Psychotherapy is a topic of endless fascination and has been for more than a century. PsycINFO, a database of publications in psychology and related disciplines dating back to 1883, includes more than 38,000 books on psychotherapy, more than 178,000 articles in scholarly journals, and close to 10,000 dissertations and theses. And yet, not until the publication of Secrets and Lies in Psychotherapy in 2019 has there been such a wide-ranging, authoritative, research-based consideration of the place of deceit in psychotherapy.
Barry A. Farber, the first author of the book, is an eminent professor of clinical psychology at Columbia University and the author of previous books, including the particularly relevant Self-Disclosure in Psychotherapy. Co-authors Matt Blanchard and Melanie Love were doctoral students in the clinical psychology program at Columbia. The three of them bring to Secrets and Lies in Psychotherapy their years (or in Farber’s case, decades) of experience practicing psychotherapy. They also have something unique to offer – a pair of landmark studies of the lies that 1,345 clients have told to their therapists.
Because of those studies, we now have a better understanding than we ever did before of such basic issues as what clients lie about, why they lie to their therapists, how extensively they lie, how they feel about their lies, and what it would take for them to be more honest. A chapter in the middle of the book describes those findings. To the growing number of researchers studying deception, that chapter will itself be worth the price of admission.
Social scientists like crisp, clear definitions, but secrets and lies are surprisingly slippery concepts. For example, is a client lying or telling the truth as she remembers it, however inaccurately? Is another client keeping a secret from his therapist or waiting until he feels secure enough in his relationship with his therapist to disclose it? In the opening chapter of Secrets and Lies, the authors explore the nuances of deception, evasions, and omissions in psychotherapy and the psychological dynamics that render those untruths so difficult to detect.
Although the focus of the book is on the deceit that occurs in psychotherapy, the authors ground their discussions in the extensive writings on lying in contexts beyond the therapy room. The second chapter is a thoughtful overview of that burgeoning literature. A chapter on what we knew about client disclosure and dishonesty in psychotherapy before the authors conducted their two new studies comes next, followed by a sophisticated discussion of the psychology of lying and withholding in psychotherapy.
Each of five additional chapters goes deep into a specific kind of deception: lies about suicidal thoughts, self-harm, and emotional distress; lies about all things sexual; about substance use and abuse; trauma; and clients’ feelings about their therapist and the progress they are making in therapy. The chapters include examples of the lies, discussions of the motives for the lies, and suggestions for fostering greater honesty.
The closing chapter, with its nuanced, fair-minded, and absorbing overview of different clinical perspectives on secrets and lies in therapy, is a gem. It includes specific suggestions for therapists on how they can encourage their clients to disclose difficult material and feel safe while doing so. My guess is that psychotherapists and other mental health practitioners will value that chapter most of all.
Secrets and Lies is an academic book, full of the kinds of formal references to relevant publications that are de rigueur in scholarly writings. It could have been boring. But with the exception of one chapter, the overview of previous writings on deception in psychotherapy, it wasn’t. The book is engagingly written. It is sprinkled with delightfully apt quotes from serious literature as well as popular culture. It includes many examples and anecdotes from the authors’ experiences as well as other publications and blog posts. As part of the research the authors conducted, hundreds of clients described in their own words the lies they told to their therapist and their reasons for telling their lies. Those first-hand accounts, quoted here and there to illustrate key points, provide a richness and immediacy missing from many academic publications.
The layperson is not the primary audience for Secrets and Lies in Psychotherapy, but I predict that plenty of them will find their way to the book and embrace it. Their favorite chapter may be the one I have not yet mentioned, about the lies that therapists tell to their clients.
Research on deception has a special place in my own professional life. Before I turned my attention to the study of single people, I spent several decades studying the psychology of lying and detecting lies. In our studies of lying in everyday life, my colleagues and I found that just about everyone lies. In our studies of the human ability to detect lies without the help of any special equipment, we found that people are surprisingly inept at separating truths from lies; on the average, they are correct in their judgments only a little more than half the time.
Psychotherapy, in theory, should be a safe place for truthful explorations of even the most difficult topics. Psychotherapists, with their training and sensitivity, could — again in theory — be especially skilled at recognizing deceptions. The research by Farber and his colleagues, though, revealed strikingly high rates of deception by clients and many instances in which therapists remained oblivious to the deceit.
In Secrets and Lies in Psychotherapy, the authors demonstrate a wonderfully respectful and open-minded attitude toward the people who seek healing in psychotherapy. They believe that therapists should help clients disclose more fully and more honestly when they are ready. But they also understand that therapist missteps can unwittingly undermine clients’ willingness to reveal their secrets. Importantly, they recognize, too, that clients can have legitimate reasons for withholding or dissembling. “Clients who are dishonest are generally not out to dupe the therapist,” they note; “they are, for the most part, reacting to the human desire to feel safe and understood.”
Secrets and Lies in Psychotherapy is a ground-breaking book. It will be the definitive source on the topic for many years to come.