Anxiety, Panic & Health » Therapy

10 Reasons Why We Lie to Our Therapists

Mike Nichols — Mon, 18 Aug 2008 23:20:38 +0000

It is a universal truth: We all lie to our therapists!

We wouldn’t lie to our auto mechanic about the funny noise under the hood. We wouldn’t lie to our hair stylist about wanting to cover our bald spot.

Then why lie to our therapists, wasting money, time and emotional energy?

There are many reasons, both complex and simple. Click continue to see the top 10!

1. We don’t want to reveal painful or embarrassing information

Emotional pain registers in the same part of the brain as physical pain. Sometimes it just hurts too much to tell the therapist everything. We avoid telling the truth or the entire truth to our therapists because:

We don’t want to own up to our limitations and failings.
We feel shame for our actions.
We perceive our actions as unpardonable or heinous sins.
The way we survived a trauma is by not talking about it, or admitting how much it affected us.
We have done something that shocks us and we can’t believe we are the kind of person to do it. If the therapist doesn’t know, we get to be who we think we are again.
We are repressing painful things and events.
We are keeping secrets that we have kept for years.
We are fooling ourselves, believing things we know are not true.

2. We are in denial

We deny we need treatment

We live in a society that preaches that we should be able to pull ourselves up by our own bootstraps. More than two-thirds of Americans deny they have a mental disorder until something catastrophic happens that drives them to therapy. We deny that we need treatment until it’s just too painful to endure any longer. It’s a victory just to get into therapist’s office. Ways that we deny our need for therapy in the therapist’s office are:

We hide what we feel and fake what we don’t feel.
We pretend we’re OK just to avoid knowing that something is wrong with us.
We are conflicted whether we want to be in therapy or not.
We are not confident therapy can help us.

3. We don’t know or acknowledge that something was important

Often we will omit telling our therapist important events or issues that seem — to us at least — to be unrelated to the issue at hand. We may even be OK with something that is of vital importance, such as purging after every meal. Part of the problem is that some of us are delusional, have false beliefs, or cognitive distortion. But some of the most common reasons for not telling something important to our therapists are:

We are confused and simply don’t know how we feel.
We don’t admit the truth because don’t know what the truth is.
We lack the experience and insight to know something is important.

4. We are afraid our therapist will judge us

We are afraid of being judged

We are used to judging others and are afraid of others judging us. But good therapists will try not to judge their patients. Therapists are human, too, and we expect them to judge us like others do. And there are therapists who judge their patients or dismiss their concerns or emotional responses. A patient will often clam up and stop being truthful when they sense or suspect that the therapist is judging them.

5. We think the therapist will report us or send us to the hospital

Many states require that therapists report certain actions or potential actions of their clients. These reports become part of a central database that can brand a person for life. Among the reasons we might fear that a therapist’s written record will haunt us for life are:

We have had a suicide attempt.
We are in danger of harming a child, family member or senior citizen.
We fear that a mental health history will harm our career, making us unable to get or hold a job.
Government security clearances require disclosure of all health records, including mental health.

6. We haven’t established trust and rapport with our therapist

Strong rapport and solid trust takes time

It takes time to establish a good working relationship with your therapist. When you have been to several therapists, you may not be sure the new one has the skills or experience to help you. Without a strong rapport and solid trust, we often feel defensive and on guard and may not share all we could. Some signals that we need to give the relationship with our therapist more time are when we:

Want more than the therapist can give with the present information we have provided.
Don’t like the way the therapist does things, but feel embarrassed about telling them.
Our lack of candor is an excuse not to talk about an issue at the time.
Give morsels of the truth and see if the therapist can guess the rest.
Have difficulty communicating in general.
Have issues around not being believed by others, and we don’t think your therapist believes us, either.
Have learned to wear a mask, and it isn’t always easy to drop just because we want to.

7. Lying as a coping mechanism for us

Many of us learn to lie to avoid abuse, ridicule or trauma, whether in the past or in the present. It is a way of survival. Undoing the common use of that coping mechanism will take time, even with a skilled and trusted therapist.

8. We lie to maintain a positive self-image

We don’t see ourselves as others do

It’s hard to maintain our own sense of self or a positive self-image when we have to confront the more embarrassing or painful aspects of our lives. We may hide information from our therapist as an attempt — sometimes unconscious — to construct desirable images for her. We often don’t see ourselves as the people we really are, and may be shocked at behaviors we can’t acknowledge to the therapist because we can’t even acknowledge them to ourselves. Mistakes we often make are:

We want our therapist to like us, but it is hard to think the therapist will have unconditional positive regard when we don’t have it for ourselves.
We want to feel loved yet feel unlovable.
We feel that if we reveal ourselves fully to the therapist and they don’t like me, then I will be lost with nothing more to give.

