furthermore, 72.6% of the respondents reported lying about a therapy-related topic. These results led Farber and his co-authors to conclude that patients lie to their therapists much more than prior studies have suggested.
Why Patients Lie
What would drive patients to lie to their therapists so often? Considering the purpose of therapy and its strict terms of doctor-patient confidentiality, lying to a therapist seems very counterintuitive. However, there are many reasons patients feel driven to lie. Here are some of the most common:
Lack of Trust
Sometimes, patients cannot share certain information with a therapist, especially if the relationship is new.
Ellen Marks, Ph.D., an associate psychologist at the University of Wisconsin-Madison, discovered that clients often keep secrets from their therapists. Luckily, with time, it becomes easier to open up. If you still feel this way after a long relationship with a therapist, there may be a deeper issue.
Fear of Judgment
No one likes to feel judged. Even in a safe space like a therapist’s office, certain subjects may seem too taboo to mention. While working with Farber, Melanie Love, Ph.D., noticed that clients are motivated to lie to avoid shame and embarrassment, especially when it comes to sensitive topics like sex.
Fear of Consequences
This kind of anxiety can become a significant hurdle. It can also take many various forms. Matt Blanchard, Ph.D., notes patients suffering from suicidal ideations often diminish symptoms.
They fear being carted away to an inpatient facility, even though that kind of escalation is highly uncommon. However, there are other kinds of feared consequences as well:
- Another example provided by Farber is hiding substance abuse to avoid a clinical intervention or push rehab treatment.
- Moffatt notes a more unfortunate but standard omission among child patients. When sexual or physical abuse occurs at home, children are often reluctant to tell their therapist for fear of retribution from the abuser or transfer into the foster system.
Desiring the Therapist’s Approval
Are you familiar with that meme where a patient gives a joking response to a serious question? Then, the therapist replies, “no.” It turns out, whether directly or indirectly, that this points to a genuine patient concern.
Patients often feel pressure to answer what a therapist wants to hear rather than speaking truthfully. It can also be a denial tactic to prove that the therapy is working even when it is not.
Protection From Painful Feelings or Revelations
This reasoning can work in tandem with seeking the therapist’s approval. For example, maybe a patient wants to avoid coming off as a whiner. Blanchard acknowledges that patients fear that talking about a painful situation will make it more real or encompassing. Patients also worry that talking about a nerve-wracking situation will worsen their symptoms.
What To Do When You Find Yourself Lying to Your Therapist
It’s quite clear that lying to therapists is a common practice. In some cases, it is okay. For example, Farber notes that, in small doses, lying helps patients shape their narrative and sense of self. However, more consistent lying is a cause for concern.
Furthermore, your therapist probably does not know you are lying. This kind of deception will keep your therapist from being able to help you. Does this sound like you? Follow these steps to address the issue:
Ask Yourself Why You Are Lying
Diagnosing the problem is an excellent place to start. This step requires some self-reflection. Psychologist Aimee Daramus, PsyD., suggests asking yourself the following questions:
- Did the therapist do or say something that made you feel uncomfortable?
- Were you avoiding confrontation?
- Were you scared that you were doing therapy wrong?
- Most importantly, clinical psychologist Andrew Schwehm, Ph.D., believes you should ask, “Why don’t I feel safe?”
Address Areas of Discomfort With Your Therapist
As uncomfortable as it is, affirmative confrontation is a positive move in this situation. After all, if a therapist did something to inhibit your progress, they will be thankful that you told them.
Maybe they triggered you or broke a boundary, or perhaps you don’t feel ready to talk about a specific topic. A good therapist will gladly work with you to resolve the issue.
Find a New Therapist
Unfortunately, the last two steps may not work out the way you wish. If your therapist is less malleable to your concerns or you find yourself lying even after they make adjustments for you, it may be time to move on. Luckily, there are plenty of resources like Blahtherapy, BetterHelp, Talkspace, and many other alternatives.
In short, therapists cannot usually tell that you are lying. Even if they have studied tell-tale signs or have recognized patient populations more likely to lie, they are not infallible lie detectors.
Your therapist is still human and seeks to help you the best they can. Therefore, if you find yourself lying to your therapist, it is vital to ask yourself why and address the issue. Furthermore, take solace in the fact that you are not alone in dealing with this problem.
John Cottrell, Ph.D., is a yoga instructor and certified yoga therapist in Salt Lake City, Utah, USA. He has been teaching yoga since 2000. John is originally from Oakland, California, earning his Master of Science and Ph.D. from Pacific Graduate School of Psychology in Palo Alto, California. His clinical practice led him to child and adolescent psychotherapy, drug and alcohol treatment, psychological and neuropsychological testing, and group/couples therapy. John continues his devotion to sharing health and well-being through his business, mbody. He offers private and group yoga classes, yoga therapy, workshops, retreats, written yoga articles, and a men’s yoga clothing line.
- Psychology Today: How We Know You’re Lying
- Well+Good: Lying in therapy is common—here’s why and how to stop
- Taylor & Francis Online: Lying in psychotherapy: Why and what clients don’t tell their therapist about therapy and their relationship: Counselling Psychology Quarterly: Vol 29, No 1
- Counseling Today: Recognizing and managing deception in the therapeutic relationship.
- American Psychological Association: The truth about lies
- APA: Secrets in psychotherapy: For better or worse?
- Know Your Meme: Therapist: No