Do Therapists Lie to Their Clients?

Curt and Katie chat about whether therapists are dishonest and whether they should be. We received a request from a listener to talk about the idea that therapists lie to their clients. We look at what types of lies are common, whether lying is expected or acceptable, what to do instead, and how to decide whether you will lie or not in session.

Transcript

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In this podcast episode we talk through how, when, and why therapists lie

We received a listener email requesting a discussion on therapist dishonesty and the impact on the therapeutic relationship.

What types of lies might a therapist tell?

• Whoppers (fraud)
• Fibs (untruths that support the clinical work or the therapeutic relationship)
• Omission (concealing facts that impact the client)
• Deflections (bending the truth for therapeutic effect)
• Denial (rejecting reality, with positive and negative results)

 Is it good or bad for a therapist to lie?

• Fraud is never okay, and is illegal and unethical
• Fibs may be in the best interest of the client OR could be to protect the therapist (which is human, but not really okay)
• Professionalism, exaggerating/minimizing emotional responses for therapeutic effect, and “social niceties” may be appropriate, but it is important to think about authenticity and whether it will negatively impact the client if they perceive the deception

“[When a client asks what I think about their appearance] I think it’s something where I’d want to talk to the core issue around what they’re seeking and if it’s how to present themselves best…I would talk through: how do you decide what clothing choices you’re making? How do you decide how you want to present yourself? Those types of things.” – Katie Vernoy, LMFT

• If a client is asking for the therapist’s opinion of them, the context of the client’s treatment agreements and their needs, as well as the therapeutic relationship impact whether a therapists will be best served by honesty or deflecting or denying the truth

What can therapists do when they are tempted to lie to their clients?

• Make the decision of whether to tell the truth based on the context of the relationship and treatment goals

“So much of this [deciding whether to be truthful with clients] is contextual. So much of this is being able to think ahead. How could this potentially go wrong? Because ultimately, what we’re working on is the therapeutic relationship with the client…especially when you do decide to not be fully truthful.” – Curt Widhalm, LMFT

• Be more transparent with the client about therapist’s limitations, while also holding hope and accountability to address these limitations
• Work collaboratively with the client to get to the information or treatment interventions that are needed, rather than working by and for yourself.
• If you lie to your client and it backfires, work to make repairs (see our episode on “Should Therapists Admit Mistakes?)

Resources for Modern Therapists mentioned in this Podcast Episode:

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Article: Lies, Deceptions and Denial

 

Relevant Episodes of MTSG Podcast:

 

Should Therapists Admit to Making Mistakes in Therapy?

Vulnerability, Mistakes, and The Impostor Syndrome

Impaired Therapists

Category: Authentic Self

Category: Whole Person Therapist

 

Who we are:

Curt Widhalm, LMFT

Curt Widhalm is in private practice in the Los Angeles area. He is the cofounder of the Therapy Reimagined conference, an Adjunct Professor at Pepperdine University and CSUN, a former Subject Matter Expert for the California Board of Behavioral Sciences, former CFO of the California Association of Marriage and Family Therapists, and a loving husband and father. He is 1/2 great person, 1/2 provocateur, and 1/2 geek, in that order. He dabbles in the dark art of making “dad jokes” and usually has a half-empty cup of coffee somewhere nearby. Learn more at: http://www.curtwidhalm.com

Katie Vernoy, LMFT

Katie Vernoy is a Licensed Marriage and Family Therapist, coach, and consultant supporting leaders, visionaries, executives, and helping professionals to create sustainable careers. Katie, with Curt, has developed workshops and a conference, Therapy Reimagined, to support therapists navigating through the modern challenges of this profession. Katie is also a former President of the California Association of Marriage and Family Therapists. In her spare time, Katie is secretly siphoning off Curt’s youthful energy, so that she can take over the world. Learn more at: http://www.katievernoy.com

A Quick Note:

Our opinions are our own. We are only speaking for ourselves – except when we speak for each other, or over each other. We’re working on it.

