Shrink Rap: Why Lie to Your Therapist?

You might think it would be foolish and counter-productive to deliberately lie about or passively omit important information to your psychotherapist. After all, you're in treatment to look honestly at yourself in the service of gaining self-awareness, insight, and change. Forming a trusting relationship with your therapist based on truthfulness is an essential ingredient in this process. But this doesn't mean that you won't ever lie. In fact, it is highly likely that you will. Here are some reasons why:

1. Wanting to present yourself in an overly-favorable light so you will be approved of by your therapist. If you are struggling to feel good about yourself, you're going to find it challenging to share embarrassing or painful aspects of your life. So you will lie in attempt to create a positive self-image to your therapist and, in doing so, preserve that image for yourself. Until you are sure you aren't going to be viewed negatively because of what you share, you may consciously or unconsciously avoid telling those stories and incidents you imagine will compromise your self-image in your therapist's eyes.
2. Fear of being judged. Therapists have their own beliefs about your behavior and sometimes let their judgments be known. If you tell me you're going to "party at the river with a keg of beer and do lots of shooters" and I know you're an alcohol abuser and also taking medication, I will tell you not to be driving your car or your boat. If you take my concern and advice as a judgment, you may think twice about telling me the next time you're planning a river party. In addition, it takes time to learn that it isn't my job (and not in your interest) for me to agree with all your thoughts and feelings. Until you understand this, you may take it as a judgment when I don't make sense of things the same way that you do.
3. Not knowing something is important; denial. A month after you begin therapy, you tell me you've been having an affair for a year. When I ask why you didn't tell me this before now, you respond that you "didn't know it mattered." You gave me a history of your troubled marriage but it didn't strike you that currently being involved in an affair might be relevant to your problems! Sometimes, patients don't have the insight to know what is relevant and what isn't. More often, they simply deny that it is important to tell me something because they are not yet wanting to confront it. Because verbalizing something makes it more "real," they omit telling me until they are ready to make it real to themselves.
4. Lying is a part of personality style or coping mechanism. Patients who have been heavily abused, traumatized, or lived a life of coping through lying, such as drug addicts and sociopaths, will lie to a therapist just as they do to everyone else in their lives. It may take a long time—if ever—for them to learn to trust a therapist enough to tell the truth.
5. Transference issues. This means that patients unconsciously react to the therapist in the same way they have toward someone else in their life, usually a parent or significant authority figure. For example, a patient who had a critical and rejecting father may be hear my feedback in the same critical and rejecting way. They may have no idea that they are "transferring" this old reaction of the parent onto me. As part of this transference, they may lie to me as a means to escape further shame or rejection, just as they lied to their parent. My job is to help them see this transference and how they need not respond to me and others in the same unconscious way.