Do I sit-up or lie-down on the couch?

People don't still lie on the couch, do they?

This might sound like a duh question, or a psychotherapy 101 type quiz, but it might be quite an amusing sight to behold when your client comes into your consulting room and just automatically lies down on the couch... I know, because I've experienced that myself!

Whilst I let out a quiet chuckle internally, I'm mindful that clients don't necessarily know any better given that most popular psychology, film depictions of psychotherapy take the form of psychoanalysis-style couch lying.  Today, if you ask most therapists (including non-classical psychoanalysts), it's a norm to be sitting across from your client, almost meeting face to face.

However, ever wondered what lying down on the couch is for?

Why the couch may be just what the Dr. ordered...

Dr. Harvey Schwartz is Clinical Professor of Psychiatry, Sidney Kimmel Medical School, Philadelphia, Training and Supervising Analyst at the Philadelphia Center for Psychoanalysis and the Institute for Psychoanalytic Education and is affiliated with the NYU School of Medicine.  He wrote a recent article via Psychology Today, discussing what these interesting functions of the couch may be.  Have a read and reflect on your own practice.

More than a century after it was first introduced by Sigmund Freud, the couch still provokes both curiosity and ridicule. Its ability to continue to be evocative is testimony to the imaginings it stimulates.

I leave you with some useful pointers from his article:

Curious About The Couch? Here Are Some Considerations

  • The couch is used when the patient feels ready for it, there is no pressure.
  • There isn’t a "right" way to use the couch. It’s a different experience for each patient.
  • The couch allows for levels of honesty that can refresh your life.
  • The couch facilitates self-acceptance and reduces inhibitions.
  • The couch is a place of freedom to discover deeper aspects of your pains and passions.