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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 purchasers to lie down. The primary time mine did, I resisted. I didn’t need 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 trainer Jean-Martin Charcot. In psychoanalysis, Freud thought a therapist being out of view would assist folks entry feelings or recollections that may be repressed. (He additionally mentioned that he couldn’t “put up with being stared at by different folks for eight hours a day.”)
Lots of Freud’s concepts concerning the unconscious haven’t held up, however he might have been onto one thing with the sofa, as I found after I ultimately adopted my therapist’s suggestion. The sofa may not be for everybody, nevertheless it may very well be price a strive.
Right this moment, therapists’ workplaces nonetheless virtually all the time 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 workplaces, and “it was a uncommon room that didn’t have a sofa,” he advised me. “Someone 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 all the time strict concerning the sofa. He additionally took walks together 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 may present some aid from the social facets of speaking with a therapist.The connection between a therapist and a consumer gained’t totally disappear, and that dynamic could be helpful to look at in remedy too. But many remedy purchasers place an excessive amount of emphasis on interpersonal dynamics. On social media, folks make jokes about how a lot they need to get an A+ in remedy or make a therapist snigger; I’ve felt the identical pressures myself. That stress may very well be lowered if 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, observing your therapist’s face (or your individual) over Zoom can really feel like a piece assembly gone unsuitable.
On a really simplistic degree, the sofa affords 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 creator of On the Sofa. Within the fashionable world, mendacity down signifies that the dialog you’re about to have in remedy is a unique sort of interplay than these you could have with household or buddies. 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 facility,” Kravis advised me. “It actually has no parallel wherever else in our social world.”
Mendacity down may additionally 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 classes. Different therapeutic strategies, reminiscent of cognitive behavioral remedy, intention to vary ideas and behaviors that aren’t working for you; psychoanalysis, in contrast, focuses on self-exploration. I did CBT for years, and it’s very efficient at fixing issues. But one thing a few therapeutic observe that’s not as goal-oriented could be therapeutic. After 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 aren’t normally prioritized.
Mendacity down for remedy classes might make a observe that’s expensive in each money and time really feel much more indulgent, and I’m certain that some folks merely wouldn’t prefer it. Nevertheless it’s accessible to everybody to strive no less than as soon as. Mendacity down is a way, not an finish objective, Ahron Friedberg, a licensed psychoanalyst and board-certified psychiatrist, advised me. It may very well be a approach 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 gives 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 all the time 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 mentioned 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 mentioned. “You’re not Velcroed to the sofa.”
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