If you go to a mechanic, you tell the truth about what’s wrong with your car. When you go to the dentist, you’re clear about which tooth hurts.
But truth can be tougher with a therapist, notes psychologist John M. Grohol, in an essay on the PsychCentral Web site. Unlike aches and pains, the information you deliver to a therapist often involves your innermost thoughts and feelings or behavior you may not be proud of. Just as patients sometimes find it tough to disclose embarrassing personal health issues to a physician, patients also worry about confiding with their therapists, he notes.
“We’re embarrassed by what we need to say, and feel the doctor might pass some sort of judgment on us,” said Dr. Grohol. “Whether it’s a rational fear or not doesn’t really matter, does it? One of the reasons many people seek out psychotherapy in the first place is to help combat irrational thoughts and fears, so in that context, it makes sense many of us share this fear of being judged or embarrassed.”
If you do nothing else in therapy, says Dr. Grohol, learn to tell the truth.
“Your therapist won’t judge you, and they won’t be embarrassed by what you tell them,” he writes. “They won’t criticize you for not sharing this information with them sooner. All they will do is use it to find a way to better help you and help you move forward.”
For the full essay, click here.
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From 1 to 25 of 127 Comments
As a psychologist, I have not found that my patients lied, but they may omit painful or embarrassing matters for a while, or bring the issue up when the hand is on the doorknob at the very end of the session, in a by-the-way, offhand manner of presenting it.
— JulieSeeking the therapist’s approval is often more important to the patient than getting well.
— MARK KLEIN, M.D.Dr. Grohol’s essay is little more than a statement of personal opinion.
— L.M.There was no comprehensive study done to assess the validity of the nature of Dr. Grohol’s observations. Though he presents an intriguing problem, he does not cite any veritable evidence (case reports, writings from others in his field, etc) to support his claims, just his own anecdotes from his experience that are presented in such a casual way that they undermine the seriousness of the question at hand.
I also think that the tone of Dr. Grohol’s essay leans towards “blaming” the client, which tends to be a big no-no in the practicing of psychology, particularly by those psychologists that possess a PsyD, as Dr. Grohol does, which has a more empathic, person-centered approach in its clinical training.
Dr. Grohol seems to take on a stance of superiority in his essay, almost bragging about the honesty his upholds with his own health providers (he always tells his “nice French doctor” about what ails him, etc). This attitude of superiority completely undermines the important work that psychologists and mental-health workers do, and is not reflective of how many people in the field approach their work.
Though lying to a therpist indeed undermines progession of the emotional healing process, taking on an accusatory tone and posing conjectures without veritable evidence to support them is equally destructive to the therapist-client relationship.
Lying isn’t about patients not wanting their therapists to know something about them. Patients often ‘lie’ to their therapist because telling the truth out loud makes denial to *themselves* impossible. To admit something to another means affirming its reality to oneself. And therein, as they say, lies the rub . . .
— MIchael M. Gindi Ph.D.Michael M. Gindi Ph.D.
Psychologist Deal, NJ
As a clinical psychiatrist who had a large and diverse practice for many years, specializing in psychodynamic psychotherapy, I can certify that patients lie to their therapist and that they also lie to themselves. Not only the most obvious are liars, like substance abusers, but most people are hesitant to admit to some aspects of their inner and outer lives.
— R.P.Part of healing, indeed, is overcoming this deception.
But the fleshis weak.
The truth indeed shall set you free, but the flesh is weak.
Hard to believe Dr. Grohol is much of a therapist - having read this, I certainly would not go to him. In telling patients what they “should” be doing … he displays a profound lack of understanding and empathy with his clients.
— A. M.I tell the truth to my therapist. I find those in the counseling profession to be understanding and thoughtful.
When I have tried to work with psychiatrists I often lied to them, since on the whole, I find people in the psychiatry profession to be judgmental and critical.
— Lorne“Hard to believe Dr. Grohol is much of a therapist - having read this, I certainly would not go to him. In telling patients what they “should” be doing … he displays a profound lack of understanding and empathy with his clients.— Posted by A. M.”
Hard to believe your opinion should be taken seriously. To the contrary, Dr. Grohol lays out a road map for a patient to get well. Therapy is a balancing act between discovery and motivation and any therapist would be remiss in not understanding or conveying to his client how important it is to be open and honest in a session. To the degree that any one patient can do that in any given moment is an individual thing but over the long haul Dr. Grohol is right on the money.
— hughMaybe therapists need to work in a setting that masks them from the therapee, along the order of a confessional.
— Sy FieldI do not reveal everything to my therapist. I consider some of my thoughts private and part of my relationship with myself.
Contrary to the article, I have experienced that some therapists do pass judgment on what I say. This has become evident after seeing my therapist for some time and getting to know how he thinks.
— anonymousOver the years, I have had two friends married to emotionally abusive spouses (one male, one female). Both agreed to therapy for their extreme anger issues. Both set out to court and win the approval of their therapists. Neither made any behavioral changes because the therapists never called them on their lies and omissions. I wasn’t impressed by the therapists who took money from the family intended to help preserve the family and let the patients completely evade real therapy. Yes, their duty is to the patient, but there ought to be some sort of protocol for dealing with patients who set out to create an idealized persona that the therapist will admire rather than doing the work they are there to do.
