Lying and Hiding

Press the button. But is it that easy?

Recently, I read an article in Psychology Today, “Why You Lie to Your Therapist” (June 2019). The article is similar to an earlier article by Ryan Howes, PhD, “Why People Lie to Their Therapists” (Oct. 2018), but in interview form with Matt Blanchard, one of the researchers behind, “The Lying Lab” where studies have been conducted. With his colleague Melanie Love, Blanchard has authored a book called Lies and Secrets in Psychotherapy. 

Apparently, lying (and hiding, for that matter), is a thing.

Even during therapy sessions, and even when there is a trusting, warm connection between client and therapist, lying happens often enough to warrant an entire arena of dedicated study. And according to the Lying Lab studies involving 547 patients, 93 percent of them recalled specific instances where they identified lying to to their therapists.

You can read about the reasons why clients lie to their therapists in the first article. My bet is that just about anyone who has ever been in therapy can relate to the primary reasons why people lie to their therapists:

  1. To avoid shame
  2. To control the focus of what is talked about (i.e. an external problem rather than an internal or threatening flaw)
  3. To avoid repercussions (particularly negative and painful ones)
  4. Lack of trust with the therapist

In this blog post, rather than covering the topic of lying again (the articles are well summarized, so why reinvent the wheel), I thought I’d write about what comes after either the client or therapist recognizes that a lie has been told.

“Um, I Wasn’t Exactly Honest”

As I client, you’re in an uncomfortable situation. You’re paying someone to listen to you talk about what is or has been going on in your thoughts and actions. You’re investing your time and money, and you’re engaging another person to enter into your reasons for doing so. They were important enough to call a therapist, make an appointment, and build a relationship.

So the moment you catch yourself suppressing, withholding, or embellishing the truth, or your therapist notices something about the way you just did one of the above, the last thing that any good therapist is going to do is to try to nail you with shame.

Instead, the research seems to indicate just the opposite. The research supports clients wanting their therapists to not only catch them, but to acknowledge not only the difficulty in being honest, but actually ask about what they just saw and heard in the client’s story.

When a client says, “Um, I wasn’t exactly honest when I told you about…”, just acknowledging how difficult that must have been to admit, and to have a discussion around what that was like holding onto that lie, can help address the underlying fear about what it would mean to tell the truth.

Just Ask

Because I understand that people have their reasons for lying, I’m not offended. Instead, I can ask directly, “I’m wondering what would make it easier for you to tell me what’s truly on your mind.” This is a more gentle way for me to say, “I think you just lied to me.” My thoughts are to fostering the next step into a client owning a dishonest moment and then choosing to change the direction into an honest one.

When I acknowledge the fear that I am seeing in my client’s expression and body language, I have a lot of empathy. It can be pretty scary to see your own crap for what it is. Worse, it can feel overwhelming to take the next step into doing something about your crap.

My approach involves asking you directly. “What do you think may happen if you told me what was really going on?” Often times, that’s just enough of a prompt to get the truth, “on the table” where we can look at it together. Underlying fears can be addressed. Concerns about what happens next can be talked about, and the client can name the actions, thoughts, and feelings to be sorted through.

More than identifying with a client’s culture, class, or by applying more skills to the moment, the Lying Lab findings all point to the therapist asking directly about the subject. Here are a few examples:

“Did you struggle with drinking last night? Did you drink one glass, or was it the whole bottle?”

“If you are feeling out of control and you aren’t sure if you can control those thoughts about hurting yourself, can we talk about what you think might happen if you tell me you’re feeling suicidal?”

“Did you think that thought, or did you actually say that aloud to your husband?”  

Are these scary conversations? Hell yes! Are they helpful ones? Yes, they are if your reason to be in therapy was to get into the “what” and the “why” of YOU, and to allow you the opportunity to be the author of your “how” into something better.

Help Me Help You

The Lying Lab studies also revealed that a little over 72% of the respondents of the study reported lying about the psychotherapy itself, such as liking the feedback more than they did, or saying that the sessions are more helpful than they are.

Most therapists want to do a good job at the thing they love: helping others. When you are afraid to tell your therapist what you really feel about a session, it doesn’t honor your story, even if you are concerned you might hurt the therapist’s feelings.

I like to ask my clients a question at the end of a session, such as, “Was this what you thought this session would feel like? Was this helpful? What would you like more or less of next time?” And I ask them to write that feedback down — and watch them do it — as well as add the feedback in my client note.

Your Turn

If you’ve been thinking about trying therapy or returning to therapy to get deeper into resolving your personal issues, I hope you can hear that we understand that it’s not always easy to face those issues with honesty and transparency, even if when a strong connection is formed with a therapist. We get it, and we’re prepared.

