I think that trying to be a "good patient" can actually turn out not only counterproductive in therapy, but sometimes directly destructive. In my mind, it is the equivalent of trying to please people in general in order to generate an artificial sense of acceptance -- parents in childhood, lovers, whatnot... Trying to be loved for what we do purposefully instead of who we truly are. I guess no need to elaborate on how this can spiral into yet another dysfunctional relationship if the therapist is not aware and courageous enough to help us see/break through it.

I think that sometimes it can be beneficial to present such "good patient" image though, if that sort of attitude is something we habitually tend to do in everyday life. Given that at some point the nature of the "image creation" will be revealed. In that case, if the therapist recognizes it and we are open to discussing it, I think it can actually add to the therapeutic potential because we are presenting/dealing with something that is a major repetitive pattern in our life.