Our guests are also only speaking for themselves and have their own opinions. We aren’t trying to take their voice, and no one speaks for us either. Mostly because they don’t want to, but hey.

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Modern Therapist’s Survival Guide Creative Credits:

Voice Over by DW McCann https://www.facebook.com/McCannDW/

Music by Crystal Grooms Mangano https://groomsymusic.com/

Transcript for this episode of the Modern Therapist’s Survival Guide podcast (Autogenerated):

Transcripts do not include advertisements just a reference to the advertising break (as such timing does not account for advertisements).

… 0:00
(Opening Advertisement)

Announcer 0:00
You’re listening to the Modern Therapist’s Survival Guide, where therapists live, breathe and practice as human beings. To support you as a whole person and a therapist. Here are your hosts, Curt Widhalm and Katie Vernoy.

Curt Widhalm 0:12
Welcome back, modern therapists. This is the Modern Therapist’s Survival Guide. I’m Curt Widhalm with Katie Vernoy, and this is the podcast for therapists about the things that go on in our practice, how we hold ourselves as therapists, and some of the things that don’t necessarily have exact prescriptions on what we’re supposed to be doing in our line of work. And this episode is inspired by an email that we received from one of our listeners. This is from Erin. “Hi, Katie and Curt. I was wondering if you could do an episode on therapist dishonesty. Examples, when it is okay and when is it not, should you correct yourself at a later time (if the truth would have been harmful at the time)? How to handle if the client finds out things and brings it up, how to handle it, if it was a misunderstanding, when it could be a good clinical decision and when it might look like the right decision, but it turns out to backfire and why and what could have been done instead. How often is it that clients can tell but just don’t bring it up and how they might behave? Example, withdraw or terminate. Give some other reason. Examples of common and uncommon situations.” Katie, do you ever lie to clients?

Katie Vernoy 1:32
Yes, I probably do. Most of the time, like little, tiny untruths, mistruths, that’s not the right word, but tiny little things, deflections, kind of avoiding talking about things. But I don’t think I have done big lies with clients, but I certainly have done some some smaller lies that we’ll talk about in this episode. But how about you? Do you lie to your clients?

Curt Widhalm 1:57
I don’t want to sound overconfident or misrepresent myself in any way here, but yeah. And I think the we’re gonna get through a lot in this episode out of like there are a bunch of different kinds of lies. And as Erin asks in the question that was sent to us by email, there’s times where it makes sense, there’s times where it doesn’t, there’s times where it backfires. There’s no blanket rules when it comes to clients, because what might work with one client might not work with another one. And we’re going to dive into all that.

Katie Vernoy 2:41
Yes, we are. We are definitely indeed. So we’re going to be basing this on an article from the Journal of ethics and mental health. The article is “Lies, Deception and Denial in the Counseling Profession: An inconvenient truth.” This is by Izaak L. Williams is the author on this, just one author, and it was published, I think in 2018. This article is very helpful. I think it’s it’s a good read. It’s like 29 pages, so it’s a little bit of a long read, but it some of it has some really great examples in there, and I think it can be very helpful. So I’ll definitely put this in the show notes over at mtsgpodcast com. But the reason I like this article for this conversation is that it talks through different types of lies and puts them on kind of a scale and gives examples. And so I think the way that we want to structure this is to start with a little bit about what lying can look like in therapy, and then talk through and kind of share our opinions on some examples of when we might lie, when we might choose not to lie, and you know, pros and cons of both, and as well as you know some of what Erin has asked for, there was a lot in that email. So I don’t know that we’re going to cover all of those things, but try to get to a place of some takeaways around the nuance of deception and what you might want to do instead, or how you might fix things when they backfire. And so what we’ll also, we’ve also talked about some of this stuff before, so we’ll, there’s going to be a lot of relevant episodes that are in the show notes as well. To get started, the first type of lie, you know, the the biggest, the boldest kind of lie are Whoppers. The authors using, I think, kind of fun words to describe these lies, but Whoppers are bold face lies. The types of lies that are discussed in here are, I think, akin to fraud, falsely certifying treatment, extending the duration of treatment beyond what you believe is beneficial to continue to receive payment, lying about what happened, upcharging or over utilization, billing for services not rendered. Those types of things like these are clearly lies, I think loosely lies, but I would call it fraud that are never okay.

