ABSTRACT
The psychogenesis of a proclivity to lie and omit in therapy and analysis is examined using traditional Freudian and ego psychological concepts. It seems counterproductive to lie to one’s analyst, or to leave out important facts. For some, nevertheless, the need to establish a perverse relationship with the analyst supersedes the wish to get better. In such deception, sadomasochism is prominent, as are anal fixations. There are superego lacunae, identifications with deceptive parents, splits in the psyche, dissociation, and fragmentation. Such patients are usually organized more primitively than they initially seem. The nature of doing analytic work makes analysts prone to gullibility. Analysts are used to suspending disbelief and cannot understand inside themselves the purpose of gratuitous lies. The technical difficulties of working with patients who lie are many: timing, tact, and dosage are most important, since many lying patients, when confronted with their lies, terminate. They are particularly prone to reactions of narcissistic rage, shame, and humiliation, and by use of projective identification, sudden suspicion of the analyst. Countertransference is another issue. The analyst, who is lied to, often feels the aggression in the lie not just in the transference but in the “real” relationship and is prone to make errors in dealing with the patient. In a societal breakdown of trust and trustworthiness, some despair of getting real help from the analyst.
