11/05/2025
Lying down on the couch during therapy might sound antiquated, but it’s worth a try, Shayla Love wrote in 2024. https://theatln.tc/qkmzTDuv
Most therapists these days don’t ask their clients to lie down. “The first time mine did, I resisted,” Love writes. “I didn’t want to be on display or unable to see her reactions.” Sigmund Freud was inspired to use the couch more than a century ago because he thought a therapist being out of view would help people access emotions or memories that might be repressed. And though “many of Freud’s ideas about the unconscious haven’t held up,” Love continues, “he may have been onto something with the couch.”
“Research on instances when [the couch] is and isn’t helpful is limited. Some patients in case studies report that they’ve missed seeing their therapists’ face when they lie down, while others have used the couch to avoid direct face-to-face communication,” Love writes. “But for me—and, I suspect, many others—occasionally lying down might provide some relief from the social aspects of talking with a therapist.”
“Many therapy clients place too much emphasis on interpersonal dynamics. On social media, people make jokes about how much they want to get an A+ in therapy or make a therapist laugh; I’ve felt the same pressures myself,” Love writes. “That stress could be reduced when you’re lying down and physically incapable of scanning your therapist’s face for signs of approval or displeasure. And in a time when many people have switched to teletherapy, staring at your therapist’s face (or your own) over Zoom can feel like a work meeting gone wrong.”
“In the modern world, lying down signifies that the conversation you’re about to have in therapy is a different kind of interaction than those you have with family or friends. It’s a time to confront difficult thoughts, admit shortcomings, or explore desires without the relational obligations to those we know in our ‘real’ life,” Love continues. “When I started to lie down, I felt that I was choosing to make space for reflection, grief, processing, and developing intimacy with my own mind in a world where such acts are not usually prioritized.”
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