— A.C.“Your therapist won’t judge you, and they won’t be embarrassed by what you tell them,’’ he writes. “They won’t criticize you for not sharing this information with them sooner. All they will do is use it to find a way to better help you and help you move forward.’
That’s the ideal and like most ideals true some of the time. But the authors blanket statement is perfect nonsense.
— John HeiderI tell only lies to my therapist, and it’s working. My alter ego is healing rapidly.
— m. dowdIn psychotherapy, lies come from the people outside of the patient’s “solitude.” This inner world has only beauty and truth but is vulnerable to the influence of family, educators, and others. My purpose as a psychologist is to peel away the false social influences revealing the person’s solitude, the only source of happiness.
— GaryVery early on in therapy I understood that my psychiatrist would not judge me because of my past activities, habits, fantasies, etc. but that did not immediately free me to tell him the truth. My feeling is that a patient might more easily tell the factual truth about an acute crisis but it is harder to even find the truth in behavior patterns that have endured for decades. Further, I was early on impressed by my doctor’s compassion and competence and so wanted him to like me so it was tempting to withhold information or tailor anecdotes to make myself more interesting or noble. (By the same token I can see patients with a particular pathology going out of their way to make therapists dislike them, at least initially, up to and including lying about themselves.) What struck me after several months was that where I had been dishonest I had been largely ignorant of my own devices. It was only after the establishment of trust between myself and my doctor that I could let myself tell the truth. This is what saddens me about HMO policies which severely restrict how many sessions a person can have with a therapist.
— DrewI decided to stop seeing my therapist when it became increasingly evident that I wasn’t telling the whole truth. My therapist was very judgmental, and I did not feel comfortable telling things for which I felt I would be scolded.
— PinocchioI receive counseling through an HMO and those people work for the hospital and company rather than me specifically. Several years ago, I was “honest” with an HMO psychiatrist and everything I said came out a few years later in a workers comp suit. Lawyers subpoenaed my mental health recordsand I was trashed in the case. I have not, nor will not, be completely honest with any “employed” medical worker again.
— J.W.Medical records protected by confidentiality? Hogwash! Certainly not when the motive to screw the patient outweighs any “rights.”
I know that I have not told all of the story to my therapist out of fear that they would diagnose me with something that I didn’t have. One crazy thought doesn’t mean I am a disease and I wouldn’t want people to jump to conclusions.
— VNHOne way I assess clients’ progress is through their increasing abiity to confront isues in their lives objectively and find the strengh, courage, and comfort level to work through shame, embarrassment, and fear. Then they are able to convey to me (and others) what they believe down deep to be true. Only when we acknowledge what we truely believe can we examine that perception. In some cases we can then begin to learn to forgive ourselves, without excusing ourselves. In other cases we may see that our deepseated self-judgments have been too harsh.
Initially we may need to avoid confronting ourselves in order to continue remail adequately functional. The therapist’s job is to support the client in moving to a healthier means of coping.
zfw
— zfwMy ex-wife’s father was a travelling salesman and would typically be on the road Monday through Friday. When he would return on a Friday, his loving spouse would light into him and rip him a new orifice. It happened so regularly that my ex and her siblings referred to the process as “Friday Night At The Fights.”
I was somewhat surprised, then, when my ex told our therapist, in response to his inquiry regarding her parents’ relationship, “They had a warm and loving relationship. They never fought.”
My laughter may have accelerated the demise of our relationship.
— SigmundUnfortunately, the therapy profession is built on nondisclosure (aka the “blank screen”). This means therapists are evasive and occasionally intentionally deceptive with their patients. Patients likely model the behavior of their therapists. So, Dr. Grohol and others - change should first come from above here.
— Jody B.Telling the truth in therapy can be very hard if it’s an ugly truth.
Perhaps not as hard as in other settings because the therapeutic setting is a safe, nurturing environment (if it’s done right).
But it is still hard.
And it is something that we have to do if we’re going to get beyond whatever is bugging us; whatever brought us into therapy in the first place.
The dynamics of telling-the-truth-in-therapy remind me of the institution of Confession, which was one of the terrors of my Catholic childhood. Thinking about it now, I find therapy a much more constructive, empowering, liberating, enlightening, and healing experience than Confession.
Nelson
— NelsonI once naively made the mistake of revealing to a therapist the size of an annual bonus I’d just received. My fee went up significantly a month later. Perhaps that cured me, because I stopped feeling the need to go shortly thereafter.
Be as honest as you possibly can with a therapist about matters directly related to the issue for which you are seeking treatment. Otherwise, be selective.
And NEVER say anything about an annual bonus.
— Jack KerrTalk therapy provides a mechanism through which patients make statements out loud, listen to what they’ve said and reflect on those statements. Therapists guide their patients through that process assisting them in understanding what they said and why. Through these efforts patients come to a better understanding of themselves and their behavior, and are more able to make positive changes in their lives. Lying to the therapist creates a barrier that prevents the patient from this better understanding. A patient should feel comfortable enough with a therapist to voice discomfort at being judged or if they do not feel this degree of comfort, should find a therapist with whom they can have a more open raport.
— See MeI assume that people also lie to their internists, ob/gyns, and gps, about eating and exercise habits, smoking, drinking, seat-belt use, and other health-related lifestyle issues.
— Margie