The need to see a clinician
We all need to see a clinician when
our psyche begins to ‘malfunction’. We need advice from an expert, a
professional who can hopefully alleviate our issues. Should I now go to the psychologist? Most of
us have asked that question at one time or another. Whether its anxiety,
depression or that nagging ideation of suicide or homicide that just won’t got
away, it can be hard to know when you should be seen by a clinician. There are
no set rules that tell you when to go or when to wait. But some general
guidelines might help you the next time you’re trying to decide. Mental health
is an important part of our overall health and should never be ignored. Having
issues with mental health is also very common and treatable. Please, call your
clinician if are experiencing any of these signs of trouble with your mental
health. Feelings of depression or sadness that don’t go away; Feeling extreme
highs and lows; Having excessive fear, worry, or anxiety; Withdrawing from
social interactions; Changes in eating or sleeping; Inability to cope with
daily problems; Delusions or hallucinations; Substance abuse; Thoughts of
hurting yourself or others.
But, why Lie?
This is common and it's not unusual
for clients to lie to me. Sometimes, they do so because they are
embarrassed. Sometimes they're afraid they are somehow going to "get into
trouble" if they tell me the truth. As professionals believe me when I say
“we have heard it all”. Years of experience shows the truth eventually ‘shows
up’ especially stretching the truth and leaving out important
details, at other times, clients may be in denial when facts are presented
to them. A client who is significantly off his baseline behavior is a red flag,
or, after failing a drug test, might insist that he had to have been
"framed" because he doesn't use drugs. Following, however are three key
reasons for lying:
Clients want to be
respectful: This is usually the case when the therapeutic
relationship is yet to be developed. Essentially trust has not been
established. Clients will just go along without challenge/clarification on all
the clinician’s directions. Admitting to things like, "I didn't try the
homework you suggested," or "I did the exact opposite of what we
talked about last week." In an effort to please the therapist or to avoid
any consequences, it's common for clients to lie about the work they're doing.
The topic is
uncomfortable: Talking about a traumatic event or describing some poor choices (especially
if it is sexually related) made is difficult telling another person. It's often
easier to divert the conversation or deny any problems exist. It's tough to
talk about things that stir up shame. In an effort to protect themselves, many
clients deny circumstances or behavior that causes them to feel ashamed.
Denial: Sometimes, patients
just aren't ready to admit the truth to themselves. So they minimize how much
time they spend on social media or deny that their substance use creates
problems for them because they don't want to face the truth. Also, announcing
one’s failures, shortcomings, and setbacks each week is a blow to the self-esteem.
To subvert this clients only talk about the good things they're doing.
Do psychologists
know when you lie to them?
Psychologists
have their training and experience which includes keen listening, observation
and logical skills. These enable them to help ask the right questions, get to
the root of their issues and command treatment. But, there’s no magic
lie-detection skill clinicians acquired. The function and aim isn’t to judge but
to help clients get a grip on their issues and give them traction that they can
use to battle and overcome these issues. If a client is lying, then there is denial
ultimately lying to himself/herself. And, lack of honesty towards oneself makes
it very, very difficult to heal or to take responsibility and control. Almost
all the time I expect my clients to lie to me. This is what they do. It doesn't
mean they can't change, but many live in dysfunctional environments which
breeds chaos, secrets, lies and omissions. With time and patience, conditions
can be created where clients can be comfortable disclosing their feelings. There
will always be unconditional positive regard from me as I will continue to be
remind them they are in a safe place and that their confidentiality will always
respected.
Now, what
So,
what can psychologists do about lies in therapy? "In some cases, the best
action is to do nothing," if you have the sense that pursuing the truth means
the client may discontinue therapy altogether." The therapist may also
find that a minor lie, such as why the client was late for a session, is better
dealt with only if it occurs again or is part of a pattern that needs to be
addressed. However if testing is necessitated this can be revealed. Tests such
as the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) contains four
validity scales designed to measure a person's test-taking attitude and
approach to the test: Lie (L) – The Lie
scale is intended to identify individuals who are deliberately trying to
avoid answering the MMPI honestly and in a frank manner. A word of caution, interpretation
of the MMPI Scales is never
done in isolation. A clinician who uses the MMPI-2 would need to
see all validity scales AND the
clinical scales (plus supplementary scales) to render an interpretation of
the entire profile of that client.
References
Farber, B.A., et al. APA, 2019 Secrets and Lies in Psychotherapy
Baumann,
E.C., & Hill, C.E. Counselling, Psychology Quarterly, 2016
Client Concealment and
Disclosure of
Secrets in Outpatient Psychotherapy
Slepian, M.,
et al., Journal of Personality and Social Psychology, 2017, The
Experience of Secrecy
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