NYC Psychotherapist Blog

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Saturday, March 30, 2013

Why It's Best to Be Honest With Your Psychotherapist

One reason why therapy doesn't work out sometimes is that some clients don't feel comfortable being completely honest with their therapists about important issues in their lives that are causing problems for them.

Why It's Best to Be Honest With Your Psychotherapist

When Shame Keeps Clients From Being Completely Honest With Their Therapists
Often, it's not a matter of psychotherapy clients deliberately attempting to deceive their therapists.  Usually, it's more a matter of clients feeling ashamed of their problems and wanting to appear in a more favorable light.

Shame can be overwhelming.  And, when clients intentionally omit important information about what's going on with them because they feel too embarrassed to reveal their problems to their therapist, they usually end up sabotaging their own treatment because the therapist is missing important information, which doesn't allow her to help the client.

Building a Rapport With Your Therapist
When clients begin therapy, it usually takes a while for the client and therapist to develop a rapport in treatment.  This is normal part of treatment.  So, it's understandable that clients might not reveal things they're ashamed of when they start therapy before they know if they can trust their therapist.  

Withholding Information From Your Therapist Can Result in an "As If" Therapy
When months and years go by and clients don't divulge important information about themselves, the therapy often becomes an "as if" therapy.  The therapist is operating on certain assumptions about the client and offering help related to what she knows, but the secrets that the client is keeping from the therapist have gone underground.   

This might become obvious to the therapist after a while.  She might have an intuitive sense that something is amiss in treatment.  Most experienced and skilled therapists would understand that a client feels too ashamed to discuss certain aspects of himself that he might be too embarrassed to reveal.  

Getting Honest With Your Therapist Can Lead to an Emotional Breakthrough
Once the therapist becomes aware that the client was withholding information, if the therapist approaches this issue with tact and compassion, it can be a real breakthrough for the client and the therapeutic work.  The client usually feels relieved that he no longer has the burden of keeping secrets from his therapist.  

More importantly, he realizes that his therapist still cares about him and wants to work with him.  This is often an emotionally reparative experience, especially if the client came from a family where love was conditional, based on his being a certain way in the family.

Attention-Seeking Behavior: Fictitious Disorder
Another reason why clients aren't honest with therapists is that they might be engaging in attention-seeking behavior.  Attention-seeking behavior could involve either lying to the therapist or exaggerating problems.

For instance, a client might make up a very traumatic family history that is completely false with the intent of getting attention and sympathy.  This type of behavior is called Fictitious Disorder (see my blog article:  Attention-Seeking Behavior in Therapy: Understanding Fictitious Disorder).

A Mismatch Between Therapist and Client Can Result in a Client Withholding Information
Another factor might be that the client and therapist are not a good therapeutic match.

Unfortunately, many clients don't realize how important it is to be with a therapist with whom they have a good rapport.  Of course, as previously mentioned, this is developed over time.  But if months pass and a psychotherapy client still feels he doesn't "click" with his therapist, rather than remaining silent about it or aborting treatment, it would be better for him to speak to the therapist about it.

Ultimately, if this issue cannot be worked out, it would be better for the client to find another therapist. Most experienced therapists understand that every therapist is not for every client, and it's important for the client to feel comfortable.

Some Discomfort With Revealing Uncomfortable Aspects of Yourself is Understandable
Being open in therapy isn't always easy.  It takes courage to go to therapy and open up about things that you don't feel comfortable about.  But, in the end, if you're not honest with your therapist, you're only hurting yourself.

Often, concerns about what the therapist might think if you reveal what you're ashamed of is actually a projection about how you feel about it yourself.

Adjunctive Treatment Might Be Necessary
Recognize that most experienced therapists have heard just about everything you could think of and more.

If your problem is outside of the scope of what your therapist is knowledgeable about, she will tell you and might refer you for adjunctive treatment.

So, for instance, if you reveal that you're having a substance abuse problem and your therapist has no experience with substance abuse, she might refer you to a 12 Step program or a structured outpatient chemical dependency program.

Recognize That You're Not Alone
Many, if not most, people in therapy have gone through times when they feel uncomfortable discussing certain aspects of their lives with their therapists.

But I believe that if you were to ask people who overcame their discomfort and were honest with their therapists, they would tell you that getting over the initial discomfort was worth it in terms of the treatment and how they felt about themselves.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist.

I work with individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 or email me.