The Freud Couch has become a staple in psychology and a cliche in literature: a soppy, tearstained patient lies down on a frilly, overstuffed couch and divulges their innermost fears while a kind-faced psychologist, usually wearing glasses, dressed in plaid, and almost blending into the room, looks on. The owlish psychologist sits just out of view of the patient, gently asking them questions, or simply taking notes as the patient babbles. Even though the psychologists in these scenes could easily be mistaken for each other, the patients are all different--short, tall, young, old, calm, hysterical, sane, insane. Nowadays, therapists and psychologists usually prefer for their patient to sit in a chair next to or across from them, but the Freud couch was a very real tool used in old psychoanalytic techniques.

 In 1889, a 33-year-old psychiatric assistant, Sigmund Freud, was presented with a patient named Fanny Moser, who was suffering from a wide range of neuropsychiatric disorders. At the time, hypnosis was a popular therapy and was best conducted with a patient lying down, as if going to sleep. One of the afflictions ailing the patient was insomnia, which was often treated with hypnosis as a hypnotist leaned over them, crooning “You are getting very sleee-eepy.” Although most patients cooperated, Moser did not. When Freud had her lie on his couch, she wanted to talk and became irate when interrupted by Freud’s commentaries. 

Freud quickly realized that if he sat quietly, and out of Moser’s sight, she let her defenses down, telling him about her mind in ways she never would have done had Freud taken a more active role in the session. He concluded that once the patient lets their defenses down, the subconscious mind would be revealed, allowing the psychologist the ability to make diagnoses and recommendations based on the entirety of the patient’s mind rather than just what the patient would disclose in conversation. 

The Freud Couch was most often used in psychoanalysis sessions, and although it has become less popular, psychoanalytic therapy is still used today. Freudian psychoanalysis was usually an intense, extensive form of therapy in which a patient would lie on the couch while Freud listened, occasionally asking questions concerning the patient’s dreams, thoughts, feelings, and unholy desires. These sessions were intended to unlock the subconscious mind; that is, the id, the ego, and the superego. But, these aspects of the subconscious are modified and less intense in current practices.

Other forms of therapy, such as cognitive behavioral therapy (CBT), are still usually preferred over psychoanalysis, as psychoanalysis usually takes place over the course of years and can be quite uncomfortable and humiliating for some patients. The extent of a patient’s psychological difficulties also greatly impacts the efficacy of psychoanalysis, as some patients are more resistant than others and some disorders require more extensive forms of treatment.

Despite the declining interest in Freudian psychology, the iconic couch of Sigmund Freud continues to hold significant importance in modern-day psychology. His actual couch is located at the Freud Museum in London, where tourists can take in its rich history. If the couch could talk, perhaps it would tell its visitors comical stories of things patients have said and done while reclining. Perhaps the couch itself would require psychoanalysis!

Information gathered from Psychology Today, Dr.SandraCohen.com, The Freud Museum, Wikipedia.