Yes, We Know You Lie to Your Therapist. Here’s what to Do Instead.

By Juli Fraga / The Washington Post

14:50 JST, February 3, 2024

When one of my patients admitted to telling me a white lie, I wasn’t surprised. As a psychologist, I know that therapy is a place to share your secrets, but sometimes it’s hard to speak the truth.

In new relationships, most of us strive to put our best foot forward. Known as “self-presentation,” this tendency can arise whenever we’re worried about being evaluated.

In therapy, this can lead you to say you’re doing well, even when you’re not. Or to tell your therapist you never use substances, even though you drink or smoke. Other individuals say they are merely stressed even though getting out of bed feels like a chore.

Such mistruths may sound egregious, but dishonesty in therapy isn’t a terrible act, nor is it rare. For example, one study of over 500 therapy-goers found that over 90 percent of them had lied to their therapist at least once. Top mistruths included pretending to like the therapist’s suggestions, denying feelings of insecurity and minimizing one’s suffering.

Speaking with a therapist takes courage, and opening up can feel vulnerable. But skirting the truth comes at a cost. Research shows it can make treatment less effective and drive patients to end therapy too soon.

I told my patient that her fib wasn’t something to be ashamed of – it was something to understand. We needed to figure out what made honesty challenging to begin with.

If you’re in a similar situation, you’re not alone.

Here are some common reasons people lie to their therapists and what they can do instead.

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Fear of being criticized

Whether in therapy or life, we often lie to avoid being criticized.

For example, I’ve counseled many patients with eating disorders who denied overexercising or restricting what they ate. Other examples include censoring your anger or omitting how often you snap at your children.

We tend to pair lying with deception, but these fibs aren’t intended to snow the therapist. Most often, they’re an attempt to avoid judgment.

But here’s something you should know: A good therapist will never criticize you. Instead, they will help you understand why you fear being judged. For example, family dynamics can play a role. If your caregivers were overly harsh, you may assume everyone will treat you similarly. Or if your parents prized perfection, you may believe anything less is a failure.

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Feeling embarrassed

In one study, over 60 percent of participants said they had lied to avoid embarrassment. For example, if you believe your thoughts, feelings or actions make you “bad” in some way, you’ll be less likely to tell anyone (including your therapist) about it.

But keep in mind that therapists are like emergency room doctors of mental health. We’ve heard many stories and helped our patients navigate many crises. What feels embarrassing to you won’t upset us. I often temper my patient’s fears by addressing them from the get-go. For example, I say: “It’s normal to feel embarrassed to tell me things, and that’s okay. I’m not here to judge you in any way.”

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Trying to please the therapist

People-pleasing can cause us to tell “altruistic lies.” These mistruths are meant to protect the other person’s feelings. For instance, you might tell a friend you love their new partner, even if they’re annoying.

Altruistic lies are also common in therapy. Years ago, I worked with someone who said therapy was going well. Weeks later, however, they admitted they felt stuck. They had feared that being honest would cause me to dislike them.

Most of us shy away from saying something hurtful, but it’s not your job to protect your therapist’s feelings. Realizing this can be very freeing. Giving your therapist feedback can foster closeness, which makes the truth easier to tell in the future.

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Trying to avoid upsetting emotions

Omitting the truth can protect us from upsetting emotions, such as anxiety, guilt or sadness.

This is common if you have survived trauma, for instance emotional abuse or assault. Or if you’re grieving the loss of a loved one. But avoidance doesn’t make agony disappear.

The good news is that your therapist can support you with whatever feels challenging. They may even teach you exercises such as deep breathing, which can help you feel calmer.

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How to address the mistruth

— Identify shame. Dishonesty can spark shame and lead you to avoid the problem. Perhaps you never mention the mistruth, which can prevent you from receiving the support you need. One way to outsmart shame is to name it. Start by exploring where it shows up in the body. You may notice a pit in your stomach or tension in your shoulders.

— Quiet shame with self-compassion. You can start by telling yourself: “I recognize that we all feel ashamed sometimes. This feeling won’t last forever.” Seeing shame as part of the human experience can make you feel less alone.

— Embrace courage and speak the truth. If you’ve been dishonest, let your therapist know. For example, if you were afraid of being criticized, consider saying: “I wasn’t upfront because I was worried about being judged.” Or if treatment isn’t going well, you might say: “I’d like to be honest about my experience in therapy.” If you’re unsure what prompted the mistruth, saying something like, “I’m not sure why I wasn’t honest,” can help.

While telling the truth can be challenging, honesty brings many benefits. It builds trust, which can strengthen the therapeutic relationship. It also provides an opportunity to dig deeper, steering therapy in a more meaningful direction.