Curt Widhalm 5:03
These ones, seemingly at face value, are illegal and unethical.

Katie Vernoy 5:11
Yes. So moving on to the next type of lie, fibs, unlike Whoppers, fibs are falsehoods that are used for the sake of the counseling relationship or therapeutic treatment process. So these ones seem to have potentially clinical utility or utility within the relationship. So I think there’s probably going to be a little bit more discussion here around the nuance that you were talking about and and some of the context that we were talking about before we hit record. So Curt, do you fib to clients?

Curt Widhalm 5:42
Absolutely yes. And I will say that more often than not, the the fibs that come up are true. They’re stories that are based in truth, but for the convenience of the client, in order to keep the focus on where it’s beneficial to the client, the details get changed. So it might be something that is, something that’s a personal experience of mine, but it would be completely inappropriate to say I went through this thing.

Katie Vernoy 6:17
Okay, so tell me, give me an example.

Curt Widhalm 6:19
So it might be something where, if a client is talking about, have you ever experienced suicidal ideation? Depending on the nature of the client or what might come up, what I’ll say is, I’ve worked with a lot of people who have been in this very specific part of suicidal ideation, which is just don’t want to be here, like I’m envisioning walking through, you know, life, and it’s just looking at a bus coming down the street and just picturing myself like, what if I stepped in front of the bus? If that’s, you know, the example that I’m using here, but if that’s my story, it’s not appropriate to tell clients like, oh yeah. I’ve totally had these, these thoughts before. What if I stepped in front of the bus? So those are the kinds of fibs where it’s like, oh yeah. I had a client that thought that once, that’s kind of just shifting it off of the focus of, let’s not make this about me. Let’s make let’s put this into a little bit of a validation hope, and here’s what that person did to get through this.

Katie Vernoy 7:25
Yeah. Okay, the example in here is actually the opposite, which is untruthfully telling the client you have experienced the same situation or felt the same way in order to relate to the client. And so I think fibs are actually a little bit more active, but the one I want to talk about in this section is denying boredom or drowsiness in session, but giving credit to an innocuous or therapeutic sounding reason.

Curt Widhalm 7:50
Interesting.

Katie Vernoy 7:51
I actually had a colleague at one point who was determined that if they started yawning, it was a sign that there was some undisclosed grief responses that the client wasn’t addressing. And so if, if that went into the session, it the conversation became about, what grief are you not talking about?

Curt Widhalm 8:12
So, this therapist had grief-dar.

Katie Vernoy 8:17
I guess so. I guess so. It was, it was a special kind of grief-dar. Yeah.

Curt Widhalm 8:21
I remember being early in my career and having that desire to validate clients experiences through empathy. And I think this is a very natural when you’re first working with a lot of clients, to kind of deal with your own sort of inadequacies. To be like, Oh yeah, I totally know what that feeling is, and talk and a lot of us end up maturing through that kind of a process to be able to explore some of that empathy or to validate clients experiences. Sometimes that does put therapists into a position where they are making up stuff just to hide their own inadequacies, as you’re talking about here to be. Oh, yeah, I totally know that. And this is one of those situations where I think to Erin’s questions in the letter to us or the email to us is this is where it can backfire, where it’s clients can be like, Oh, tell me more. And then if you don’t really have, you know, a story that goes along with that, that can be something that creates a therapeutic rupture with your clients, and then you’re going into damage control. And I think that that’s really one of the big dangers here. I’ve learned for a lot of my career where those situations that come up where I get asked, you know, do you have any experience with this? I’ve largely come to a place of honesty, which is, I don’t have my own personal lived experience with this particular thing. And if it does become something that ends up becoming a barrier in our therapeutic process. We’ll address that for what it needs to be. In the meantime, let’s talk about the concerns with it. And so there’s really being able to own kind of your own limitations that’s the antidote to this.

