Elements of Dynamics III: The Face and the Couch

Abstract

In this article the therapeutic and scientific advantages of face-to-face psychoanalytic treatment are contrasted with the symbolism, power, and mystery of the psychoanalytic couch. Beginning with recent commentary on the meaning of the couch, I consider some problems associated with its use, such as regressive irretrievability of learning, paucity of affective and empathic connection, preservation of shame, and coercive aspects. Compromises between couch and face are offered, and more clinical and research focus on facial affective expression is encouraged.

The Googled and Googling Analyst

“…It goes without saying that both parties can also act to induce envy; they aren't limited to evading it.8 See, for example,Forrest (2004),Schachter and Kächele (2010),Friedberg andLinn (2012), andSkolnick (2015). A much earlier (and often cited) author writing in this vein isRobertiello (1967), who heaps scorn upon use of the couch as "a truly ridiculous anachronism" (p. 71).…”

The Role of the Couch in Psychoanalysis: Proposed Research Designs and Some Preliminary Data

“…69-70). Forrest (2004), after quoting Grotstein (1995) on the importance of mutual eye-gaze in the infant-parent situation, states that "the lack of potential affect recognition and exchange of expressions in the analytic dyad deprives the couch-using psychiatrist of the many useful nuances, including, but not limited to, the play of the momentary microexpressions that are so telling and betraying" (p. 556). He believes that many unspoken exchanges take place through the facial expressions and gestures of patient and analyst, and that the removal of these components in the analytic situation limits therapeutic gains.…”