Article explaining the theory: “Lying down on the couch during therapy might sound antiquated, but it’s worth a try, Shayla Love wrote in 2024”.
“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.”
My take on the theory: With my previous therapist I had the option to lie down or not. Sometimes I did especially if I was super tired or overwhelmed, I have even fallen asleep in therapy before. But most of the time while there was a couch I chose to sit up and have a conversation rather than have a one-way digestion of my problems onto my therapist, I wanted a somewhat back and forth discussion, and some advice on the things bothering me. Currently I don’t have the option of laying on a couch or not during therapy, because my therapist is remote and we meet on Zoom. I guess I could lie down but I would still be facing him, and I do like that my current therapy relationship allows for time for me to vent and digest but also to take in some advice and a different perspective on the things bothering me.
I think there is some merit to the theory above. That maybe lying down not facing anyone, somewhat alone with your own thoughts being spoken aloud is freeing. And I get the part about the wanting a positive reaction. I have found with any therapist I have seen one thing I want in the relationship is for them to “like” me as a person. I want them to empathize with me and like me, understand my struggles, and for them to “get” me. And I can see how the article above points out that maybe that is a distraction from therapy and not being your authentic self to win over your therapist is counterproductive to the point of therapy which is to heal by being our most authentic selves with someone along who can guide us. I guess it really shouldn’t matter if the therapist I am seeing “likes” me or “gets” me, I am really in therapy to work on myself, my true self. Unfortunately I have found if my therapist can’t empathize with me and my situation it turns that I don’t like them very much and don’t get much out of therapy (this has happened quite a few times).
And I wouldn’t say I change who I am or stretch or bend the truth at all I just don’t let any therapist see my darkest sides out of self preservation I guess.
Therapy has been life changing for me when I work with a therapist that is a good fit and sometimes that can be hard to find. One year I tried 7 therapists with no luck. Currently I have a therapist who specializes in high-conflict divorce, co-parenting, and family relationships especially through divorce and he has been very helpful in navigating the hardest part of my life right now which is co-parenting with my ex-husband. He is not as well versed on Bipolar or managing that disease, but after managing my Bipolar diagnosis for 24+ years I am somewhat of an expert on my own unique situation regarding that and I have done extensive therapy in the past to help me understand and manage my mental illness. That is why, right now, having a therapist who specializes in co-parenting and high-conflict divorce has been more helpful, because that is the area of my life that is hardest for me to manage right now.
I think if I had the ability to lay down on the couch or not, like I did with previous therapists, I would still use the option the same as before- maybe sometimes lie down when I am particularly overwhelmed or tired, but most of the time I would choose to sit up and have a back and forth dialogue with my therapist. I feel like there are positives and negatives to both scenarios, it is really just about finding the right therapist for you to get the most out of therapy.
And for anyone struggling with mental illness, a psychiatrist, medicine, and talk therapy are all such important aspects to managing these very difficult diseases.
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