Since Freud’s time, couches have been a kind of icon associated with psychotherapy. How did that happen? Why did Freud’s clients lay on a couch and why are therapeutic couches rare these days?
Why a Couch?
From what I understand, Freud encouraged his clients to lie on a couch for two reasons 1) so that they would not look at him, and 2) so that they would relax and more easily free-associate. Was Freud self-conscious? Have practices changed because contemporary therapists want their clients to look at them and not relax? I wonder….
I doubt that Freud was self-conscious about his looks. Rather, I believe he felt that if clients looked at him during a session, they might detect body language or facial expressions that would influence their thoughts and feelings. The clients might tune in to the therapist and attend to his/her needs instead of looking within. They might aim to please the therapist rather than explore their own psyche.
Relaxation and the Subconscious
Couches also facilitate relaxation. When a client relaxes, free-association comes more easily. Free association is one of the key therapeutic psychoanalytic devices. The idea is that the client, by not censoring her own flow of thoughts and words, accesses her subconscious. The subconscious, according to Freudians, is a place of repressed drives, threatening impulses, prohibited desires. Why access this scary place? Because “what you don’t remember you act out.” An abused child may grow into an adult who subconsciously seeks an abusive mate so that she can work out what she couldn’t as a child. Acquainting one’s self with subconscious desires brings understanding, a chance to process, and subsequent freedom from destructive desires. In the words of Dr. C. George Boeree, "When the client can be made aware of the meanings of his or her symptoms (through hypnosis, for example) then the unexpressed emotions are released and so no longer need to express themselves as symptoms.”* Freud wanted clients to relax to more easily access their subconscious and ultimately find relief and release.
Psychotherapy on a Massage Table
As a psychotherapist and integrative healer at the Lotus Center, I have similar goals. Unlike Freud, however, I give clients the option of lying on a massage table. The results are basically the same. The client relaxes and looks inward and I am more able to focus on the client. I can also focus more deeply on the client’s process and not on my own facial expressions or what the client thinks of my shoes. (Seems that I’m the self-conscious one!...) It also allows me (with the client’s permission), access to feet, hands, elbows. I’m thus able, through touch, to channel Reiki energy and sense the client’s energy. I tune in to different parts of the body -- and sometimes bring the client’s attention to certain parts of his or her body. It allows me to use touch as a vehicle of healing. Most importantly, having the client on a massage table gives her/him a chance to tune into his/her body, notice sensations, and relax. Relaxing the body facilitates inward reflection (accessing the subconscious), and mindfulness (awareness of present feelings and sensations). These are key goals of most psychotherapy approaches; self-awareness as a path towards understanding, freedom, and ease. And these are my goals also. I encourage clients to relax, look within, and love what they find.
So, to summarize, you could say that I’m a Freudian in the sense that I encourage bodily relaxation as an aid to psychotherapy. Whatever you call me, I would like to invite you to relax on my couch.