Chapter from the book, Duped by Kottler and Carlson. Clients who taught Barry the value of believing clients and even the therapeutic impact of a big fat lie.

1. Chapter 21
Cut the Crap
Tall Tales and the
Value of Lies
Barry Duncan
Before I tell you about the most memorable lie of my career, there
is another story, a tawdry tale that inspired me to reflect about
truth in psychotherapy, that sets the stage. Richard, a 29-year-
old systems analyst, was referred by his company doctor because
of his increasing distress and frequent absences. When I greeted
Richard in the waiting room, he jumped out of his chair, got right
in my face—not three inches away—and demanded, “What are
you going to do for me?”
Richard didn’t look too good. The 60-cent therapy words would
be agitated and disheveled. Tension and distress characterized his
every move, and he looked as if he hadn’t slept in days—if he had
slept, it was surely in the clothes he was wearing. I tried to stay
calm and just invited him to accompany me to my office, where-
upon Richard raised his voice another notch and repeated his
question, and was once again too close for comfort.
I was definitely freaked at this point but I simply replied that I
didn’t know if I could do anything for him but that I would try
my very best. Richard finally sat down on my couch and told his
story, and the floodgates opened. Richard began suspecting his
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2. 128 Barry Duncan
wife, Justine, of having an affair after he discovered footprints in
the snow in his backyard. Consequently, he followed her, searched
her belongings, and kept track of her whereabouts. But he could
not find the incontrovertible evidence that he was sure existed.
Throughout Richard’s growing mistrust, Justine emphatically
denied the affair and told him he needed help. Perhaps in despera-
tion, Richard began to secretly check Justine’s underwear for signs
of semen, which would provide ironclad evidence of her unfaith-
fulness (given there was no sex with him).
Finally, Richard found stains on her underwear and took it
to a laboratory, which confirmed the presence of semen. Justine
still denied his accusations and insisted the semen was his. She
stepped up her efforts to involve others, telling friends, family,
his employer, and their own children, that Richard was sick and
in need of hospitalization. Justine rallied many to her cause and
filed for divorce. The company doctor concurred with her assess-
ment, as did the first provider that Richard saw, a psychiatrist who
offered an antipsychotic to ease Richard’s pain.
After Richard’s first unsuccessful encounter with the psychia-
trist, the company doctor was peeved. Perhaps hoping to admon-
ish Richard into sanity, he had yelled, “Cut the crap!” Richard
didn’t do much to disconfirm everyone’s assessment of his san-
ity. He was doing some pretty wacky things and looked more dis-
tressed and haggard with each passing day.
Richard told me that he was obtaining a DNA analysis of the
semen to see if it was a match with his. While scrutinizing my
every reaction, not in a threatening way but rather like a con-
demned man waiting for a sentence, he nervously asked me if I
believed him.
So was Richard psychotic or was Justine a liar? Subsequently, I
talked with Justine and invited her to therapy, but she declined.
She was very persuasive and pulled out all the stops to describe
Richard as hopelessly psychotic and in need of medical help, not-
ing that Richard’s sister was also schizophrenic and lived in a
group home. What would you say to Richard?
I told Richard that I did believe him. Richard allowed himself
a moment of relief, but pressed on and told me that the DNA test
was going to cost a lot of money. He then leaned forward, stared

3. Cut the Crap 129
uncomfortably, and asked me the big question: Did I think he was
crazy for spending all that money?
I responded that peace of mind is cheap at any price. Richard
broke down and cried long and hard. He had been through a lot,
and was starting to believe what many had told him—that he was
paranoid and needed medication. After a while, we started talking
about what he needed to do to stop looking crazy while he waited on
the DNA results. If we took the affair as a given, and that her intent
was to make him look crazy as a loon, then everything he was doing
was playing right into her hands. Richard and I worked out a plan
to get normalcy back in his life: Return to work, start spending time
with his kids, and taking better care of himself. He did all of those
things and continued to bide his time as best he could.
Finally the results came in. Although Richard was greatly sad-
dened when the DNA results confirmed that the semen was not
his, he was not surprised. Ultimately, the whole seamy business
came to light, and Richard went about rebuilding his life. I was
both relieved and heartened by the results. I had taken a bit of
a risk to believe Richard. Justine threatened legal action against
me for not insisting on medication, and the company doctor sug-
gested I was acting unethically. In a sense I was vindicated along
with Richard, but moreover, I was heartened that my belief in him
seemed to make a difference regarding getting Richard back on
track in his life—regardless of the ultimate truth of his story.
I was so moved by Richard’s response, the depth of his wailing,
to my simple act of believing him and understanding his desire to
know what was going on that I have never forgotten it. Richard
taught me that I have to believe my clients, pure and simple.
Honestly, while Richard told me his story, I struggled with believing
him, which I knew was risky to our alliance. But I ultimately made
a conscious choice, during that session, to believe Richard—that
it didn’t matter how bizarre it seemed or how classically paranoid
it looked. I decided, at the very least, that my clients deserve to be
believed. That was a significant event in my development as a thera-
pist. From that day on, I no longer struggled with being a reality
police officer. And while it’s true that sometimes people do lie, even
maliciously, like Justine, I am willing to suspend disbelief until the
“facts” appear, or maybe even into perpetuity, like with Nora.