I would not blame you if your first reaction to hearing that people lie to their therapists is, “Well, I would never do that.” Again, we understand that you are investing time, money, and effort in your own personal development and insight. We also just acknowledge that we’re all human. Lying and hiding happens in therapy. A good therapist knows how to ask and to seek when sensing that a subject is difficult to talk about.

Together, we’ll find you.


    Reflections on Adulting, Part Two

    Adulting is a term that describes the skills, actions, and attitude involved in the often mundane tasks of being an independent adult. Read more in this Part 2 post on Adulting.

    In 2016, I wrote a post, On Adulting, that included ten somewhat tidy points on how I gauge one’s ability to function as an adult in the real world.

    I thought to revisit that post and add additional reflections on how we can engage the concept of adulting with both the lightheartedness of the original blogger, Kelly Williams Brown, as well as the seriousness of gauging your own progress if you find yourself struggling with some skill deficits and challenges, regardless of your age.

    What I didn’t talk about in that 2016 post are the concepts of immediate gratification and delayed gratification. These are both in play when talking about what is often needed to help people learn to “adult”, aka learn a skill that requires patience, dedication, commitment, and willingness to engage tasks that are routine, mundane, or sometimes emotionally painful enough that you avoid it.

    We have studies such as the 1960’s and 1970’s Stanford Marshmallow Experiment, which gave children the option to receive a small food reward immediately, which was on a plate in front of them, or to wait in that empty room approximately 15 minutes without taking the food reward, and receive two treats (both the item on the plate, plus another treat, such as an Oreo cookie or a pretzel). The follow up study correlated a child’s ability to delay gratification to outcomes such as better SAT scores and BMI scores (Body Mass Indicator).

    Not quite a balm for his soul – more like rubbing alcohol in a wound. It stings, but you know that means it’s working.

    Jenny Jurek, North: Finding My Way While Running the Appalachian Trail

    Since then, we have more evidence beyond Dr. Walter Michel’s experiment that experiencing delayed gratification — that is, waiting for a pleasurable reward after time, hard work, and effort — can have positive effects in later life outcomes.

    But what makes adulting so hard that we resist its tasks as well as its benefits? Mel Robbins, author of, “The 5-Second Rule,” suggests that our brains are wired to protect ourselves from painful experiences, emotional or physical. It is painful to get out of bed before the sun comes up in order to fit in some time to exercise and take care of our bodies. It is painful to say no to a sugary treat offered for free at work, even if that treat will cause a rise in blood sugar followed by a crash in energy afterwards, or a tummy ache. It is painful to watch your child throw a tantrum when you limit screen time so he can finish his homework, and then pitches a fit when bedtime arrives and he wants to stay up and play video games with you. The urge to defend against that pain has us renegotiating boundaries, breaking promises, and making exceptions instead of revisiting our pain.

    One of the challenges with Adulting is that delayed gratification and “Just do it” mentality about engaging those mundane adult tasks, like saving for retirement, cleaning your home, cooking and preparing healthy meals, and developing skills to develop a meaningful and caring relationship with another human being, have no guarantees attached. Just because you do the actions does not automatically mean you collect the anticipated reward.

    You could save money every year, and still be behind what is recommended for retirement. You could save money every month, and then an unexpected expense, such as a doctor’s visit, or a car maintenance that required more than you budgeted, or an increase in your apartment’s rent, could make saving money more difficult.

    You can spend hours cleaning your home, and never feel completely caught up, since dust and dishes and pet fur and muddy shoes happen.

    You can buy the food to cook all the meals, and your kids can refuse to eat it. Food can get wasted. You might not eat enough variety, and eventually need supplementation. You can eat out at a reputable place and get a case of food poisoning.

    You can invest years of emotional, mental, spiritual, and financial energy into a relationship, and it can sputter out, become tangled with conflict, heavy with grief, or end.

    There are no guarantees for all your adulting efforts.

    There is one guarantee, however, if you don’t learn how to delay gratification and you don’t learn skills of adulting. You’ll likely fail at adult life, and you’ll likely find it difficult to sustain friendships or partnerships. When no one expected you to act grown up, it was just fine not to. Over time, friends take on the tasks of adulting and launch off on their own.

    We tend to gravitate towards those most like us, so you can imagine what happens when an adult operating from a child mind finds him or herself spending time with the same kinds of people who are avoidant of dealing with their deficits. There is a lot of failing going on. And so, there is good reason why learning the skills of adulting is practical and relevant. I’m not making fun of these deficits. Just the opposite. I find them entirely relevant to address them in order to successfully navigate adult life, whether you live in a remote area of the country, or you are in the center of a bustling city.

