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Matter of trust: what do people hide from the psychologist?

04.06.2019 Author: Psychologist Pavel Khoroshutin
lie to the psychologist

A group of psychologists led by Barry Farber, a professor of psychology at Columbia University College of Education, has long been working on patient openness in psychology and psychotherapy. They conducted some studies and surveys which have confirmed that patients keep secrets, avoid painful topics, and often just lie:

  • 93% of patients deceived their psychologist at least once
  • 83% of patients lied about a specific topic or avoided discussing it

What do people lie about?

The most common “unpleasant” topics are:

  • sex
  • alcohol or drugs
  • suicidal thoughts
  • traumatic situations
  • attitude to the psychologist and faith in the result

Patients named the following reasons why they prefer to hide the truth or tell only a part of it:

  • 61% embarrassment or shame
  • 27% do not want to be distracted from other topics
  • 24% doubt that a psychologist can help or understand
  • 19% are afraid of bad consequences (problems with the law, forced hospitalization)
  • 18% are afraid of their own emotions
  • 16% do not want to offend or disappoint the psychologist

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Much depends on the personal limit of an individual’s frankness, the perception of a psychologist and the reliability of psychological contact. Seventy percent of patients who hid thoughts of suicide were guided by a fear of undesirable consequences of their frankness, for example, forced hospitalization. Lying and being secretive about sex is mostly due to shame and embarrassment. People lie about their sexual lives, the presence of sexually transmitted diseases in the past and the present, fantasies and desires, dysfunctions, masturbation and infidelity. Some fear that candor will change the subjective attitude of the psychologist. In sexual minorities, the discussion of sensitive topics can awaken a feeling of their own “wrongness” and an inconsistency with generally accepted norms.

Of 798 patients, 65% answered that they do not discuss the topic of sexual activity with the psychologist and 80% do not talk about their fantasies or desires.

Why do we need frankness?

One lie stimulates another. Insincerity destroys the much-needed atmosphere of trust and slows down the process of solving psychological problems. Sometimes an individual chooses which topics to talk about and which to remain silent. The time of communication with a psychologist is often limited, and due to unnecessary secrecy, it is possible to miss important details or disrupt the therapy process. Frankness helps to find answers to questions of relationships, emotional state and health.

How to help the patient to open up?

  • Ask specific questions. About half of the interviewed patients said they could be more explicit about sex if the psychologist asked about it directly.
  • If the patient is not in the mood to discuss sensitive topics, you should not continue to show interest in them: it repels and the person closes.
  • Instill confidence in the patient. Many patients are ready to open up if they are sure that frankness will not affect the attitude of the psychologist towards them.
  • It is important that the patient is aware of the fact that understatement prevents a specialist from fully helping him/her.
  • The frankness of the psychologist about the peculiarities of his/her worldview, restraint of reactions and respect for personal space encourages the patient’s reciprocal frankness, as well as confidence in the competence of the specialist in the discussion of sensitive issues.
  • The specialist needs to ensure impartiality and completely exclude condemnation.

Sometimes it is difficult to open up to a psychologist at a personal appointment, because first of all we see not just a specialist, but a person. In such cases, technical progress helps and remote anonymous psychological assistance is now widely available. Remember that you can always choose the most suitable format for psychological therapy.