Are You Lying to Your Therapist?

Honesty is the first chapter in the book of wisdom. —Thomas Jefferson

As a psychologist, I assume that all of my clients will lie to me at some point. Although that may sound surprising, research suggests that it’s very common for clients to lie to their therapists (and for people to lie in general). For example, in an adult sample of 547 adults in psychotherapy, 93% reported lying to their therapist at some point (Blanchard & Farber, 2015).

The truth is that being honest—first with yourself and then with someone else—is hard. It takes a great deal of self-awareness, trust, and self-esteem to be radically honest with a therapist.

There are different kinds of lies that reflect different levels of awareness, intention to deceive, and motivations for not telling the truth. Sometimes clients deliberately lie by making false statements with the intention of making their therapist believe they’re true. These lies are efforts to convince the therapist of something that is false—and the client knows it (see Stanford Encyclopedia of Philosophy). Other times, clients self-deceptively lie, meaning they’re unable to admit the truth to themselves, so they end up inadvertently lying to their therapist. As humans, we often lie to ourselves by believing something false or refusing to believe something true (Warren, 2014). When we do, we’ll pass lies onto other people without any intention of misleading them because we actually believe the lies we’re spreading (Mahon, 2008). Finally, both lying and self-deception are somewhat different from keeping a secret. Sometimes clients aren’t ready to share something with their therapist. They deliberately withhold information, but they’re not necessarily trying to make the therapist believe something they know is false—they’re omitting information because they don’t want to talk about or acknowledge something (Slepian, Chun, & Mason, 2017).

In therapy, clients may use all of these types of lies—deliberate, self-deceptive, and keeping secrets—in session (Curtis & Hart, 2019).

8 common reasons clients may lie to their therapist

1. Impression management. Often, clients want to look or seem healthier than they actually feel inside. For example, it’s very common for clients to minimize distress and the severity of symptoms to their therapist.
2. Feeling ashamed. Feeling personal shame about something they have done or experienced that’s incredibly painful to share is a common reason to lie.
3. Fear of the consequences. Sometimes telling the truth leads to difficult conversations or treatment interventions. For example, admitting to a therapist that someone is feeling suicidal can lead to follow-up questions or even hospitalization.
4. A desire to please. Wanting approval from a therapist and thinking that if the therapist really knew the truth, they would no longer like them is a common reason to lie.
5. To maintain control. Some clients want to feel as though they have the power not to share because it feels safer, more exciting, or interesting.
6. Denial. When a client can’t admit something to themselves, they are likely to spread that lie to their therapist.
7. Trust issues. Not trusting that other people can hear the truth and won’t continue to work with them, support them, or care.
8. Tension in the therapeutic relationship itself. Sometimes clients lie to their therapist about issues they have with the therapist themself. For example, sharing that a client is sexually attracted to their therapist or feels angry about how the therapy is progressing can be very difficult—even when the therapist is open and willing to talk about anything.

How does lying to your therapist affect treatment?

Despite how common it is, lying can have some negative consequences for therapy (Hart, Barnett, & Curtis, 2024). It limits how well a therapist will understand a client, which generally leads to less effective case conceptualization and treatment planning. It can delay treatment progress because the therapist may focus on the wrong issues, use ineffective strategies, or be unaware of what is not working in the current framework. In the long run, this can be a waste of time and money, for both the client and therapist.

Lying can also negatively affect the therapeutic relationship. Trust and honesty are at the core of any therapeutic alliance, and if lies are discovered or suspected it can weaken the connection. It can lead to missed core issues that are required for healing. Lying may lead to avoidance of some of the most important (and painful) emotional struggles of a client that fuel their primary mental health issues. The therapeutic relationship is a model for intimacy and can serve as an important experiential corrective experience. If a client is lying in session, they are likely doing the same in their relationships outside of session.

Finally, lying to a therapist can be dangerous. If a client is lying about the severity of their mental health symptoms, like drug use, it can put them at risk for worsening symptoms that won’t be addressed in treatment.

The Naked Truth Is This

Deliberate lying, self-deception, and keeping secrets are commonplace in therapy. How a therapist handles these issues really depends on what they believe is in the best interest of the client at that moment in time. We all have stages of growth as humans, and there are times when we know something is true but aren’t ready to admit it to another person yet. That said, I would encourage anyone in therapy to be as honest and open with their therapist as possible.

Copyright Cortney S. Warren, Ph.D., ABPP.

Note: This content is only for informational and educational purposes and should not be considered therapy or any form of treatment. I cannot respond to personal requests for advice over the internet. Best on your continued journey.

To find a therapist, visit the Psychology Today Therapy Directory.

Image Source: Photo by Nik Shuliahin  on Unsplash