{"id":2998,"date":"2021-01-13T09:00:00","date_gmt":"2021-01-12T22:00:00","guid":{"rendered":"https:\/\/blog.amt.org.au\/?p=2998"},"modified":"2021-01-12T14:24:11","modified_gmt":"2021-01-12T03:24:11","slug":"my-clients-are-liars","status":"publish","type":"post","link":"https:\/\/blog.amt.org.au\/index.php\/2021\/01\/13\/my-clients-are-liars\/","title":{"rendered":"My Clients Are Liars"},"content":{"rendered":"\n

By Sharon Livingstone (with Tim Clark)<\/strong><\/h2>\n\n\n\n

I\u2019d been treating Colin (not his real name) every week for nearly 2 months when he walked into the treatment room, sagged onto the treatment table and, avoiding eye contact, said that he hadn\u2019t been honest with me.<\/p>\n\n\n\n

And, hoo boy, was it a doozy.<\/p>\n\n\n\n

I\u2019ve been treating his wife for a few years but until 2 months ago, I\u2019d never met Colin or even knew his name.<\/p>\n\n\n\n

Colin was making great progress. He was motivated, doing all the homework I set and had taken tentative steps to returning to sport \u2013 which was his goal when he started treatment.<\/p>\n\n\n\n

I kept my face composed as Colin sat on my treatment table to explain that he is undergoing treatment for cancer and that the area he\u2019s been struggling with was not actually a muscle tear as he\u2019d told me on intake but a site of metastases.<\/p>\n\n\n\n

My face lied. I was not composed. Our treatment sessions had to change. Our goals had to be reset. I had so many questions, and it was clear he really<\/em> didn\u2019t want to dwell on the answers.<\/p>\n\n\n\n

After Colin left, I re-read the intake form he\u2019d completed. My intake form specifically asks about cancer and there wasn\u2019t even a contemplative blue dot on that part of the form to show that he was wavering in his decision to not disclose his complete health history.<\/p>\n\n\n\n

Why had my client lied?<\/p>\n\n\n\n

All Clients Are Liars<\/strong><\/h4>\n\n\n\n
\"\"<\/figure><\/div>\n\n\n\n

Let\u2019s clear a few things up. <\/p>\n\n\n\n

First, everyone fibs<\/a>. We have our reasons for our fibs \u2013 we may get ourselves (or someone else) into trouble if we are honest, we want to win the poker game, the surprise party will be ruined, don\u2019t want the kids to know that Santa is a fraud just yet \u2026 Sometimes a lie is kinder than the truth.<\/p>\n\n\n\n

Second, I expect a certain level of dishonesty in the clinic room, e.g.:<\/p>\n\n\n\n

Me: Have you been doing those stretches\/exercises I suggested?<\/p>\n\n\n\n

Client: Why, yes, all of them, every day.<\/p>\n\n\n\n

Third, while I have my expectations of the treatment, they are not necessarily the client\u2019s expectations. I know that if I have all the information available, I can create a treatment plan that will benefit my client. My client does not know which information is important and doesn\u2019t know how a non-disclosure may impact their treatment.<\/p>\n\n\n\n

Fourth, all massage therapists are liars. There are things we don\u2019t tell our clients for whatever reason \u2013 it\u2019s too personal, it may be nocebo, we don\u2019t want to admit that our clinic diary is a bit sparse. It doesn\u2019t mean we\u2019re bad people. Massage therapists work by the principle of \u201cdo no harm\u201d, so if our fibs are not harmful to our clients, we will continue to fib.<\/p>\n\n\n\n

When I reopened my clinic after the first shutdown, I asked clients to fill in a health declaration form which asked specific questions about their health and the health of their close contacts. It quickly became apparent that my clients weren\u2019t honest when they filled that form in. If I ever wanted a lesson in rapid fire risk management and crisis decision-making, my clients made sure I received it.<\/p>\n\n\n\n

All clients lie. They even lie to their favourite massage therapist.<\/p>\n\n\n\n