    Everyone starts out life with a child’s mind. Open, creative, positive and trusting, present-moment focused (unless early childhood is oppressive, negative, and full of unpredictable adults), the child mind wants what it wants, when it wants it, which is usually Now, not Later. It takes experience, delayed gratification versus immediate gratification, and a history of enjoying rewards and benefits following a period of commitment and dedication to lay down a pattern of behavior and attitude that turns the child mind towards adult decision making and willingness to engage in hard work and waiting.

    For example, if your doctor told you that you needed to change your diet and lifestyle because you had high blood pressure, and you realized every time it came to decision time about what to eat you chose to indulge in high fat, sugar, and salted foods, you would need to take a look at what happens in the moments leading up to those food choices. Did you organize yourself so you had time to grocery shop? Did you plan a menu? If eating out, did select a restaurant that had healthy options with macronutrients listed? Did you take a moment to look at portion size? When it came time to exercise, did you make sure you had clean workout clothes ready the night before? Did you have a plan for your workout? Did you consult a trainer, read about exercises, or attend a group exercise class if the exercise requires some safety skills? Did you schedule your workouts in your calendar like you schedule other important appointments? Did you plan enough sleep in your schedule to help you feel refreshed and ready to exercise?

    I think you see the challenge. The child mind will get to the moment that it’s time to take an adult action or just do what it wants — roll over and go back to sleep instead of take a brisk walk or go to the gym. Eat the piece of pizza for breakfast, or leftover pie. The child mind will watch TV when it’s time to clean house, pay bills, or study for a certification program to advance one’s job prospects. “I don’t want to put off for later what I can have now!” whines the child mind. The task that would help is put off another day, another week, month, or year. Sometimes, it is completely forgotten, until a painful consequence puts it top-of-mind again.

    Adulting behaviors ask us to engage the part of the mind that can delay immediate gratification in order to take another action that completes a required task or set of tasks in order to continue functioning. An example might be choosing to work extra hours or picking up a second gig to save up enough money beyond covering expenses so that there is more money than month. I

    I knew of a woman who had come into a large amount of money at once, and her child mind allowed her to spend all of it in a relatively short time rather than saving a portion of it. She wanted to live like the rich people she saw on TV, if but for a short time. The money was blown on lavish parties, travel, food, and drugs, until the money ran out.

    Contrast that story with the young woman who worked extra hours and set aside money over many years. She also attended evening college courses in order to get a degree that would help her attain better paying jobs. She spent her personal time between keeping fit, sleeping, and visiting her family. Eventually, she was recommended to the position to which she hoped to apply with her college degree. Talk about delaying gratification!

    Is this just another story that sounds like Pinocchio’s Jiminy Cricket, who did not prepare for winter? Perhaps. Part of growing up is the ability to march out on one’s own, aware of the changing seasons, and prepare for lean or more difficult times. The child mind believes someone will always be there to help them through that difficult time; growing up allows us to see that we do our best to learn to care for ourselves, and when we have done what we can, our family, neighbors, and community members may also step in and help us.

    Finally, we have to talk about burnout if you want to understand the full picture of what inhibits or discourages people from engaging their adulting abilities. However, I think I’ll hold off on that topic for a Part 3 post in the near future.

    Have you identified any areas of your life that need Adulting? One subject that gets little discussion is preparing for death. If you are thinking about the same topic, please join me in reading Michael Hebb’s book, “Talking about Death Over Dinner.” It is available for eBook checkout through your public library, as well as online retailers wherever books are sold.

      Counseling Online Therapy Psychology Telehealth

      What Can and Cannot Be Seen During Online Therapy

      When a person contacts me to initiate online therapy, they will receive a short consultation that helps both of us determine whether we’re a good “fit” to work together. I believe there are some good reasons to refer some people to see a counselor, psychologist, or psychiatrist who has a brick-and-mortar office, depending on their specific needs and the outcomes they seek.

      For all others, online counseling can help bridge one of the most important gaps in healthcare: timely access. Getting people the help they need when they need it has been one of my lifetime goals for my mental health practice, now going entering its 19th year.

      What I want every person to know, unequivocally, is what a licensed mental health professional can and cannot see in an online therapy session, based on the nature of the technology. While this appears plain, I’ve noticed that a brief discussion about the nature of online counseling — whether they will become my client or someone else’s — helps every person make better decisions regarding their health needs and the options they have to meet those needs.

