Tuesday, September 29, 2015

Honesty in Therapy

     Therapists must ask themselves an important question very early on in their practice: How honest do I want to be with my clients? Honesty can be either an important building block in the relationship between therapist and client or a stumbling block that sends the duo into disarray. I think that there are positives and negatives to honesty in therapy. I would like to talk about the advantages and disadvantages for each side, the long-term and short-term outlooks of each, and what it says about the clinician to use stark truth and/or white lies.
     I will talk about white lies first. Are they every appropriate? Sure, depending on the state of the client, a white lie might be a good bet. Just like with a client, though, white lies can be slippery slopes, increasing the chance of this "intervention" in the future, especially if the lie is never found out. A good question to ask here is When is it appropriate to use this? The therapist must always keep in mind that a white lie might be found out and that consequences could ensue. So, the lie should be as white as possible, be explainable by the therapist, and, taking those two into account, should not be so hurtful that they fundamentally injure the relationship. If the issue at hand is life or death (it could be a trauma case, a client with SI or HI, etc.) and a very small white lie can help that person to endure their situation and possibly survive until they, or someone else, can ensure their safety, then the answer is a non-idealistic and pragmatic "yes." I think that white lies have to be monitored closely because, just like normal lies, they can multiply quickly if one is trying to cover them up, and they can be detrimental to any relationship, as mentioned. In the end, after giving this some due thought, I think that lies in general should be avoided - after all, it is the place of the therapist to screen behavior and call clients on maladaptive thoughts, emotions, and beliefs.
     When it comes to honesty, there are, of course, times when the therapist must care to soften a blow and use more of an opaque honest (versus a clear honesty). I do think, though, that honesty really is the way to go. As previously mentioned, a crucial effect of honesty is trust. Without trust, a client would get nothing from therapy. I don't want to belabor that point as I think that it is relatively self-evident. I do think that one good topic for discussion is how to go about being honest.  A good velvet-wrapped brick approach seems appropriate here. I think that this is a good metaphor because being honest can be pretty traumatic and blunt. Wrapping it in velvet (a.k.a. saying it in a way that is softer than merely blurting out the truth) can go a long way. No client wants their therapist to tell them the honest truth outright that they are absolutely wrong, absolutely screwed if they continue their current actions, etc. No one wants to hear that. What good therapy allows us to do is to hear the client, their reasons for saying their piece, and then discuss their choices. A declaration of incorrectness can be just as hurtful to a therapeutic relationship as a found-out lie could be.
     Is one theory more honest than another? I'm not certain that this is a particularly fair question and is not one that I am prepared to answer. I think that it is less the theory and more the therapist that is the final answer to the question.

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