The traditional image of psychoanalysis
The couch has played a part in psychoanalytic psychotherapy treatment since its earliest days, with adult patients lying down, faced away from the therapist. The idea behind it is that, in order to encourage free association – saying whatever comes into your mind during a session, without censorship – it is easier to be in this reclining position, and not facing your therapist. It is somewhat similar in the way it can be easier to share your feelings with a friend or relative when not looking straight at them, say when you are sitting next to them in the car.
Although some people find that lying down helps them to get into a space conducive to the process, others find it more helpful to sit in a chair. This is something you can discuss with your psychoanalytic psychotherapist.
In some settings and circumstances, using the couch may not be suitable or appropriate (e.g. working with infants and parents, people with a disability, children and young people, families or in groups).