Dr. Stanley Goldstein - Author and Psychologist

A Psychologist's Thoughts on Clinical Practice, Behavior, and Life

Why Do Patients Lie to Their Therapist?

September 17, 2018

Tags: psychotherapy, lying

A prevalent belief is that a patient always tells the truth to their therapist but this isn't true.
1. A woman was referred by her internist to a psychologist for "counseling," the unspoken motive being that she was a continuing, troublesome presence in the doctor's office. That the patient was seriously ill was obvious from her appearance. A later telephone conversation between the psychologist and the internist revealed that virtually everything this courteous, charming patient had told the psychologist was a lie. Her behaviors were injurious to her health and she had no interest in changing.
2. A teenager, after telling the Child Protective Services that her mother had beaten her, was placed in foster care. She was then treated in a Girls Therapy Group where she told the same story. When, several months later, the CPS worker phoned the psychologist to ask his opinion, he replied that he had no reason to question the truth of the girl's assertion. Only later did the girl confess to lying: that she had stayed overnight with her boyfriend and feared her mother's wrath.
3. Ten years after her therapy ended, a girl told her mother that her slightly older cousin, Jack, had molested her while on a family vacation during the time that she was in therapy. The parents wanted to call the police but, before doing so, contacted the therapist for confirmation. The girl's records revealed no such incident. "The only complaint she ever made was that a boy named Craig called her a name in school." That ended that.
Why do people lie and it take a particular shape? Attempting to make sense of their existence, all people create stories of their life based on memories. Some of these are accurate, some are exaggerated, and others are false though, to each person, their story is "true" particularly many years later.
I have changed certain characteristics of these anecdotes to insure privacy.