Katie Vernoy 10:15
I agree. I think it’s something where, when the fib is to protect the therapist, whether it’s their inadequacy, you know, hiding their inadequacies, pretending that they’re not sleepy, or, you know, those types of things. I think there is some room for it. And I think we’re all human, and we’re going to want to protect ourselves. But there’s also this other element of it where it feels very self serving, and I feel like those are the things that you’re more likely to get caught at. You know, whether it’s asking for more details or even just the client feeling the inauthenticity in the relationship.

… 10:51
(Advertisement Break)

Katie Vernoy 10:51
Another example of a fib is faith, feigning compassion and empathy when no such sentiment is felt or pretending to show interest in a client’s story. I think that’s for the protection of the client, and the part that’s for the protection of the client is helpful, or it’s part of our job. There’s, there’s another section in this article that’s about professionalism being a type of deception or a lie, and that we put on our professional armor. And that’s not really us, and we can talk about that more if we have time, but I think it’s, it’s this piece of if I am rude to the client, to say like you’re super boring, and I guess it depends on the client, or if I’m having a day that is challenging and I’m not feeling compassion, but I know that my job is to be compassionate. I don’t necessarily see the harm in that, but you still may be caught. So, so what do you think?

Curt Widhalm 11:45
I think a lot of this comes down to the environment that you work in, the relationships that you have with clients. And you and I have had years of publicly talking about being very authentic to how we work, and I think that that’s probably going to come up in some of the discussion that we have throughout this episode here. And I’ll be the first to say that not every therapeutic style, not every therapeutic placement/agency wherever you work, is going to necessarily support what we’re talking about here. And so I want to frame this very much as these are possibilities. These aren’t necessarily blanket rules. And so you can put down your pitchforks that you have not yet picked up to maybe go on a journey through some of these stories. But sometimes clients need to be told they’re boring.

Katie Vernoy 11:45
Yeah, yeah.

Curt Widhalm 11:48
And you know, it’s not like we’re gonna lead sessions with how you gonna bore me today, but…

Katie Vernoy 12:01
Although I could hear you say that to some clients.

Curt Widhalm 12:19
Probably, and that’s gonna come very much to the therapeutic relationships that I have with some clients. But,..

Katie Vernoy 12:40
Yeah.

Curt Widhalm 12:54
…or people who are working on social skills. Who are working on I want to better be able to storytell, to be able to keep people engaged in conversations with me. It can be very much a part of the therapeutic treatment plan to be able to say, hey, as we’re talking about things, I’m noticing my attention drifting off and getting bored, because you’re really honing in on parts of the story that are not important. And so in a practical skill building sort of way, that’s very much a part of a treatment plan, but that’s done with the cooperation of the client to be able to get to the space of getting that kind of feedback.

Katie Vernoy 13:38
Sure, and if it’s not part of the treatment plan for clients who have different styles of speaking, who are interested in things that are different than you. I feel like there is a certain fib that may be in the client’s best interest if they’re not wanting to work on storytelling, or if what they what they’re talking about, isn’t interesting to you. I don’t think we say you’re uninteresting to me. I’m having trouble staying awake. Like that doesn’t feel therapeutically helpful for a client, that that’s not what they’re working on. And I’m just saying the reverse of what you just said. So I’m speaking the same thing, but I think it’s important to acknowledge that so much of this, like all of therapy, is it depends. If it’s something the client is working on, if it’s something that is relevant, that may impact their other relationships, whether they want to work on that or not. I think you it’s a clinical decision that depends so much on the client’s ego strength, on the client’s ability to take really direct feedback and and, you know, like you said, what you’re collaborating on. There’s a lot of other examples with fibs, but I think it makes sense to kind of keep moving down the list here. The next one is one that I feel like is really probably the one that therapists do the most. It’s lies of omission. So there’s not a cute name, it’s just omission. And this one is it can take the form of bluff, concealment, omission that hides or fails to disclose information that might have special significance to the client in the context of the therapeutic process, is how it’s defined in this article, and it’s distinct from simply not telling the full truth, since the information is withheld specifically for the purpose of misleading or giving a false impression. One of the examples that I think is really important, and we have a whole podcourse episode about this, and I’ll link to tons of other articles that relate to this in the show notes, pretending to know what to do when, in reality, you don’t know, and then engendering a sense of false hope.

