The topic of secrets and lying in therapy is just one aspect of research at The Psychotherapy, Technology, & Disclosure Laboratory at Teachers College, Columbia University. Dr. Barry A. Farber is the lab’s leader, while doctoral students Matt Blanchard and Melanie Love run the Lying in Psychotherapy element.
From the latter’s online description:
Client dishonesty is a broader category of non-disclosure that includes distorting and fabricating as well as omission, avoidance, secret-keeping, etc. Our initial survey of 547 psychotherapy clients showed large percentages of clients concealing therapy-relevant information, such as suicidal thoughts. We are now preparing a follow-up survey to replicate our initial findings, conducting interviews with clients, and developing a related survey for therapists.
According to the abstract of an article by Blanchard and Farber, the vast majority of clients (93%) admitted to lying in therapy.
Common therapy-related lies included clients’ pretending to like their therapist’s comments, dissembling about why they were late or missed sessions, and pretending to find therapy effective. Most extreme in their extent of dishonesty were lies regarding romantic or sexual feelings about one’s therapist, and not admitting to wanting to end therapy. Typical motives for therapy-related lies included, ‘I wanted to be polite,’ ‘I wanted to avoid upsetting my therapist,’ and ‘this topic was uncomfortable for me.’
Ryan Howes, Psychology Today, interviewed Blanchard about the research, and some of the more interesting excerpts from their exchange are presented below verbatim:
- Omission is about 3.5 times more likely than fabrication. Similarly, clients report minimizing the truth about 6 times more commonly than they report exaggerating.
- …(M)ost demographic factors—gender, ethnicity, education, income—had no relationship to dishonesty in therapy.
- …(Y)ounger clients reported more lying. Those who lied about one or more topics were on average 4-to-7 years younger than those who reported total honesty. This finding matches findings about lying in everyday life outside of therapy, too.
- Most commonly, clients lie to avoid the shame and embarrassment they feel even in the confidential, protected space of the therapy room.
- One of the last questions we ask clients is: “How could your therapist help you be more honest?” We imagined that clients would want more warmth or skill from their therapist, or to know their therapist shared their problems, or understood their culture or class. On the contrary, the dominant response was, “If my therapist asked me directly.” So one simple takeaway from our work is: Just ask.
A “spinoff” of the Lying Lab is the PATCH Lab (Psychotherapists Assessment of Tact, Concealment, and Honesty). “Specifically, the lab is exploring how therapists respond when they believe a client is being dishonest with them…”
Tori DeAngelis, not a representative of the above resources but a journalist, has compiled her own suggestions for therapists (APA) to minimize lying in therapy. Some examples paraphrased from her article:
- Establish a safe space for clients; convey a nonjudgmental attitude.
- Model the practice of honesty.
- When possible use humor and acceptance regarding omissions and lies.
- Tread more lightly regarding possible secret-keeping of a more sensitive nature, but do consider how to reach that material, as clients usually benefit.
- Keep in mind that you as a therapist may have also had difficulty admitting the truth in therapy. One study “found that about a fifth of 800 therapists surveyed admitted there was something important they had kept secret in therapy. In most cases it involved sexual issues.”