Why Do Clients Lie?<\/strong><\/h4>\n\n\n\n

Lies take a lot of forms \u2013 kindness, malice, avoidance, selfishness.<\/p>\n\n\n\n

I don\u2019t believe Colin lied out of malice or intent to deceive. His demeanour made it clear he was uncomfortable talking about his cancer and his cancer treatment. He redirected or shut down my questions. He\u2019d been dealing with \u2013 or enduring \u2013 it for a significant time before he entered my treatment room. It is possible all Colin wanted was to feel better and get back to sport.<\/p>\n\n\n\n

Tim Clark, our favourite massage therapist\/psychotherapist combo, offered his thoughts on clients lying.<\/p>\n\n\n\n

Our clients are allowed to lie. When they do, it doesn’t necessarily mean a thing about us. If it leads us to reflect on how we might have inhibited their behaviour in some way \u2013 made them think they had to lie to us to stay in our good books \u2013 then okay. So be it. Might be useful reflection.<\/em><\/p>\n\n\n\n

But the real responsibility for the lie rests with the client. Why they lie will be a confluence of all sorts of experiences and ingrained beliefs that have nothing to do with us. It’s up to us to give them an experience of feeling free to be honest.<\/em><\/p>\n\n\n\n

Is Our Relationship Conditional or Unconditional?<\/strong><\/h4>\n\n\n\n

Why did Colin\u2019s lie bother me so much? Aside from having to re-draw his treatment plan and determine whether any part of our previous sessions might have caused harm to Colin, I was essentially unaffected by the lie.<\/p>\n\n\n\n

Tim suggested I read a chapter on \u201cUnconditional Positive Regard: Constituent Activities<\/a>\u201d by James R. Iberg. Unconditional Positive Regard (UPR) is a concept put forward by Carl R. Rogers. You can read a reprint of Carl R. Rogers\u2019 original 1957 article from the Journal of Consulting Psychology here<\/a>. Tim says:<\/p>\n\n\n\n

Look at Rogers’ explanation of UPR: \u201cIt means a caring for the client as a separate person, with permission to have his own feelings, his own experiences.\u201d<\/em><\/p>\n\n\n\n

The important thing about UPR is that (Rogers says, and Iberg quotes) it “is a quality of the therapist\u2019s experience toward the client”. In a Rogerian framework, it’s part of the therapist’s responsibility to provide UPR, to put judgement aside as much as possible and give the client an experience of acceptance no matter how grave their confession (or lie, for that matter). Rogers is realistic about UPR, saying it probably wavers at times, but puts it forward as an ideal to strive for. It’s rare to experience UPR in day-to-day life, which is why it can be so transformative in therapy. This is where the therapist’s self-regard comes into it. If the therapist sees themselves as beholden to conditions (‘rules’) that govern their own worth, or is excessively self-punitive, they\u2019re likely to extend the same rules and expectations to others, consciously or not.<\/em><\/p>\n\n\n\n

\"\"<\/figure><\/div>\n\n\n\n

Can a massage therapist regard their client with an unconditional positive regard or is there always a condition? Is the massage therapist\u2019s self-image or ego putting a condition on the relationship with their client? Hmm, something else to reflect on.<\/p>\n\n\n\n

Massage therapists see themselves as an authority figure, a person of trust and with a lot of relevant knowledge. We see ourselves as trustworthy and deserving of receiving honesty, so when a client lies, it feels personal.<\/p>\n\n\n\n

Tim says, \u201cour own self-regard can limit our capacity to offer others positive regard. If we’re inclined to be harsh on ourselves for lying, then we’ll view others negatively for lying too, rather than seeing ‘incomplete\/imperfect truth’ as one of the givens of existence<\/em>.\u201d<\/p>\n\n\n\n

If we see ourselves as someone who deserves honesty and full disclosure, is it really that inconceivable that we\u2019re hurt when our self-styled designation as a trustworthy expert is disregarded?<\/p>\n\n\n\n

