Friday, March 25, 2011

Doing bad therapy - client information.

KYLady states

“According to your diagram, as long as you never catch your client in a lie or he doesn’t admit lying to you, you can provide good therapy. What if the problem he comes to you with is that he lies all the time. Can therapy help somebody like that?” (end quote)

Here, I discuss therapists doing bad therapy when what they believe about the client is not true.

One can do bad therapy when the information they have is inaccurate and thus they believe things about the client that are not true.

Clients lie all the time. Indeed people lie all the time.


I have said before there are similarities between a police interview with a suspect and a therapist interview with a client. Both are seeking to identify the lies but for quite different motives. One is constantly cross checking information provided by the client to identify inconsistencies. The same question asked in different ways, in different contexts two weeks apart. At the beginning of a session I might begin with chit chat therapy as this is a good way to cross check information and just get information about the client. Their defences are more down compared to the interview situation of therapist and client.

For example, as I meet the client at the door she may talk a bit about what she did last night and may mention a restaurant she went to that I know. As we chat about it I may ask her about the meal she ordered. She reports a meal that is high fat and high calorie and she is skinny. What is going on there? The little bell rings in the therapists head - to be revisited later on!

By simply chatting about an evening at a restaurant one can get a lot of information about a client and their relationship to food, eating and so forth. Chit chat therapy is good as the defences are down. police so the same with good cop, bad cop. If they can create that situation in the crims mind the person will be less defended with the good cop person.

informal man

Now, I am not suggesting that clients are a group of pathological liars. When one meets a new client for the first time one has got to expect they are not going to get the truth or at least the whole truth. Clients sometimes talk about very intimate things and I am a complete stranger to them. If a woman is talking about a bad marital situation I may ask her if she has had an affair. At that point I know she may not be fully candid simply because she does not know me and there has not been the time for trust to develop. I would be the same if I was in her situation.

Secondly clients lie all the time because they lie to themselves. This is the lie the therapist is most often looking for. The client who says she loves her husband whilst shaking her head. She is lying to her self about her love for her husband. If the therapist does not see the lie then he will believe something about the client that is not true and do bad therapy.

Fake sun tan! Even body language can lie.

Coerced clients could be seen as more likely to tell falsehoods. If I was told I had to go to counselling I would be resistant at some level as well.

However in my situation where clients pay money to see me one can expect more truths to be told. The client knows if they tell me falsehoods, I will do bad therapy which they are paying for. However this does not always happen. I wrote a long time ago of a man I saw semi regularly over a 4 or 5 year period.

In the last 3 months of our meetings he told me that he required a heart lung transplant and it was quite likely he would not survive the operation. I had noticed he had trouble breathing at times and he said he was asthmatic. He wasn't. This piece of information significantly changed the course and form of therapy and he didn’t tell me for 4 years. So I did bad therapy for 4 years. It’s like working with someone to give up smoking when they are on death row. What’s the point.

Why he did that I am not too sure as I never got a clear answer to that question either. However as he slowly disclosed further information it became apparent that he was not doing all that he could, medically. Refusal of treatment for a life threatening illness? A suicidal act? Maybe?

Man dog


PS. Oh! about my comment that clients lie all the time. I am just being a bit obtuse. I like clients.

1 comment:

  1. Thank you, Tony. You answered my questions very well. Your reply highlights a problem with instant messaging (chat), which some therapists use to conduct therapy. They get no visual clues from their clients.