Therapists Reveal The Most Manipulative Patients They Have Ever Had

What happend to doctor/patient confidentiality?

Therapy is sacred, and it's something we can all benefit from. So it's aggravating when people take advantage of the mental heath process. Those who can maneuver the system ruin it all. Some therapists must have some great stories about the people who have taken advantage.

Redditor.... Unknown wanted to hear from the mental health community by asking.... Therapists of reddit, what are have been the most manipulative things done by incredibly difficult patients?

Meth is a No!


Most recently, it's a tie between someone testing positive for meth because "she was walking barefoot and stepped on a needle that had to have had meth in it" and another testing positive for opiates because "she picked up an unknown pill in her home and it melted in her hand and that's why she was positive for opiates." Both of course denied using. stellarsphere

The Hearing. 

Was a therapist in a short-term (two weeks at most) psych hospital. Had a very clean-cut man come in with a police hold pending a mental health court hearing. He was a dentist with a fairly well-known practice in the area and the police had brought him after a domestic dispute where he choked his wife. First clue we were dealing with a narcissist/manipulator?

He choked his wife because she found evidence of him cheating on her and asked him about it. By the end of his stay, he had managed to convince his psychiatrist to let him sign in as a voluntary patient, then asked to sign out against medical advice within hours of the doc letting him sign in with the guarantee that he'd not try to sign himself out. He also got one of the nurses on his side and he had to be taken off her case load because of how much she was doing for him.

I talked to the wife and it's honestly one of the only times I've ever gone against my patient's best interest and told her to start looking for options for herself to get away from the situation. What scared me the most was that he could turn on/off an emotion in a split second. One second he'd be sobbing then he'd stop the minute you asked him something else. mac9426


Therapist here. I think the situations that stand out to me are parents of teens being a bit manipulative (the teens are my clients). They would lie about needing a letter about their child for one thing when really they wanted to use it to get their child out of some consequences/punishments at their school. Or parents emailing me to ask me to get Little Johnny to do XYZ (anything from eating more vegetables, go outside more, not be friends with so-and-so). Basically asking me to do the parenting.

I make it a policy to show teens any and all emails that their parents send me to avoid secrets (I tell parents about this policy on day one). I'm there to help the teen with their goals, not the parents' goals.

Most people lie about something in therapy. I take that as a sign that trust needs to be further established in our relationship, and I don't expect the whole truth right away.

I've had people try to push my buttons or corner me in hypothetical situations, "if you could choose between having dinner with me or Michael Jordan, you definitely wouldn't choose me!" Or, "Would you leave me alone in your office with your purse sitting out?" BaileyIsaGirlsName

Location X

Clinical director/couples therapist... making several comments in this thread. Been at it a while! In university I did volunteer counseling which occasionally involved house calls.

I saw a couple at their wealthy family's farm about 40 mins from my city. I would do two individual sessions followed by a couples session, for a total of about three hours. When the husband left the room so wife and I could do our individual stuff, he was doing cocaine. This next bit was a major crime so I'm going to change details for anonymity.

He gets high and tells wife he's at location X, and when she goes to meet him he kidnaps their twin daughters. A police chase ensues and there's a standoff. A court case comes of this and they considered flying me from my new location elsewhere back to the original place of practice to testify. Thankfully that was not the case. otiumisc



Trainee but I've been counseling for a while. I mostly work with kids and parents who've had trauma/abuse. I get a lot of kids who lie to hide the abuse or would lie to protect their parents. A lot of suicidal gestures or fake suicide attempts, The absolute worst one I had was a parent who lied telling us all their child was skipping sessions and school without their knowledge, turns out they were sending their child to a grown mans house in exchange for money. lozzamm

Through the lenses....

I'm a marriage and family therapist. I once had a client tell me he had cancer. Even faked walking with pain as he came in for a session after "half his colon was removed." I did some research and it turns out the whole thing was a lie. He mentioned doctors and diseases that didn't even exist. I continued to treat him through the lenses that he was after some sort of validation from me or the world. I did not confront him on the lies but allowed him to feel comfortable telling me what he was ready to tell me.

He never did reveal any dishonesty in the end, but he continued to come to the sessions, so I assume he was getting some benefit from it. Most of our sessions were centered around some childhood trauma, that also could have been a lie. I eventually had to terminate and refer him to another therapist because I moved. I wish him all the best in life still. west2hale


Most of the time lies and manipulation are a preservation of the self they have created to protect whatever is broken down underneath.

That said, I worked in a supermax male prison a few years ago in the psych ward of segregated housing unit. These guys were in prison, in prison. The psych ward section was full of legit sick guys, and guys who wanted to get out the cell WAY more often than the normal SHU, talk to ladies (any lady will do when in prison, and a lot of therapist in prison are female), and have an easier jail time.

The dudes that were faking it were the epitome of manipulation, and would often times prey on the legit sick guys, and that pissed me off, so I came at them hard and documented EVERYTHING to get them out of my program. Pissed a lot of scary people off lol.

Edit: I give up on the ama. I'll try again tomorrow, I'm pregnant and tired and apparently suck at proof. Sorry guys.

Lair. Liar. 

Chronic liar, but my therapist was an angel and would call me out super gently and wouldn't shame me for it-- which is exactly what I needed. Lying is so hard to stop doing because of the fear of people getting furious with you. She was SO kind and accepting even when 50% of the things that came out of my mouth were lies.

She also by coincidence was at an ice skating rink when I was there with friends while also recovering from social anxiety, and while she kept an appropriate distance and didn't engage, I saw her once smile when she saw me order some snacks by myself without help. That was so heartwarming. I wouldn't be half of who I am today without her. <3 ggravendust

Substance use counselor here, I work in a women's residential (inpatient) program. Most of our clients are court ordered and will do anything to get out of treatment, e.g., fake seizures, lie about illnesses, etc. but will also lie and manipulate to get contraband brought in or to deviate off site. Some of the lies are convincing, but I find most to be hilarious. stellarsphere

It's in the Behavior...


Dialectical behavioral therapist here. I predominately work with people with a diagnosis of BPD and unsurprisingly it seems as though borderline personality disorder is getting mentioned quite a lot in this thread. I find BPD is a pretty crappy label for what could rather be much more accurately described as having difficulty regulating emotions and tolerating distress with quite often a history of childhood trauma and or poor attachment.

It's just easier to label someone as having BPD, so easy that it tends to become synonymous with what is essentially perceived as having a clinical diagnosis of being a bad person. CyanideSeedbell