Curt Widhalm 15:46
I have done this in the past, and a lot of it did come from places of my own insecurity, and I think that one of the things that has really happened through our process in this podcast is becoming a lot more confident in myself and in my clinical abilities. And learning a lot of things, it’s hard putting out content week after week, as far as, like, your stuff that comes up. And so I’ve learned a lot through this, but most importantly, what I’ve learned is recognizing the limits of what I can provide in a particular moment. And so I’m thinking and I’m rambling until I get to the thinking point that I’m trying to come up to here…

Katie Vernoy 16:28
I must be rubbing off.

Curt Widhalm 16:29
But I’m I’m thinking to the point where I got to the point where I could comfortably sit with clients and say I don’t have an answer for that right now, and here’s my process for what I’m going to do to look into how we can address this. Sometimes that ends up being more training, sometimes that ends up being consultations. But earlier in my career, it was very tempting just to double down on what I already knew and to kind of force clients into whatever treatment modality that was. Part of what’s emerged through all of this process, for me is becoming really clear about how I work from the beginning of treatment. And so a lot of my intake sessions, or in the first couple of sessions I’m talking with clients about I don’t know everything. There might be things that we run into. And part of how I work is I try to be pretty darn straightforward about what I’m experiencing. Does that mean I’m going to tell you everything? Absolutely not. But that did come from kind of a place early in in my career, where it was I don’t know what to do. People are coming to me for expertise, for help in their life. They might be paying me a lot of money in order to do that. And so all of that builds up to this insecurity where it’s very tempting to be I do have answers, and I’m proving my worth, but I really want to be able to say, like, it’s okay to not know everything. It’s okay to not have answers for your clients all of the time. That can sometimes be the permission that your clients need to be, you know, not everything has an answer right in a particular moment. Yeah.

Katie Vernoy 18:19
One other piece of that, I think, is how you talk about it. Because I’ve had clients, or clients who had, you know significant others, who received a message like that, like I don’t have the answers for this. I don’t know how to treat you, or those types of things. And if it’s too direct, if it’s too quote, unquote honest. There are some clients that get the message I’m too much, or what I have is untreatable. And so I think in adding to what you’re saying, I think there are times when you can say, this is a specialty that I’ve not dug into a lot. I have some colleagues I can refer you to on this. Or what I’m planning to do is to consult with those colleagues so that I can bring some of that back in. That is honest and is a plan. Whereas, like, I don’t know how to work with that. This is outside of my scope. I can I’m going to need to refer you out. Which I I think that clients may report back an experience that is not what was actually said, because it felt, they felt abandoned by the therapist. So I’m going to acknowledge that sometimes you do a great job of saying all those things, and the client still feels like I’m too much and they kicked me out. But I think that there’s that element of being able to speak to the honesty, while still staying in a compassionate space and in a collaborative space. And I think that’s maybe that’s not what the question has been, but it seems like sometimes, and this assisted in the article, and I’ve experienced this myself, when you go to a place of, I don’t know, or you go to a place of overstating a little bit your capacity to get to a place that you can help them and your clients find out they can see it as very harmful. You lied. You don’t know about this, or you lied you, you, you told me that you couldn’t work with this, and you kicked me out. Right? Like and it can feel very, very harmful if we don’t handle it correctly. Understanding how we talk about things, whether they’re, you know, the next one, which is deflections, or if they’re full emissions, I think we need to make sure that we’re thinking about it and doing it consciously and not from a defensive space of I have to prove my worth. I have to be everything to my clients, my client. I need to hold hope for my clients, even though it’s going to require a whole bunch of homework and I’m not going to tell them about it. Like there can be all kinds of reasons why we think we need to lie to our clients in that moment. And I think that there’s compassionate ways to talk about our own limitations while still holding hope and still providing the grounding for the client.

