The Use of the Analytic Couch

The Analytic Couch not only has come to symbolize analysis, it has been considered to be analysis. This rigid and absolutistic attitude obtains in the public mind and in the practice of many analysts. For some it is a dictum: no couch, no analysis. Such a dogmatic position is at variance with newer psychoanalytic theory and practice, which regard the couch as another important tool to be used when it can be effective in helping move the analysis forward in a constructive direction.

The analytic couch has a history. Our attitudes are influenced by it. The couch was used prior to Freud and by him as an aid in hypnosis. He continued with it as he developed the method of free association and other fundamental aspects of psychoanalysis. His continued use of the couch was consistent with the passivity of his method and his notions of transference and counter-transference.

That Freud proceded in his investigations as he did is understandable. His method was in keeping with Nineteenth Century notions of science which had deeply influenced him. It required that the experimental situation have as many fixed coordinates as possible and as few variables. For Freud the couch became one of the fixed coordinates. I feel his scientific orientation determined his constant use of the couch much more than his personal feeling that he could not stand patients staring at him all day. He added that it was “the only method suited to my individuality,”1 and regarding some suggestions on technique, he brought them “forward as ‘recommendations’ without claiming any unconditional acceptance of them.”2 Such tentativeness and openness reflect the sincere scientist.

Whether we would have come to use the couch had we not inherited it from Freud, I feel is a productive question. Some may counter with: “Freud lived; we have the couch; are we trying to change the past? And besides, you cannot prove what might have been.” The fear of posing often unanswerable questions is to me an expression of close-mi