Prologue

This issue of Psychoanalytic Inquiry addresses a topic that is perhaps the least controversial in psychoanalysis. Since 1912, when Freud made his famous recommendations about the use of the couch in psychoanalytic treatment, psychoanalysts have by and large been committed to the classical psychoanalytic setup, regardless of the school of psychoanalytic thought they adhere to.

Freud did not have to elaborate at length in order to persuade the analyst to use the couch. As a matter of fact, he hardly wrote anything on the subject after his original recommendations in 1912. Other psychoanalytic authors have, from time to time, discussed the issue of the patient's resistance to lying on the couch and elaborated on the meanings patients attached to that experience. Generally speaking, there seems to be an implicit consensus among psychoanalysts that using the couch in psychoanalytic treatment constitutes the sine qua non of the whole enterprise. In the absence of any open controversy, the reader may wonder about the purpose of this publication.

Actually, it is precisely this “silent consensus” that attracted my attention to this subject. It seemed to me somewhat paradoxical that, given all the changes introduced in psychoanalytic clinical theory during the last 25 years, no new rationales have been offered for using the couch in psychoanalysis and no questions have been raised about the relevance of Freud's original propositions.

As long as the psychoanalyst maintains strict adherence to Freud's original definition of the basic aim of psychoanalytic treatment—bringing the dynamic unconscious closer to consciousness—the usefulness of the couch remains clinically and conceptually indisputable.

This, however, may not be the case when the psychoanalytic process is conceptualized in the light of more contemporary psychoanalytic theories. With the advent of structural theories in psychoanalysis, attention has been directed away from the recovery of the repressed and more in