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An individual who’s “on the sofa” is understood to be in remedy, however most therapists lately don’t ask their shoppers to lie down. The primary time mine did, I resisted. I didn’t wish to be on show or unable to see her reactions. Plus, the concept appeared antiquated. Sigmund Freud was impressed to make use of the sofa greater than a century after observing dramatic hypnotherapy demonstrations by his instructor Jean-Martin Charcot. In psychoanalysis, Freud thought a therapist being out of view would assist folks entry feelings or recollections that is likely to be repressed. (He additionally stated that he couldn’t “put up with being stared at by different folks for eight hours a day.”)
A lot of Freud’s concepts in regards to the unconscious haven’t held up, however he could have been onto one thing with the sofa, as I found once I finally adopted my therapist’s suggestion. The sofa may not be for everybody, nevertheless it could possibly be value a attempt.
In the present day, therapists’ places of work nonetheless nearly at all times have a sofa. For his e-book, Within the Shadow of Freud’s Sofa, Mark Gerald, a psychologist educated in psychoanalysis, took portraits of therapists of their places of work, and “it was a uncommon room that didn’t have a sofa,” he instructed me. “Any individual as soon as talked about they really by no means used the sofa with their sufferers, but when they didn’t have a sofa, they wouldn’t really feel like a psychoanalyst.”
Regardless of the ubiquity of the therapist’s sofa, analysis on situations when it’s and isn’t useful is restricted. Some sufferers in case research report that they’ve missed seeing their therapists’ face once they lie down, whereas others have used the sofa to keep away from direct face-to-face communication. Even Freud wasn’t at all times strict in regards to the sofa. He additionally took walks along with his sufferers; he famously analyzed the composer Gustav Mahler throughout a four-hour stroll round Leiden.
However for me—and, I think, many others—often mendacity down would possibly present some reduction from the social points of speaking with a therapist.The connection between a therapist and a consumer received’t totally disappear, and that dynamic might be helpful to look at in remedy too. But many remedy shoppers place an excessive amount of emphasis on interpersonal dynamics. On social media, folks make jokes about how a lot they wish to get an A+ in remedy or make a therapist snicker; I’ve felt the identical pressures myself. That stress could possibly be lowered once you’re mendacity down and bodily incapable of scanning your therapist’s face for indicators of approval or displeasure. And in a time when many individuals have switched to teletherapy, looking at your therapist’s face (or your personal) over Zoom can really feel like a piece assembly gone unsuitable.
On a really simplistic stage, the sofa provides a change in perspective—actually. The traditional Greeks and Romans reclined throughout banquets, which created an environment of consolation and intimacy, says Nathan Kravis, a psychiatrist and historian of psychiatry at Weill Cornell Medical School who’s additionally the writer of On the Sofa. Within the fashionable world, mendacity down signifies that the dialog you’re about to have in remedy is a special sort of interplay than these you’ve gotten with household or mates. It’s a time to confront troublesome ideas, admit shortcomings, or discover needs with out the relational obligations to these we all know in our “actual” life. “Its strangeness is a part of the ability,” Kravis instructed me. “It actually has no parallel wherever else in our social world.”
Mendacity down can also higher fulfill folks’s starvation for a extra inventive and humanistic type of remedy. Over the previous few years, curiosity in psychoanalysis has made a dramatic comeback, although the strategy nonetheless makes up a minority of remedy periods. Different therapeutic strategies, reminiscent of cognitive behavioral remedy, intention to alter ideas and behaviors that aren’t working for you; psychoanalysis, against this, focuses on self-exploration. I did CBT for years, and it’s very efficient at fixing issues. But one thing a few therapeutic follow that’s not as goal-oriented might be therapeutic. Once I began to lie down, I felt that I used to be selecting to create space for reflection, grief, processing, and creating intimacy with my very own thoughts in a world the place such acts are usually not normally prioritized.
Mendacity down for remedy periods may make a follow that’s pricey in each money and time really feel much more indulgent, and I’m certain that some folks merely wouldn’t prefer it. But it surely’s out there to everybody to attempt a minimum of as soon as. Mendacity down is a method, not an finish aim, Ahron Friedberg, a licensed psychoanalyst and board-certified psychiatrist, instructed me. It could possibly be a means of cultivating consolation, intimacy, and reflection, or talking in a fashion that you just’re not used to—to your self or to a therapist.
In Gerald’s workplace, he offers selections. There’s a chair straight throughout from the place he sits. There’s a sofa, lately changed as a result of the unique grew to become saggy from years of use. A few of Gerald’s sufferers at all times lie down; others reserve it for once they’re feeling overwhelmed. One affected person normally sits up however will curl up right into a ball on the sofa when she’s going via a troublesome time. Kravis stated he talks with a brand new consumer face-to-face, then offers them the choice of mendacity down after a session or two. “It’s not obligatory,” he stated. “You’re not Velcroed to the sofa.”
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