      What You Can See During An Online Therapy Session

      Here’s is what I am able to see (and hear) during an online therapy session under the conditions of bright lighting, good audio, a video camera trained on head, shoulders, chest, and arm movements, robust Internet speed, and a quiet room where the session takes place:

      1. Facial expressions, which helps to reveal mood and changing emotions related to the content being discussed
      2. Body language, such as shoulder shrugs, hand wringing or rotating, posture, and body motions (i.e. rocking, shaking, trembling)
      3. Eyes: blinking, tears, darting, rolling, attentive, sleepy
      4. Breathing patterns, such as shallow, deep, rapid, slow, etc

      Part of the reason online therapy can be helpful for people seeking mental health help is that the various measures of pain and progress can still be seen, heard, and felt through an online counseling session through your computer or smart device.

      In terms of insight-oriented counseling, the same elements that you would experience in a F2F session can be transmitted and experienced in an online session. But there are exceptions.

      What You Can’t See in an Online Session

      1. Just like F2F sessions, I can’t see what someone is hiding. I can, however, see the indicators that would lead me to believe someone is hiding something. Another way to say this: if you are seeking therapy to end your ability to manipulate and lie to the people you love (and you’re good at it), a good therapist may detect the lie in both an online and a F2F session, and both may not be able to determine what exactly the lie is.
      2. I can’t see what you’re doing off-camera. I can only see the reaction of your body and mind to what is happening outside of your camera’s view. For example, if you broke your foot and you were on a pain medication that produces sedation, I would not see the foot cast, but I might see the effects of the sedation in your eyes and facial movement, or the slur or slowness of your speech and cognitive functions.
      3. I also can’t use my other senses, like my sense of smell. This is important for therapists treating someone for depression, as a depressed person might not have the energy or will to attend to their own personal hygiene or wear clean clothes.
      4. Energy levels take longer for me to feel through the lens of the camera, putting together such clues as body posture, vocal quality, alertness of the eyes, and extraneous movement cues, such as “happy feet” and nervous finger movement off camera.

      Would Online Counseling Work for You?

      So, would online counseling work for you? The answer, like so many other answers contingent on multiple points of concern: it depends.

      The best way to determine if online counseling would work for you is have a brief consultation with a licensed therapist to discuss your needs. Next, host a brief time on a HIPAA compatible online counseling platform, such as the one I use, 

      Take a moment to make direct eye contact during the video chat. Ask yourself if you sense your emotions and expressions can be easily read, even if you didn’t explicitly name them. You can also see how we bridge the physical gap by using the text box to write things down, send a resource link, or even give you a virtual high five.

      If you feel you have your own bias against online counseling, I think it’s important to just say that upfront. I call this, “Putting your cards on the table.” When you do this, you’re acknowledging your bias. That acknowledgement can be helpful to know if you have some openness to experiencing something other than what you are “certain” you know; that is, that your experience might be different than your feelings.

      For example, it might help to talk about your skepticism and negative feelings about talking about difficult things on a video chatting platform. At the same time, I might ask you if you like pets, such as a cat. If the answer is yes, and my cat obliges us, she may poke her head on the camera, and you can interact with her while you experience your real emotions about seeing my fluffy cat as she head butts the laptop and purrs into the microphone.

      The reverse is true as well. You may be eager to try online counseling, only to be told that what you are wishing to address in your life needs more support and hands-on or sensory input than an online counseling experience can deliver.

      You may have heard in the news that a man with a terminal illness received the bad news of his prognosis through a teleheath robot using a live video connection to his provider. The man died from his illness, and the family was so upset by the delivery method — a robot and a video chat instead of an in-person visit to the man’s bedside in hospital – that they complained to the hospital.

      I personally don’t believe we as humans are ready for receiving bad news in this way, whether it is for the end of a relationship (an email), the end of a job (a group email or a recorded video message from the CEO), or an health prognosis. In the case of the latter, a patient may need their hand held, or to feel a presence in the room that speaks to the unspoken — “I’m still here, and my life has value because of the respect being paid to it by someone taking the time to be here.”

      It is a subtle shift in thinking to understand that your online therapist has taken time to meet with you over an Internet connection, and the time has as much value as time that passes in the same room. It may help to ask an online counselor what they do to prepare, minimize distraction, and apply the steps of attending during a session.

      In the end, a good first online counseling consult should leave you feeling like you made a good connection with the therapist, enough so that you would want to meet again to discuss more complex or difficult subjects.

      During the time that the Greater Puget Sound area received a record number of snow days, school closures, and dangerous road conditions, I received an increase in calls inquiring about online counseling. You should know that I used the same elements in this post to help each person make their own decision about online counseling, and that not every call meant that online counseling was the best fit. Sometimes, it’s just not.

      But when it is the right fit, we’re ready for you.