9. We lie due to transference

Transference occurs when we unconsciously redirect, or transfer, feelings we have toward one or more important figures in our lives onto our therapists. Those figures may include parents, family members or people at work. This leads to:

We may lie to our therapist because he represents another important person to whom we also lie.
We may seek approval from our therapist that we never got from our parents or others.
We may feel compelled to protect ourselves from the therapist in what feels like a dangerous situation.
We lie because we think the relationship might end otherwise.

10. We lie out of fear

Many of the reasons we lie to our therapists can be reduced to a single reason: fear. Fear is at the root of many mental disorders, and naturally comes to the fore in the therapist-patient relationship. Among these are the:

Fear of admitting how bad things are, making the situation too real.
Fear of how much our lives feels out of control. By not admitting these deep fears we maintain some semblance of control.
Fear of feeling something is basically wrong with us when we feel emotional pain.
Fear of losing control of our private thoughts. We feel fearful and violated if the therapist delves too deeply.
Fear of how others will perceive us.
Fear of what others will think of us.
Fear of what will be done with the information we share, or how it might someday be used against us.
Fear of what the therapist will think of us.
Fear of how others will judge us.
Fear of having our feelings or thoughts dismissed, of not being believed.
Fear of being in therapy for the first time and not really knowing what to expect.
Fear of being told we’re “crazy” or worthless, of being unloved and unlovable.
Fear of rejection by others.
Fear of the unknown.
Fear of change.

What do you think?

While writing this article, I realized how much I had lied to my therapists over the years, mostly by omission. It’s embarrassing, and probably something I wouldn’t admit to if I were talking to you face to face!

Have you ever lied to your therapist, either overtly or by omission?
Have you ever had a therapist you felt you didn’t have to lie to?
How long do you think that it takes to build a therapist-patient relationship of trust and rapport?
Can you add any more reasons why we lie to our therapists?

As always, your comments are welcome!

If you have enjoyed this article, please consider subscribing to this blog, either via RSS or email at the top of your screen. I would also appreciate your sharing it using your favorite social media, such as StumbleUpon or Digg. Just click the little green “ShareThis” button at the bottom of this post.

Resources used in this post:

Grohol, John M. (2008, February 6). 10 Common Reasons to Lie to Your Therapist. Retrieved August 18, 2008 from Psych Central Web site: http://psychcentral.com/blog/archives/2008/02/06/10-common-reasons-to-lie-to-your-therapist/

Grohol, John M. (2008, January 9). Why Would You Lie to Your Therapist? Retrieved August 18, 2008 from Psych Central Web site: http://psychcentral.com/blog/archives/2008/01/09/why-would-you-lie-to-your-therapist/

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Group Therapy: Is It Right for You?

Mike Nichols — Thu, 31 Jul 2008 22:57:03 +0000

We usually think of psychological therapy as a one-on-one proposition, just you and the therapist.

But many find group therapy to be just as — even more — effective than individual therapy.

How do you know whether group therapy is right for you? What exactly is group therapy? How does it compare with individual therapy? Does insurance cover group therapy? These are all valid questions you may have.

This post will explore what group therapy is and is not so you can make a good, informed decision.

What is group therapy?

Group psychotherapy is a therapy format where a group of 6 to 12 people with similar diagnoses meet with a specially-trained therapist. You improve not only from the comments of the therapist, but also from observing others in the group and receiving feedback from group members. The therapy has been widely used and has been a standard treatment option for over 50 years.

The typical group session lasts 75 to 90 minutes. The number of weeks a group meets depends on the type of group and the nature and extent of your problems. Short-term groups devoted to specific issues can last anywhere from 6 to 20 weeks. Support therapy groups (for example, those dealing with Post Traumatic Stress Disorder) may be more long-term. There are also more open-ended groups in which members work at their own pace and leave when their particular needs or goals have been met.

What is the difference between group therapy and a support group?

The psychotherapy group is different from support and self-help groups in that it not only helps people cope with their problems, but also provides for change and growth. The focus goes beyond alleviating symptoms to finding the underlying roots of your problems and changing those for the better.

Support groups, which are generally led by professionals, help people cope with difficult situations at various times but are usually geared toward alleviating symptoms. Self-help groups usually focus on a particular shared symptom or situation and are usually not led by a trained therapist.

I’m not sure I could open up in a group

Many people who have never tried group therapy before are frightened by the idea. Sharing intimate information and details about one’s life and problems can be challenging enough to do with a single therapist. To do so with six other strangers might seem overwhelming.

It’s not unusual to feel uneasy or embarrassed when first joining a group, but within a few sessions you will begin to develop feelings of interest and trust. Most people find that group therapy provides a great deal of relief because it allows them a chance to talk with others who are experiencing similar problems in a private, confidential setting. Many people who have experienced group therapy believe that working together with others is helpful and they feel better by participating in this form of therapy.

