Saturday, December 4, 2010

Therapists, clients and trust

In a previous comment Harriet stated:

“But I am sorry that his lack of disclosure led to distrust on your part.”

This comment resonated with me and led me to muse on the topic of clients, therapists and trust. (I like words such as resonate and muse, they make me sound like I know what I am talking about!)

I mused - do I have a sense of trust or distrust with clients? The answer I came up with was in one specific sense yes, but I would say generally, no.

In my work circumstances of private practice I do trust clients in our business relationship. I deliver a service, then they pay once they have received that service. There is a small group of clients who come to therapy and have no intention of paying. Over the years I have seen all sorts of methods employed by people who are wanting to get sessions without paying for them. I never let new clients accumulate any significant debt so those who are not intending to pay may get a few sessions for free but that is all. Then they leave and I never see them again.


This indeed raises another interesting question in terms of the therapeutic relationship. If a client enters into a therapeutic relationship with no intention of paying how does that effect the therapeutic relationship. Perhaps I will muse on this some more for a later time. However in terms of our business relationship, I do have a sense of trust and distrust with a client.

Other than this the concept of me trusting or distrusting a client kind of does not make sense. In particular, as Harriet was mentioning, I don’t have a sense of trust or mistrust about a client telling me the truth and the whole truth. I just don’t see it that way. It does not ‘compute’ like that.

Ethiopian hairdress

Clients, like everyone else have a Child ego state that is struggling to cope the best way it can, with the psychological resources it has, at a particular point in time. If the Child ego state feels it necessary to tell me a falsehood or not tell me the whole truth then I accept that. I do not feel like my trust has been betrayed by the client. I see it as them coping the best way they can.

I also know that clients, like everyone else, will behave in consistent patterns over time. I know that if a client tells me a significant falsehood about the facts of their life, then it is likely that they will do so again in the future in some way. Not because they are trying to trick me or deceive me but because they are coping the best way they can at that time. I don’t ‘win’ or lose’ anything if the client tells me the truth, just like I don’t ‘win’ or lose’ anything if the client tells me a falsehood.

Man & pig dog 3

Thus in relation to Harriet’s comment I don’t get led to distrusting a client if they tell me a falsehood. Instead I accept they are doing their best they can at the time and I know they may employ the same coping mechanism of telling falsehoods in the future.



  1. In your first post about the man needing the transplant you said, "The other problem this creates is that once a falsehood of this significance and type (ie not embarrassment based) is disclosed then I don’t know if what is now being disclosed to me is yet another falsehood or at least partial falsehood."

    This is what led me to believe that you cannot trust him once you find out he has not revealed something to you. Perhaps I jumped to conclusions in thinking that this is distrust. My definition of distrust is when you don't know if someone is telling the truth.

    And you said it is a problem. Sometimes I lie to my t, either by accident or on purpose. Then I tend to email him right away because I feel guilty about lying and I don't want him to think I'm distrustful. I also lie by omission, I don't tell him everything. I feel about that as well, and I hope that if and when I do eventually tell him whatever it is that I was omitting, that it won't cause problems with trust on his part. But I think these are the more embarrassment based type of issues that you mention above.

    I'm not talking about such huge issues as your client had - impending death is a lot different than having a fight with one's spouse I'd say.

  2. Graffie,

    You know I couldn't do your job - I reckon you must really enjoy people.

    But you know mostly you are not on to a winner. Either your clients have higher expectations that you will never fulfil and ultimately you will disappoint them, or they are playing out a script that will cause them to flick you off at some point to reinforce their script, or maybe life gets in the way and the own therapists insecurities.

    Ho hum. If you hadn't become a therapist what would you have done?

    Anyway, I ramble. I am off to bed. I hope you have a good day, with good weather. No rain. Particularly I hope its dry in Adelaide.

    A very 'umble Kahless

  3. Thanks for your comment Harriet and I agree with most of what you say. I only raised this issue because as you say the information with held in this instance was 'big' so to speak. I think we all, including me, with hold information and tell the odd 'white lie' from time to time. It sounds to me like you are candid with your therapist like most would be


  4. Hello Kahless,

    I find relating to people interesting. I am not sure that I would say that I really enjoy people, anymore than say the average.

    I very much enjoy my own company and can easily spend time alone. That may be because my work involves at time intense relating to others and there is a bit of over load.

    And thank you for being humble in what will today be a victory for you. Well done to you and your lot. As I heard one aussie commentator state on the radio yesterday, "The poms have only done three things better than us this game - batted, bowled and fielded".

    If hadn't become a psychologist I would have been an ichthyologist.