In my clinical experience, it’s more common than we might think for our clients to lie, be dishonest, or fib in therapy. This behavior–especially in the context of non-mandated therapy–may feel confusing and agitating to both clinicians and clients alike. Therapists may wonder why clients would lie when it seemingly works against their own interests. There may be a temptation to criticize clients, “catch them out,” or even emotionally withdraw from the therapeutic relationship.
In this post, I provide a roadmap for providers to better understand why clients may lie, the therapeutic challenges and opportunities this behavior presents, and key considerations for conceptualizing and managing dishonesty in therapy.
Why Do Clients Lie?
Here are some common reasons why clients may lie in therapy:
- Lying is a common human behavior. People lie outside of therapy, so it’s not surprising this behavior shows up in the therapy room. Lying is often a defense mechanism used to avoid shame or punishment. People don’t magically act differently in therapy, so we should expect these behaviors to surface here as well.
- Too much, too fast. Our medical model training emphasizes gathering as much information as quickly as possible. However, “clinical information” is often deeply personal and sensitive. Clients may not be ready to share certain things. Lying could indicate that the therapist is pushing for disclosures or vulnerability at a pace the client isn’t ready for. Remember: we are not entitled to information from our clients, and paying special attention to the pacing of therapy can reduce the risk of misattunement or rupture.
- Fear of judgment or rejection. Clients may fear that if we knew certain details about them–their innermost thoughts, beliefs, or experiences–we might judge or reject them. Likely, they’ve experienced judgment or rejection before, whether from personal relationships or other providers. What may feel like a relationally disconnecting behavior might actually be an attempt to preserve or protect the therapeutic relationship.
- Loss of control, freedom, or autonomy. Clients may (rightfully) worry that disclosing certain information could lead to forced hospitalization, termination of therapy, or sharing of their information with others they don’t trust.
- A historical and adaptive pattern. Behavior makes sense in context. If lying doesn’t seem to make sense in the present, it likely made sense in the past. For those who grew up in environments where it wasn’t safe to be honest about their needs and weren’t allowed to ask for help or acknowledge mistakes, lying can develop as a way to promote safety.
That Makes Sense, But What Can I Do About It?
Clinical considerations:
- Set a precedent for client autonomy, consent, and permission-giving. While we can’t always prevent lying, we can potentially reduce its frequency and help clients feel safer to name and manage it when it occurs. Build a therapy space where clients feel comfortable being themselves and expressing their needs.
Given the inherent power differential between the therapist and the client, the therapist must initiate conversations about consent, pacing, and planning ahead for handling difficult situations when they arise. Regular check-ins are a helpful tool to foster openness. I regularly ask my clients how they feel throughout a session–about the content we are discussing, our relationship, and how my responses are landing.
I provide frequent invitations for my clients to check-in with their inner world–noticing body sensations, emotions, thoughts, images, and impulses. I also pay close attention to discrepancies between what they say and non-verbal cues, like body language, facial expressions, and tone of voice.
I ask for explicit permission to explore certain topics, and continually check-in, recognizing willingness and consent can change over the course of a conversation or session. For example, I might ask, “What would make you feel more comfortable discussing X?” or “Is there something you need to hear from me or yourself before we proceed further?”
- Understand the function of the behavior. Consider whether any of the reasons mentioned earlier might apply to your client. If the behavior is something you and the client have named openly, ask how the client believes it may be serving them.
To reduce shame, I frame this inquiry in a neutral or strengths-based way. For instance, I might say, “Lying is a common human behavior that usually makes sense in context. What do you think might be happening here? Could lying about X be serving a purpose? Would you be willing to explore this together?”
- Identify and explore the client’s fears. If lying is protective in nature, discuss the feared outcome of being honest. What is the client worried will happen if they disclose certain information? Validate these concerns while modeling curiosity about the accuracy of these fears.Explain why this situation may differ from previous ones or explore how a feared outcome could be managed if it arises. Remember: repeated, attuned curiosity is a powerful intervention.
- Collaborate with the client on how to proceed. Some clients may be open to discussing the lying behavior explicitly. If so, you can work together to determine how to handle it when it happens again. For example, “I’m so glad you’re open to exploring this together. If it happens in a future session, how would you like me to address it? What approach should we take?”
Clients are often the best resource when deciding how to handle their own behavior in therapy. Furthermore, offering the client choice and agency can increase buy-in.
- Acknowledge the impact on the relationship. Lying can disrupt trust, closeness, and connection. If dishonesty persists, it may be necessary to explore how this is inhibiting therapeutic progress. Emphasizing the negative impacts lying has on both therapy and relationships can promote greater relational- and self-awareness.
- Bring curiosity to your own reactions. It’s natural to feel frustrated, hurt, or inadequate when clients lie. These responses are worth exploring. You might feel that your client isn’t progressing quickly enough or that they don’t trust you. Processing these emotions with a trusted colleague, supervisor, or your own therapist can help you care for yourself, and model the awareness we want to foster in our clients.
Conclusion:
While there may be specific and unique circumstances that inform your response to a client lying, I find that common clinical reactions are often tied to underlying fears of inadequacy or failure as a therapist. This can range from worrying that the client isn’t progressing quickly enough to feeling shame that they don’t trust you.
Exploring your own reactions and processing them with a trusted colleague, supervisor, or therapist is a vital way to care for yourself, both as a clinician and as a whole person. This practice also models the same relational self-awareness and self-inquiry that we aim to cultivate in our clients.
If you are interested in one-time or ongoing clinical supervision/consultation that seeks to instill clinicians with confidence and clarity, reach out.