… 21:08
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Katie Vernoy 21:08
So deflection is another type of misleading prevarication, a form of reality distortion that tends to bend the truth rather than contradicting it. And so it can be deliberate use of vague, figurative or metaphorical language in order to emphasize false or partial truths for the purpose of deflecting attention from the facts of the matter. And an example of this is just passing time in counseling rather than the honest hard work of therapeutic intervention, so as to escape a role for which the counselor feels inadequate, and also be deflecting blame or distorting truth by being intentionally vague or using metaphorical language, figurative speech or words with softening connotations. It’s evading what’s happening in the room.

Curt Widhalm 21:55
So when you first bring this up, I’m thinking, how many therapists are taught when a client asks you a direct question about things, Hey, are you married or hey, where do you where do you live, what neighborhood are you in? That we get taught into kind of these deflection kinds of things, which are, oh, why are you interested in that?

Katie Vernoy 22:16
That’s interesting that you talked about: why are you asking about this? So another one is exaggerating your emotional response for therapeutic purposes. So some of it is avoiding, right? It’s saying, hey, you know, that’s an interesting question. What brought that up? Some of it can be just chit chatting and not, and avoiding the hard question, right? And some of it can be actually having an emotional response and be like, you know, or overstating it, and potentially even understating a response, so that you’re focusing your attention on the client, but you’re trying to manipulate how you present for therapeutic effect, pretending to be happy to see them, or having a big response, or those types of things, and I can see that as being potentially helpful. And I could also see it being one of those things that backfire, where you’ve had this big response and then the next week, they ask you about it, and you don’t remember.

Curt Widhalm 23:19
I’m thinking about working with little kids when you’re dealing with other things going on in your life, where you do have to exaggerate, kind of that excitement, where it might be necessary sometimes in order to do what’s needed for the client. I mean, if you’re going through something like your own grief process, you have, you know, a four year old who’s bounding into the office kind of thing. I don’t think you’re going to be completely honest and say something, oh, you know, I’m just really sad today. Too bad kid.

Katie Vernoy 23:56
I agree. And I also think that it may all it may be something that you don’t want to bring in to your adult clients, depending on what their clinical material is for the day. I think there are times when we might say, I’m, you know, I’m a little bit tired, I’m a little off. This is what’s going on. And I think there are times when it would be more likely that we don’t present that and we do our best to potentially mask or manipulate our body language and words, to try to be as present as possible for the client, even if we’re pulling from a place that’s not authentic, because our job is to do so. And I think this, this speaks to that that professionalism is inauthentic, inauthenticity and deception as well. We are supposed to show up a certain way. And if we cannot, we have to decide, do we fake it, or do we call out? And I think there are times when faking it is required.

Curt Widhalm 24:52
You also don’t want clients coming in and telling them straight up, Oh, it’s you.

Katie Vernoy 25:01
I think that would be pretty bad. Social niceties are one of those things that we may lie about in all of our relationships, including the therapeutic relationship. So the last one is actually one that we had a little bit of a debate ahead of time. So I want to make sure we get to this: denial is the conscious rejection of reality or believing that something false is true. And the one that we talked about ahead of time, that I want to make sure we get to is not acknowledging sexual transfer, sexual or other transference and countertransference, an attempt to reject such feelings. And the way we framed it, and I think that where we can go with the conversation is if a client says, do you find me attractive? How do you respond?

Curt Widhalm 25:46
Huge caveats before I start talking.

Katie Vernoy 25:51
So what are these caveats?

