The therapist couch. A long, contrite stereotype – that is somewhat appropriate as I find myself writing this blog post from one of my offices couches… The therapist couch is commonly depicted in almost every movie or show with a therapist or psychiatrist in which we see an individual lying flat on their back with their hands folded over their stomach sharing some childhood story about mother while the serious looking, glasses wearing therapist slightly frowns and nods slowly saying, “tell me more”. Oh, don’t forget the cardigan either. While this may have been true back in Freud’s day and on the latest blockbuster hit, this does not resemble the majority of actual sessions. While I do have a couch- please see the above confession- I also greatly enjoy creating a space of exploration and immersion with my clients. This does not mean we are digging up fossils in the back of the office building (confession #2: I have only done that a few times with my child clients as a way to build rapport!). Rather, the vessel by which we enter our experiential space is through dialogue, stories, and uncovered narratives of the self. Sometimes this is done by maintaining direct eye contact with the big oak tree outside my office window as we disclose challenging past experiences. Other times, this is accomplished by sitting on the floor as it feels safer than being on the couch. I will never forget my first client that asked me if it was okay if they could sit on the floor after a handful of “couch” sessions. I remember thinking how I was never taught about this in school and if I was breaking any ethical or legal codes of conduct by agreeing. I hastily brushed off the frequent nervousness and fear of doing something wrong that is so common in new therapists and nodded to my client. They sat down and our session immediately opened up into all new territory. As we processed together towards the end of session, we shared in the freedom felt to literally be grounded to the earth (AKA carpet) and how felt more comforting and soothing than my overly expensive couch did to them.
After a few years in my PhD studying the effects of long-lasting abuse and trauma on mental health and working alongside more clients, I slowly became acclimated to the “floor request” and the feelings that it can bring up in the new therapist if it has not been introduced in their schooling. A lot of us who grow up in traumatic households learn from a young age to “stay out of site to stay out of mind”. Similar to the African safari, being out in the open and vulnerable area such as a couch in a living room can result in harm of some sort. It makes all the sense in the world to me now that some clients feel threatened by a big, wide couch. Sometimes we feel like we do not have permission to take up that much space. While you are always deserving of taking up space, sitting on the floor may bring up feelings of comfort in an act to self-soothe during a stressful situation. Growing up in a home with abuse, I have heard countless stories on individuals seeking refuge in a closet, under the bed, or anywhere that felt low and safe.
Thinking about it now, I believe that this is such an important developmental milestone for therapists to overcome the insecurity of looking “bad”. In school, most of us are taught exact and specific ways on what we should do in many different circumstances with clients. This is helpful for the level 1 therapist who is still learning their theory and the skill and art of therapy. However, part of the nature on being a therapist is that it is indeed based on unique creatures: humans. It is possible to be human, attentive, professional, and authentic with a client. Humans are diverse and our ways of thinking match our biology. No one approach to therapy will be as effective with everyone you work with.
It was in that moment early on in my career where I was directly confronted with having to let go on how “I thought” sessions should go and how I thought I should present. Interestingly, so many years in higher education I meet people sometimes who automatically assume formality with myself. I, along with my clients, would laugh at that. Between my rodeo metaphors and floor sitting sessions with clients, sessions are not how you may conventionally think they may look based on media or tradition. And that is okay. Our sessions morph to what the client is needing in that moment and to be able to come alongside a client and assist in creating a secure space in whatever fashion works best for them… well, to me, there is no greater honor. So, come one and come all. Step into my office. And if you would like, sit on my floor.