4. 130 Barry Duncan
Nora was a delightful 7-year-old who suddenly started soiling
herself when she was at school. The problem had persisted through
pediatrician visits and an EAP counseling service that ultimately
made the referral to me. In the first session, I saw Nora and her
mom, Kathleen, together for a while, but Nora didn’t say much
and Kathleen indicated that she wanted to talk to me privately.
So I escorted Nora to the waiting room and showed her the toys,
books, and TV. Kathleen expressed her concerns as well as her
belief that the encopresis was related to the death of Nora’s bio-
logical father, who was recently killed in a car accident. Although
Nora never knew her father, Kathleen believed the death was
largely responsible for Nora’s soiling problem. As I tried to wrap
my head around that, Kathleen spent most of the session talking
about how Nora had been abandoned by her father as well as all
the things that had been tried to help Nora with the problem.
I learned a lot but unfortunately it didn’t leave much time
for Nora. After commiserating with Nora about the toughness
of her problem and how embarrassing it was, I asked her what
she thought it was about and what she should do about it. Nora
couldn’t wait to tell me about this very mean third-period math
teacher she had, Mr. Miller, who wouldn’t let her go to bathroom.
Nora said that she repeatedly raised her hand to be excused but
that he ignored her and that was why she soiled her pants. I was
appropriately indignant and told Nora that this just wasn’t right.
Unfortunately, it was time to end the session and other clients had
already arrived. So I told Nora that we would get into this more in
the next session and figure out what to do about it.
The next week I asked Kathleen’s permission to start out with
Nora to both explore Kathleen’s hypothesis regarding the biologi-
cal father but also to hear the full story about mean Mr. Miller.
We played a couple of games together while we talked, but not
much came out of the discussion about her biological father. But
Nora came to life when I mentioned Mr. Miller. Nora hated this
guy. With unbridled energy, she described situation after situation
in which he always gave her a hard time and not others. Mr. Miller
particularly favored boys, and it was Nora who got in trouble
whenever boys would pick on her. She described one incident in
detail in which a boy next to her pulled her hair three times before

5. Cut the Crap 131
she punched him, which resulted in Mr. Miller standing her in a
corner and writing her name on the board. Regarding the soiling
problem, Nora explained, she just couldn’t get to the restroom in
time. Mr. Miller, Nora said, allowed the kids to go to the restroom
by rows, and that was the way it was done, regardless of Nora’s
need to go quicker. Nora asked and was ignored; she waved her
arms and was overlooked; and she stood up to no avail. As Nora
told me about this heartless teacher, she became more animated,
demonstrating each of her failed attempts to get his attention with
all the attending frustration.
I couldn’t believe what a jerk this Mr. Miller was. I asked Nora
what she thought could be done to set this guy straight and offered
to call him (after I talked with Kathleen) to see if I could get to the
bottom of this. But Nora had a different idea. She thought it better
to have her mother write Mr. Miller a note. She even knew what
she wanted the note to say. It was important that it properly put
him in his place, essentially scolding him and telling him that he
had better let Nora go to the bathroom. This sounded like a good
plan, especially given that this solution was Nora’s and she was
participating in a meaningful way in our work together. I invited
Kathleen to join our discussion, and Nora and I presented the
note idea to her mom. Although Kathleen looked confused and
a bit out of sorts, we composed the note right there. I continually
checked out what we were writing with Nora to ensure that the
note captured her sentiments. Nora was very happy with the note
and put it in her purse to take to school to give to Mr. Miller. She
skipped happily to the waiting room. The note must have really
put that guy on notice because Nora never soiled her pants again.
But that’s not the whole story. After Nora and I shared her plan
with her mother, Kathleen asked once again to speak to me alone.
She told me that Nora’s math class was actually her fifth period
and that her teacher was a woman—in fact, Nora had no male
teachers; and, finally there was no Mr. Miller at all in the school!
Kathleen was a bit at a loss about what to do about this and was
worried that Nora’s lie reflected deeper psychological issues. I reas-
sured her that children have rich fantasy lives and that I wondered
if this was a way that Nora has devised to solve her soiling prob-
lem. I suggested that we implement the plan anyway to see what

6. 132 Barry Duncan
would happen and that we could immediately regroup if there was
no movement, so to speak.
So this impassioned, compelling story of the malicious Mr.
Miller, with all its attending nuance and detail, was a lie, a big
fat fabrication. But it worked. Nora defeated the poop problem.
Perhaps it was Nora’s way of “externalizing the problem” or sav-
ing face with an embarrassing situation, or maybe Kathleen was
right and it was Nora’s way of working through issues about her
biological father and his death. Who knows? Follow-up revealed
that the problem had vanished and that Nora stopped talking
about mean Mr. Miller. Although one can speculate many rea-
sons why Nora suddenly took control of her soiling problem, the
fact remains that the lie served a purpose and was somehow ther-
apeutic. Nora helped me to continue my reflection about lies and
the truth in psychotherapy. Most lies are decidedly not malicious
in nature, and it may very well be that clients have very good
reasons for lying, and perhaps, sometimes a lie can even be just
the ticket.
Barry L. Duncan, PsyD, is director of the Heart and Soul of
Change Project and author of The Heart and Soul of Change
and On Becoming a Better Therapist.