IN PRAISE OF THE THERAPEUTIC FIB

“In human relationships, kindness and lies are worth a thousand truths.”  - Graham Greene
 
Children of difficult older parents should not let a naive commitment to total honesty blind them to the difficult person’s emotional idiosyncrasies or brain disease-induced cognitive impairment.

A person with a personality disorder or dementia cannot consistently acknowledge the truth, respect facts, and obey the rules of logic, because their internal life is ruled by their emotions or by damaged brain circuits. Since they are not constrained by the truth, you also must be free to bend the truth when necessary for their and your wellbeing. Appropriately bending the truth to reduce the person’s resistance to necessary care is called the “therapeutic fib.”   

For example, imagine that your mother with clearly documented dementia insists that you give her the car keys or take her to get her license renewed. Mom wants to have access to driving, but she needs to not have access to driving.

It is totally loving and appropriate to tell a small untruth about the car being “in the shop waiting for incredibly expensive repairs,” or “the computer system at the department of motor vehicles is broken, so they can’t process renewals now.”  When mom asks, “When will this get fixed?” your answer should be vague. You’ll say, “Soon, I hope.” Or, perhaps you’ll say that the doctor says she can’t drive. When mom asks, “For how long?” you’ll answer, “Just for now, until you get better.” “Well, when is that going to be?” You’ll say, “Soon, I hope.” For now and soon are very useful answers in many situations, because they keep hope alive. For now and soon are therapeutic fibs.

If these words shock you, you are not the first. My patients often respond, “You’re just teaching me to manipulate my parent! Isn’t this just lying?!”
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I think not. I call it influence, and I like to assume that everyone’s motivation for providing feedback or input to others is benign or even constructive and loving. When the person in question is unable to make appropriate use of honest feedback, the legitimate, loving, and more effective approach is to finesse them, through such strategies as the therapeutic fib, into behaving more wisely.
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I believe that good people who view the situation impartially would all agree with the wholesomeness of this approach.
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