Tim points out that Colin choosing to admit his deception should be seen positively. \u201cLook at the good work you’ve done that has allowed him to feel comfortable enough to come clean with you. That’s huge! You can look at that as PART OF (not contrary to) your treatment. Yes, he was deceptive, but now a barrier has been broken down and you’re able to make decisions from a baseline of truth.\u201d<\/em><\/p>\n\n\n\n

Perhaps his positive regard for me grew during our 2 months working together to the point where he trusted me and regarded me in such a positive way that he felt induced to come clean? Or maybe his wife berated him when he admitted to her that he hadn\u2019t told me about his cancer. I don\u2019t know \u2013 I never asked.<\/p>\n\n\n\n

The Truth About Lies<\/strong><\/h4>\n\n\n\n

There has been surprisingly little research done on lying by patients. In this research<\/a>, there is some support for therapists (in this case, physiotherapists) undertaking specific education in patient deception to understand why patients lie and to not harbour ill feeling towards a patient who lies. Would massage therapists benefit from similar education around patient deception?<\/p>\n\n\n\n

This paucity of research may be because lying is regarded as normal behaviour instead of extraordinary behaviour.<\/p>\n\n\n\n

Tim shared his thoughts:<\/p>\n\n\n\n

\u201cI feel like accepting that clients will not (cannot?) always tell the truth \u2013 and not punishing them for it \u2013 is essential. Clients who lie may already have an excessively self-punitive internal dialogue (the gift of punitive parents) and further punishment will only leave them feeling deflated. Instead, getting closer to the reason they lied to you in the first place, and letting them know that they don’t need to do that with you, can offer them a healing relationship. And a lie like the one made by your client might be based on misinformation too. Maybe he thought cancer treatment meant no massage ever?\u201d<\/em><\/p>\n\n\n\n

I\u2019m a terrible liar. It\u2019s not that I can\u2019t make stuff up and make it plausible. It\u2019s that I can\u2019t remember what I said in my lie and always seem to get caught out. Perhaps that\u2019s a reason why I dislike lies \u2013 I\u2019m jealous that people can sustain their lie. I also expect people to tell me the truth. I guess I\u2019m gullible like that. Yes, I\u2019m one of those people who thought my pet dog really did go to live on a farm (he went to a farm all right, just not to live there). Not to mention that for years, I thought my pet chook went to live with my sister-in-law\u2019s mother instead of her actual fate of failing to get out of the way of my sister-in-law\u2019s foot. This might simply be a lesson in not becoming one of my pets.<\/p>\n\n\n\n

We Shall Go On<\/strong><\/h4>\n\n\n\n

I asked Tim if there was something we therapists can do to minimise the gaps in information provided by clients.<\/p>\n\n\n\n

\u201cI suspect the short answer is no \u2013 if<\/em> someone’s not comfortable sharing something with you, they won’t. But the long answer is, yes, it’s possible \u2013 by earning their trust, so they can feel safe sharing information that they feel renders them immoral\/undesirable\/unlikeable etc.\u201d<\/em><\/p>\n\n\n\n

If we accept that we aren\u2019t necessarily getting the full answer from our clients, we can still find a way to achieve progress with our treatments and provide support and help to our clients..<\/p>\n\n\n\n

In the meantime, Colin continues to experience improvement and has recommenced his favourite sport, albeit not quite at full throttle yet.<\/p>\n\n\n\n

Further Reading<\/strong><\/h4>\n\n\n\n

https:\/\/www.theschooloflife.com\/thebookoflife\/why-were-all-liars\/<\/a><\/p>\n\n\n\n

https:\/\/www.theschooloflife.com\/thebookoflife\/honesty\/<\/a><\/p>\n\n\n\n

https:\/\/www.psychologytoday.com\/us\/articles\/199705\/the-truth-about-lying<\/a><\/p>\n\n\n\n

https:\/\/www.psychologytoday.com\/us\/blog\/the-nature-deception\/201905\/what-is-lie<\/a><\/p>\n\n\n\n

