A therapist is confronted with a new patient who she suspects is fabricating her story. The therapist wants to know if she is indeed lying and, if so, why.

Maxine sits comfortably in my chair, runs her hand through her curly brown hair and begins. “I came to therapy because I keep having fantasies about killing my daughter.”

Oh oh, I think, remaining silent and neutral. Maxine seems a bit taken aback by my silence. What she doesn’t know is that I am immediately on guard, unsure if I am about to hear a story that is truly every therapist’s nightmare, or one that is completely fabricated. A colleague told me she saw a new patient who told her a similar story and then admitted it was only a test for the therapist.

“I don’t know why I’m having these fantasies,” Maxine continues. “I love my daughter. We’ve always been close.”   

Not wanting to accuse a truly troubled person of lying, I decide to go along and see what develops. Of course, a woman who goes from therapist to therapist fabricating a story, must be pretty troubled as well. “What’s your guess?” I ask. “Why do you think you have been having these fantasies? How long have you been having them?”

Maxine sits comfortably in my chair, runs her hand through her curly brown hair and begins. “I came to therapy because I keep having fantasies about killing my daughter.”

Oh oh, I think, remaining silent and neutral. Maxine seems a bit taken aback by my silence. What she doesn’t know is that I am immediately on guard, unsure if I am about to hear a story that is truly every therapist’s nightmare, or one that is completely fabricated. A colleague told me she saw a new patient who told her a similar story and then admitted it was only a test for the therapist.

“I don’t know why I’m having these fantasies,” Maxine continues. “I love my daughter. We’ve always been close.”   

Not wanting to accuse a truly troubled person of lying, I decide to go along and see what develops. Of course, a woman who goes from therapist to therapist fabricating a story, must be pretty troubled as well. “What’s your guess?” I ask. “Why do you think you have been having these fantasies? How long have you been having them?”

“It was right after Barbara’s – that’s my daughter – right after her thirteenth birthday, about six months ago. I don’t know why I’m having the fantasies. If I knew I wouldn’t have come here. What do you think?”

I think this is a sham, but I’m still reluctant to confront Maxine.

“It’s pretty hard for me to have any idea since I know next to nothing about you.”

Maxine sighs, seeming exasperated.

I’m rather annoyed myself, but try to return to my more neutral tone. “Can you tell me about you?  What’s your present life like? Married? Other children? Working? And what was it like for you growing up?”

“I’m a stay at home Mom. My husband is an entrepreneur. He travels a lot. I was thinking I should probably go back to work. With Barbara growing up there’s not that much for me to do.”

“What are your feelings about Barbara growing up.”

“Mixed. I’d like my little girl back and I’m looking forward to seeing where my life takes me.”

“Where do you want it to take you?”

“I’m not sure yet. I think that’s one of the reasons I feel so dissatisfied with myself.”

I find myself liking Maxine more, yet feel entirely confused about what’s going on in the session or what’s real and what isn’t. I decide to take the plunge.

“Maxine, what of what you’ve told me today is true and what isn’t?”

“You figured it out! You’re the first one. Oh good, now you can be my therapist.”

“I had a rather big clue. One of my colleagues told me she’d seen a patient who told her a pretty similar story and that it was supposed to be a test for the therapist.”

“Oh! What a disappointment. Now I can’t tell if you’re really smart or not.”

“Maxine, you must by now know from therapists’ reactions that it’s quite insulting and infuriating to be tested by a series of lies. But I’d like to know the underlying reason you found it necessary to go through this charade.”

“I didn’t think I could trust someone who wasn’t smart enough to figure me out.”

“Well, I’d guess that you definitely feel you can’t trust people and I’d also guess that you see yourself as very troubled and in need of someone who can not only understand you but handle you as well.”

“You are smart. You can be my therapist.”

“But this is a two way contract. There’s the question of whether I feel I’m up to being your therapist.”

“Please, please, I’ll be good.”

“You sound like a scared little girl when you say that.”

Maxine starts to cry.

“Maxine, I know this is unusual for a first session, but this has been an unusual first session anyway. I want you to tell me what the secret is.”

