Life of the mind: The importance of the couch

If you go to the Freud Museum in Hampstead, you can see Sigmund Freud’s actual couch, a chaise longue given to him by the grateful patient Madame Benvenisti in 1890-ish. Once alone in the museum, with his collection of antique figures, his desk, books and paintings, I found something painfully moving about that couch, draped with Persian carpets and now empty of anyone’s unconscious. Dora, the Rat Man, Anna O, the Wolf Man (pseudonyms given to his patients) all lay there, Freud sitting behind them. This is where it all began. (Well, actually, it began in Vienna—here is where it ended when Freud died in 1939.)

The thing itself seems full of the shivering foreboding and promise, the extreme sorrow, pain and eventual calm of an analysis, Freud’s presence almost tangible. (Freud could pack the whole disintegrating, re-integrating roller-coaster of analysis into six weeks—something to envy for today’s analysands, who are looking at a good five-year minimum.) Upstairs you can watch home videos of a party held in the garden here, the dogs, blue-tongued Chows, pootling about in the flowerbeds, Freud receiving well-wishers. In any case, it’s worth a visit for the gift shop alone: Post-its labelled Freudian Slips, a pair of Freudian slippers, the Freudian Sips mug, which reads “When you say one thing but mean your mother.” I could go on (and on).

My own relationship with The Couch is complicated. The first (and only) one I was invited to lie on was actually a single bed in my analyst’s attic consulting room. There were Freudian knick-knacks about the place, little sculptures and stuff and a carpet covering the bottom of the bed that brought me out in a rash in summer. The pillow was covered with a piece of medical paper, changed between patients. I never liked lying there, always felt panic and not relief. Bed just has too many difficult associations—I have enough trouble feeling safe or sleeping in my own bed. I was once interviewed by an analyst whose couch (which I was not on) was a Scandinavian-style piece of furniture, a beautiful reclining “S” in light wood and pale leather—much less scary. The ubiquitous cartoons of psychoanalysis in the New Yorker always show a kind of chaise longue, the patient’s head propped up at one end. I think not being completely prostrate would have felt a touch more benign to me.

But not everyone, obviously, is me. There is a patient I see via Skype (for reasons of inaccessibility) who begins sessions facing me, sitting on her bed. She tends to kick off quite aggressive, dismissive, not having any of it. If I make an interpretation that hits home, she concedes: “I’ll give you that one.” We have compared this to some competitive game and she suggested vodka shots—I drink for a rejected interpretation, she drinks for an accepted one. The underlying question being, I think: “Is mother feeding me poison or nourishment?”

By minute 40 (of 50) she is always lying fully under the duvet, speaking to me openly, relaxed and quite regressed. It’s fascinating that she has invented “the couch,” without my having invited her to lie down and without either of us ever having mentioned it. As if, like Pythagoras’ theorem, it is simply a truth to be discovered.

Another patient I see leans forward in her chair and grabs her knees, curling up as uncomfortably as possible in an expression, perhaps, of being tortured, threatened, cornered. If I suggested that she recline, I think she’d be petrified and run away.

It’s astonishing how the patient’s attitude to the couch, that ultimate symbol of psychoanalysis, provides so much in-sight into his or her unconscious mind.