References<\/strong><\/h4>\n\n\n\n

1. Patient Deception in Health Care: Physical Therapy Education, Beliefs, and Attitudes (Curtis, Huang and Nicks), IJHSE Vol. 5, Iss. 1, December 2018<\/p>\n\n\n\n

2. The Necessary And Sufficient Conditions Of Therapeutic Personality Change (Rogers) Journal of Consulting Psychology, 1957, Vol. 21, No. 2, 95\u2013103<\/p>\n\n\n\n

3. Psychotherapy: Theory, Research, Practice, Training 2007, Vol. 44, No. 3, 240 \u2013248<\/p>\n\n\n\n

About the Author(s)<\/strong><\/h4>\n\n\n\n
\"\"<\/figure><\/div>\n\n\n\n

Sharon Livingstone is a massage therapist in Sydney, NSW. She has a size US6 foot but wears a size UK6 hiking shoe in an ever-decreasing radius from her home.<\/p>\n\n\n\n

\"\"<\/figure><\/div>\n\n\n\n

Tim Clark is a massage therapist and psychotherapist in Melbourne, Victoria. He does not enjoy writing his bio for blog articles.<\/p>\n","protected":false},"excerpt":{"rendered":"

What happens when you find out your client has lied to you? Throw them out of the room and tell them never to return? Or something else?<\/p>\n","protected":false},"author":1,"featured_media":2037,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[32,110,2],"tags":[708,709,710,705,706,62,217,707],"class_list":["post-2998","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-amt","category-clinical-practice","category-professional-practice","tag-carl-r-rogers","tag-client-lies","tag-client-lying","tag-lies","tag-lying","tag-sharon-livingstone","tag-tim-clark","tag-unconditional-positive-regard"],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2019\/09\/aaa-pig2.jpg?fit=725%2C464&ssl=1","jetpack_likes_enabled":true,"jetpack_sharing_enabled":true,"jetpack-related-posts":[{"id":3589,"url":"https:\/\/blog.amt.org.au\/index.php\/2022\/04\/13\/the-ineffable-meaning-of-us\/","url_meta":{"origin":2998,"position":0},"title":"The Ineffable Meaning of Us","author":"admin","date":"13\/04\/2022","format":false,"excerpt":"Is it time to reflect on exactly what a massage therapist is?","rel":"","context":"In "AMT"","block_context":{"text":"AMT","link":"https:\/\/blog.amt.org.au\/index.php\/category\/amt\/"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2022\/04\/light-2156209_640.jpg?fit=640%2C360&ssl=1&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2022\/04\/light-2156209_640.jpg?fit=640%2C360&ssl=1&resize=350%2C200 1x, https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2022\/04\/light-2156209_640.jpg?fit=640%2C360&ssl=1&resize=525%2C300 1.5x"},"classes":[]},{"id":3470,"url":"https:\/\/blog.amt.org.au\/index.php\/2021\/10\/12\/helping-your-client-get-help\/","url_meta":{"origin":2998,"position":1},"title":"Helping Your Client Get Help","author":"admin","date":"12\/10\/2021","format":false,"excerpt":"Do you know how to help your client find a psychotherapist\/counsellor?","rel":"","context":"In "AMT"","block_context":{"text":"AMT","link":"https:\/\/blog.amt.org.au\/index.php\/category\/amt\/"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2021\/10\/awareness-g6c6490fab_640.jpg?fit=640%2C360&ssl=1&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2021\/10\/awareness-g6c6490fab_640.jpg?fit=640%2C360&ssl=1&resize=350%2C200 1x, https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2021\/10\/awareness-g6c6490fab_640.jpg?fit=640%2C360&ssl=1&resize=525%2C300 1.5x"},"classes":[]},{"id":2213,"url":"https:\/\/blog.amt.org.au\/index.php\/2019\/12\/05\/top-7-articles-of-2019\/","url_meta":{"origin":2998,"position":2},"title":"TOP 7 ARTICLES OF 2019","author":"admin","date":"05\/12\/2019","format":false,"excerpt":"Revisit 7 of the best articles we've featured on AMT's blog in 2019. 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