At times a deep urge to please the doctor or therapist as a kind of authority figure has interfered with my accurate reporting of how I'm doing; I semi-consciously want to stress progress to make them happy. I find I have to struggle against those urges, and sometimes I do that by writing things down to take to the sessions.

Apart from my urge to please, I've noticed many of the mental health professionals I've seen over the years have their own "progress" or "improvement bias": they pay more attention and assign more weight to anything they can point to as improvement.

Thanks for bringing up this topic, Jean17.