What's All This Stuff About The Couch?

[Dana1010]

At my last session, my therapist said she wanted me to lay down on the couch and sit behind me while we talked. Up until then we had sat face to face, which is the only configuration I'd ever done in therapy. She said it would be easier for both of us if I got on the couch. I expressed some doubt and said I rather like face to face; being forced to look at someone while you relate secrets has a confessional, purgatory quality, and I like being validated by their acknowledgement and reaction. Anyway, I said I'd give the couch a try next time.

What is this all about in your experience? Does the couch improve your sessions? Is she uncomfortable looking at me for some reason (Oh no, not another squeamish therapist)?

 

[Biz]

I'm so interested by this. You've found a rare one.
How long have you been with this therapist? What are your goals? (Feel free to be as general as you wish). Did she give you a good reason besides 'it's easier' that she wants to do this?

I mean, I'm sure you googled it but it's old school psychoanalysis. There are folks who practice in that form, but it really is rare and not the method of the majority of today's practitioners, especially not those who are trauma specialists. (Although, there's a whole chapter in Van der Kolk's recent book on traditional psychoanalysis's treatment of PTSD). It's a blank screen to the extreme so your stuff/story doesn't get moved at all by someone else's social cues, validation, facial expression, movements. I'm very interested (and I would be if I were you too) as to why she thinks this is the best method of treatment for you. And, if the truth is that it's easiest for her (and not for you as your post seems to question), then it may be time for a serious discussion and/or new therapist.

 

[Friday]

Considering how much you've talked about reflecting people / trying to be a person for them/ what they expect you to be / chameleon like... It makes sense that your therapist might want to try this.

As @Biz says... It removes all social clues for how you "should" be responding, so you're not reflecting what you think she wants you to be.

 

[Dana1010]

How long have you been with this therapist? What are your goals?

Tomorrow will be our fourth session, I believe. We are just getting to know each other. My goal is to lessen PTSD symptoms (I'm not so Pollyannic anymore as to expect a cure). The worst symptoms are constant, neurotic ruminating and involuntary convulsions when I relax.

Did she give you a good reason besides 'it's easier' that she wants to do this?

She said something about being able to "free associate" more. I can't shake the feeling that she's insecure about being face to face with people. Pretty odd for a therapist.

And, if the truth is that it's easiest for her (and not for you as your post seems to question), then it may be time for a serious discussion and/or new therapist.

I realize that, but I have really crap insurance right now, and she's pretty much the best thing going-and I explored the options for a while there. I really like feeling like I'm being heard and understood by someone-I'm a shut-in, so I don't get that anywhere else. I just don't know if the couch is going to feel like talking to a ceiling instead of a person.

 

[Suzetig]

I'm not sure how is feel about that - I need to feel connected to my therapist and I need eye contact etc. in saying that, I'd try just about anything once - could you say you'll give it a go but agree that if you feel uncomfortable or you find it triggering, you reserve the right to change back?

 

[angrypanda]

I do emdr therapy this way. I had to build up the trust with my therapist because I couldn't see her. She says it's easier to watch my breathing, body stiffening, eye movements and other small physical cues and lead me through them. She's right about that. I

would ask my therapist specifically why she wants that arrangement and be honest with her about why it makes you uncomfortable. Maybe coming to an understanding would make it easier

 

[Dana1010]

Tried the couch. The benefit is you can get some stuff out that might be difficult or embarrassing to say to someone's face. Drawback is that without the difficulty and embarrassment, a lot of the cathartic effect is lost. I can lay on my couch at home and yammer this crap to no one in particular all day. It's not going to help me. Upon leaving, I didn't feel cleansed and "worked-out" the way I usually do after a good session.

 

[lostforgottensoul]

At my last session, my therapist said she wanted me to lay down on the couch and sit behind me while we...

My therapist has the most comfy couch in the world but hos desk is in front of the couch, a wondow behind it and a few chairs beside it (we do EMDR in the chair) and he sits in his desk chair but his back to his desk and we are face to face so never expeirence that. I always wear flip flops cuz i like to curl up on the couch and hug the fluffy pillow. When i hit VERY painful stuff or embarrasing stuff (theres a lot of that), i look out the window which is the furtherest point away from him i can look and i always stare at the little table beyween the two chairs and the digital clock and/or lamp on it and the cords that are tangled wanting to untangle them. I dissaccociate A LOT in therapy and he bends to meet my eyes at times to get me out of my head. Maybe its a form of what i do, not look at him cuz its easier to say things, go deeper, when you arent looking at the person, for me anyway.

 

[Crow]

My therapist does this every now and then. But it took years to build up trust to have someone in the room that I could not see. We haven't talked about the why of this modality but I think it has something to do with me reading her every expression/movement and trying to be what she wants instead of being 'in myself' at the time. Anyway, it's been helpful when we have done it but it still takes a lot of energy to have her where I cannot see her and she's one of the people I trust most in this world. I can't imagine doing this with a new T.

 

[Biz]

@Dana1010 , you're probably right about your therapist needing not to be looked at since that's something you're intuiting and that's why Freud used the couch in the first place. I'm glad you gave it a try. It's cool that you could have the option to go back to if you wanted, but I hope for you that she doesn't force that.

 

[VioletButterfly]

My gut reaction would be:"What, I've met with you 4 times and I don't trust you to be that vulnerable." From what I read above, maybe I'm projecting my trust issues into this picture, although I see "trust" mentioned in many of the responses. Hmmmm. I say, go with your instincts. If you still don't feel comfortable after trying it once, tell her so. You shouldn't feel that you have to "do" what your therapist tells you to do in this regard. How is that therapeutic in terms of empowerment and recovery? IDK. Hope it works out for you. VB

 

[Seasounds]

I have exlored the various options. I make sure that I am in the position that suits me, at the time of my session.

Eye contact for me is challenging, so I like to practice looking at my therapist.

Lying down is relaxing.

I also stand up and move around my therapist's room, if I start to muscularly tighten up when I speak about my concerns.

Lately, my therapist has said things that trigger me, so I sit up, look eye to eye. I don't feel safe enough to lie down.