“No, no, I can’t. Not yet.”

“I’m sorry. That’s my condition for us starting therapy. And if you tell me another lie you’ll only be hurting yourself. There’s something you’re terribly afraid of or guilty about, something you need to start dealing with even though you want to keep it hidden.”

“I killed my sister.”

“Is that another lie?”

“No, no, it isn’t. I wish it were. I didn’t do it deliberately.” Maxine’s next words are flat, expressionless. She stares straight ahead. “A group of us were playing soft ball. I was at bat. I swung. I lost control of the bat. It hit my sister in the head. She died. My parents sent me away.”

“I’m so sorry, Maxine. What a horrible accident. How traumatic. And then to be sent away on top of it. I’m really, really sorry.”

“So you’ll be my therapist?”

“Yes,” I say, although I realize that it will take me some time to totally trust what Maxine tells me.  Hmm, I think, Maxine has led me to feel the distrust she feels in the world.  

“It was right after Barbara’s – that’s my daughter – right after her thirteenth birthday, about six months ago. I don’t know why I’m having the fantasies. If I knew I wouldn’t have come here. What do you think?”

I think this is a sham, but I’m still reluctant to confront Maxine.

“It’s pretty hard for me to have any idea since I know next to nothing about you.”

Maxine sighs, seeming exasperated.

I’m rather annoyed myself, but try to return to my more neutral tone. “Can you tell me about you?  What’s your present life like? Married? Other children? Working? And what was it like for you growing up?”

“I’m a stay at home Mom. My husband is an entrepreneur. He travels a lot. I was thinking I should probably go back to work. With Barbara growing up there’s not that much for me to do.”

“What are your feelings about Barbara growing up.”

“Mixed. I’d like my little girl back and I’m looking forward to seeing where my life takes me.”

“Where do you want it to take you?”

“I’m not sure yet. I think that’s one of the reasons I feel so dissatisfied with myself.”

I find myself liking Maxine more, yet feel entirely confused about what’s going on in the session or what’s real and what isn’t. I decide to take the plunge.

“Maxine, what of what you’ve told me today is true and what isn’t?”

“You figured it out! You’re the first one. Oh good, now you can be my therapist.”

“I had a rather big clue. One of my colleagues told me she’d seen a patient who told her a pretty similar story and that it was supposed to be a test for the therapist.”

“Oh! What a disappointment. Now I can’t tell if you’re really smart or not.”

“Maxine, you must by now know from therapists’ reactions that it’s quite insulting and infuriating to be tested by a series of lies. But I’d like to know the underlying reason you found it necessary to go through this charade.”

“I didn’t think I could trust someone who wasn’t smart enough to figure me out.”

“Well, I’d guess that you definitely feel you can’t trust people and I’d also guess that you see yourself as very troubled and in need of someone who can not only understand you but handle you as well.”

“You are smart. You can be my therapist.”

“But this is a two way contract. There’s the question of whether I feel I’m up to being your therapist.”

“Please, please, I’ll be good.”

“You sound like a scared little girl when you say that.”

Maxine starts to cry.

“Maxine, I know this is unusual for a first session, but this has been an unusual first session anyway. I want you to tell me what the secret is.”

“No, no, I can’t. Not yet.”

“I’m sorry. That’s my condition for us starting therapy. And if you tell me another lie you’ll only be hurting yourself. There’s something you’re terribly afraid of or guilty about, something you need to start dealing with even though you want to keep it hidden.”

“I killed my sister.”

“Is that another lie?”

“No, no, it isn’t. I wish it were. I didn’t do it deliberately.” Maxine’s next words are flat, expressionless. She stares straight ahead. “A group of us were playing soft ball. I was at bat. I swung. I lost control of the bat. It hit my sister in the head. She died. My parents sent me away.”

“I’m so sorry, Maxine. What a horrible accident. How traumatic. And then to be sent away on top of it. I’m really, really sorry.”

“So you’ll be my therapist?”

“Yes,” I say, although I realize that it will take me some time to totally trust what Maxine tells me.  Hmm, I think, Maxine has led me to feel the distrust she feels in the world.