303. Will I have to lie on a couch and talk about my dreams like they do in the movies?

The stereotype of a client lying on a couch, describing dreams to a psychologist is based on early psychoanalytic techniques, from the beginnings of psychotherapy. Psychoanalysts still use the therapy couch, but it is not usual for psychologists to work this way anymore. Part of the purpose of the couch, aside from allowing the client to be as comfotable as possible, was to allow the analyst to sit out of view of the client. The analyst wanted to be able to observe the client, but did not want his/her own reactions to influence the client. 

Most psychologists have several chairs in their office, especially if they see families or groups, as well as individuals. Some psychologists have recliners in their office, rather than a couch, while others have sofas or comfortable chairs. Today, psychologists want to be able to maintain eye contact with their clients, because facial cues are important in assessing emotions. Additionally, psychotherapy is seen as a more collaborative effort today, and face to face contact is more appropriate to that model. 

Talking about your dreams is still common in psychotherapy, although that depends on the theoretical approach of the psychologist. Behavioral approaches to treatment will almost never talk about your dreams, except if you are experiencing distressing dreams as the result of trauma. Cognitive therapists will focus on dreams to stimulate a re-evaluation of your perception of problems, but will not dwell on dream work very much. Psychodynamic therapists, who use a theoretical approach similar to psychoanalysis, are most likely to incorporate dream work into treatment. In general, there is much less emphasis on dreams than in the early days of psychotherapy. Most people complete therapy without ever discussing a dream, and do quite well. Even among psychodynamic therapists, dreams are seen as being less essential than was thought in the past.