The theoretical and historical rationales for the use of the couch in psychoanalysis are reviewed. This is followed by a consideration of both conservative and radical critiques of its use. Given the contextual and intersubjective vantage points inherent to a contemporary relational perspective, and recent findings from neuroscience research, the author argues that justifications for the use of the couch have been stretched to their theoretical and clinical limits. Clinical examples are used to illustrate the author's ideas.