It is important to always remember that only you determine what you will talk about in the group. No one will force you to reveal more about yourself than you are willing to.

If someone is in a group, do they also need individual therapy?

It depends on the individual. Typically, you first will have individual one-on-one therapy, then later have group therapy. But some Anxiety Disorders, such as Post Traumatic Stress Disorder, respond well to group therapy, and it may be used as the main or only treatment approach.

Sometimes group therapy is used along with individual therapy. Often people find that working in both group and individual therapy stimulates growth in mutually complementary ways. You may be seeing two different therapists for individual and group therapies. If this is the case, it’s generally considered important for the two therapists to communicate with each other periodically for your benefit.

In what ways can group therapy help you?

Unlike individual therapy sessions, group therapy offers you the opportunity to interact with others with similar issues in a safe, supportive environment. You can try out new behaviors, role play, and engage with others in not only receiving valuable feedback and insight from other group members, but also in giving it.

Here is a list of the kinds of benefits group therapy can give you:

You recognize that other members share similar feelings, thoughts and problems. You realize that you are not alone in your feelings and concerns.
You gain a boost to self concept through extending help to other group members. Helping others is a good feeling and is therapeutic in and of itself.
You recognize that other members’ success can be helpful to you and help develop optimism and hope for your own improvement.
You learn from the advice given by the therapist and other group members.
You can reenact critical relationship dynamics with group members, learning how to interact with others better.
The group provides you with an environment that fosters good communication and the development of socializing techniques. Since so much of our daily interaction with other people, you can learn to improve your social skills.
You expand your personal knowledge and skills through the observation of other group members as they explore themselves, work through problems and develop themselves personally. By seeing how others handle similar problems, you can rapidly add new coping methods to your behaviors.
The group experiences feelings of trust, belonging and togetherness, fostering cohesiveness.
You learn to accept responsibility for life decisions through observing the other group members and through working through your own problems.
You can release strong feelings about past or present experiences. These feelings build up continual stress, and you will feel great relief in resolving this stress.
You gain personal insight about your impact on others through feedback provided from other members. We often do not realize how our behavior affects others, and the group is an effective way to learn and modify our behavior.
The group provides an environment that allows members to learn from each other and interact in a more adaptive manner.
You gain self-understanding and insight into psychological motivations underlying your behavior and emotional reactions.

Does insurance cover group therapy? What is the cost?

By treating several patients at the same time, the therapist can reduce the usual fee. In most cases the cost of group therapy is from one-half to one-third that of individual therapy.

Insurance coverage is usually similar for both individual and group therapy. In addition, most managed care companies cover group therapy much the same as individual therapy.

Can just any therapist offer group therapy? Are there special certifications?

Group psychotherapists are mental health professionals trained in one of several areas: psychiatry, psychology, social work, psychiatric nursing, marriage and family therapy, pastoral counseling, creative arts therapy or substance abuse counseling. Your own therapist may be the group leader, or may recommend another therapist’s group.

In considering a therapist for a group, make sure he or she is also qualified to lead group psychotherapy. The National Registry of Certified Group Psychotherapists certifies group therapists by the designation “CGP,” which means the therapist has received specialized training in group therapy. Clinical Members of the American Group Psychotherapy Association (AGPA) also have received specialized training.

What do you think?

As someone who has participated in group therapy, I can heartily recommend it to you. In my mind, it doesn’t replace one-on-one psychotherapy, but complements it. What I learned in my therapy sessions, I put into practice in the group. And some of my deepest knowledge about myself and my behavior have come from group sessions.

Have you ever participated in group therapy? What was your experience?
What are your feelings about group therapy; is it something you think you might like to try?

As always, your comments are welcome!

If you have enjoyed this article, please consider subscribing to this blog, either via RSS or email at the right top of the screen. I would also appreciate it if you shared this article with your favorite social media, such as StumbleUpon or Digg. Just click the little green “ShareThis” button at the bottom of this post.

Resources used in this post:

American Group Psychotherapy Association. (2007). Group Therapy: Therapeutic Factors and Therapeutic Mechanisms. Retrieved July 31, 2008 from American Group Psychotherapy Association Web site: http://www.agpa.org/guidelines/factorsandmechanisms.html

American Group Psychotherapy Association. (2007). Group Works! Information about Group Psychotherapy. Retrieved July 31, 2008 from American Group Psychotherapy Association Web site: http://www.agpa.org/group/consumersguide2000.html

Herkov, Michael. (2006, December 10). About Group Therapy. Retrieved June 27, 2008 from Psych Central Web site: http://psychcentral.com/lib/?p=677