Curt Widhalm 25:53
It depends on the nature of how it’s brought up. It depends on the relationship with the client and the agreed upon way that you work with the client…

Katie Vernoy 26:04
Yeah.

Curt Widhalm 26:05
…because sometimes this can be incredibly rich discussions that are part of what the the client’s treatment plan is. If this is somebody who’s working on being better presenting for dating and saying, I have a really hard time getting matches with people. I’m concerned that people are not finding me unattractive, or I’m concerned that people are finding me unattractive. I need some honest feedback. Do you think that I’m attractive? I would probably answer that pretty straightforward. Clients…lients…

Katie Vernoy 26:40
But what would you say?

Curt Widhalm 26:42
Depends on the clients. Like, if, if they’re, if they’re a hottie, I would be like, yeah, you have some conventional attractive features to you. Maybe there’s something else about your dating profile that goes along with things. If it’s something where people are less conventionally attractive, I might give them the direct feedback that says, Not everybody’s going to find you physically attractive. You might need to lean into things more that feature your personality or feature your hobbies or your interests, out of things that bring about an enthusiasm. And I’ve had for me in my practice, I’ve especially had like, teenage boys kind of struggling with some of their their self identity, out of trying to find their place in the world and wanting honest feedback to know kind of where to orient themselves from. And so it might come around things like, hey, the way that you dress doesn’t help the way that you’re presenting yourself, and that might be something specific that could help you appear to be more attractive. Now, if I get the sense that clients are asking this, because there’s a transference, countertransference aspect into this, where it’s more Hey, are you feeling what I’m feeling here and like, is there something between us? I’m not going to answer that as directly, and that’s going to get more into what the relationship with the client is. It’s going to get more into what the client’s ultimately feeling, why they might be feeling that way that would fall into more of looking at their underlying processes. But I don’t have a blanket I’m never going to comment on a client’s appearances sort of thing, especially when they’re eliciting direct feedback.

Katie Vernoy 28:35
We have different caseloads. We’re also different people, and I think this is the biggest difference, in I think how we respond, I don’t know that I would, by and large, answer that question. I think it would depend on the relationship, all of the things that you talked about, but in that question is very fraught, I think for women, I think if, if I have men who are asking me this question, it may not be safe for me to answer it honestly, because of the potential for the, you know, are you feeling what I’m feeling kind of thing. And so the way that I address it is trying to seek what is underneath it, if it’s truly just a question about their physical attractiveness, I think I go to my own perception of attractiveness, and I talk through kind of philosophically, what makes someone attractive and how I might find them attractive or unattractive, and what those things are. I wouldn’t say I find you attractive or I don’t find you attractive. I don’t think that I want to be that direct ever. I think it’s something where I’d want to talk to the core issue around what they’re seeking and if it’s how to present themselves best, I don’t know that I know the answer to that. And so I would talk through, how do you decide you know what clothes, clothing choices you’re making? How do you decide how you want to present yourself? Those types of things. I don’t know that I would say, Well, you might want to change what clothes you’re wearing like. I don’t think I would go there. And I think oftentimes with women, when someone asks me about their appearance or about or whether or not I think that they they are looking better or worse than they were before. I am very hesitant to comment on women’s bodies, because so much of society does and it feels like oppression. And so to me, I want to go down to how they are feeling about their body, their body, their relationship with their body, their relationship with their appearance, and going into the clinical issues that I think are more present than answering: Do you think I’m attractive or whatever the question is. And so to get there, I think I have to deflect to a certain extent around not directly answering the question, or maybe going to that’s something that doesn’t fit into our relationship, you know, and trying to talk about the therapeutic relationship and how it can be affected by those types of evaluations, but, but I think it’s, it’s always an it’s It depends.

Curt Widhalm 31:21
And I want to be clear that this is kind of very specific cases where this is being brought up, because it’s either part of the client’s treatment plan that is agreed upon by the client. Hey, we’re going to be working on this. It’s clients where the relationship does have the understanding and the clinical understanding on our part, where this is not going to greatly impact what the relationship is. I’m not greeting clients every day with Hey, I’ll go How you doing today? You know, if that’s not something that’s being asked for. And so it does take a tremendous amount of trust to be able to give completely honest feedback to clients who are asking for completely honest feedback. And I think part of how I work is very much kind of curtains pulled back. Here’s where I’m coming from in this, whether it be situations like this, where here’s the thought process that goes in this. If I get the sense that clients are asking some of these questions, and it’s not coming from a place where they want that completely honest feedback, I think there’s a tremendous amount of our field that tells us to go exactly where you’re going and what you just described.

Katie Vernoy 32:45
And I guess it was denials, not deflection. So to clarify for those who were playing along at home. To get to kind of the takeaways that we’re wanting to to get to here, I think the biggest thing is: context is key.

Curt Widhalm 32:59
Yes.

Katie Vernoy 32:59
Who is the client in front of you, what’s going on? The biggest piece is, is there a therapeutic benefit to the client or not? Because if it’s just to protect yourself, you’re human, you might do it anyway, but that’s not necessarily a deception that we’re co signing, for example. And it speaks to the relationship. Some of my clients, I think even if they ask me direct questions, are wanting me to connect with them in a compassionate way. And some people are asking for direct truth, and so I need to understand what’s in the relationship, and when is there social niceties? When are there the what, quote, unquote, white lies that we tell all the time, versus when is the lie harmful, and pushing the treatment back because there’s not a full discussion of what’s actually there, or it’s harming the relationship because you’re withholding important things. That’s what I’m taking away. What are you taking away, Curt?

Curt Widhalm 34:02
So much of this is contextual. So much of this is being able to think ahead. How could this potentially go wrong? Because ultimately, what we’re working on is the therapeutic relationship with the client, and especially, when you do decide to not be fully truthful, even as much as you know, I rebranded my practice a couple of years ago to real honest therapy like that does not mean that we are 100% telling the 100% truth all of the time. But what we tend to do is work in a lot more straightforward way, and so it does give us the clinical judgment to not be completely transparent when it’s needed. And a lot of thought process goes into a field, a job that is very much about needing to react in the moment to things that are unplanned, and recognizing when I say something that’s not the complete truth. Why am I doing this, and how is it going to be something that we respond to? Are there times that I’ve been guilty of, most of the things I don’t think I’ve really done, like whoppers.

Katie Vernoy 35:23
I don’t think I’ve done whoppers either.

Curt Widhalm 35:24
But most of the other stuff I think has come up at one point or another in my career, sometimes with success, sometimes it’s backfired horribly, and then it goes into that relationship repair. And not all the times, has it been something that’s been helpful. My takeaway is really, be really comfortable with yourself in going through the process of how honest you are with clients, how directly that you’re going to respond to direct questions. And I think even in a lot of the times where you know I’m giving some of these examples here, it is, in route to getting to some of those deeper questions that you’re talking about that many clinicians who are listening to this would say, Oh yeah, I would totally just go into the process part of why is the question coming up? Or how does it fit? Sometimes I find a benefit out of answering more directly. Sometimes people have that trust. Sometimes, as a as a therapeutic client myself, I would rather just have my own therapist just be more direct and honest about some things. So a lot of this is going to come down to your client preference, too.

Katie Vernoy 36:37
For folks and Erin who asked for, what can you do instead? Or what can you do when it backfires? I think we’ve talked about, what can you do instead. When it backfires, I think we covered that pretty well in ‘Should Therapists Admit Mistakes.’ So I’ll link to that one in the show notes so you can if you have had some of this backfire, or you’ve had other types of mistakes or or ruptures within the relationship. We definitely have some content too to go through there, so I don’t we don’t need to cover it here.

Curt Widhalm 37:08
You can find our show notes over at mtsgpodcast com. Follow us on our social media. Join our Facebook group, the Modern Therapist Group, to continue this conversation, and until next time I’m Curt Widhalm with Katie Vernoy.

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