The chair and the couch: A comparison between the two settings based on a linguistic analysis

Aim: Although impactful to psychoanalytic practice the choice of couch or face-to-face setting has received little attention from theoretical and empirical research. The reasons for one choice or another are usually given on a theoretical basis. Depending on the theoretical orientation of the author, the couch is considered an effective device to promote regression and introspection, or at the opposite an unnecessary communication barrier that limits the potential for change. Empirical studies conducted on this issue are very rare and have not yielded meaningful results. Method: We investigated the effect of setting conducting an analog experiment procedure as suggested by Liable and colleagues (2010). We administered to 120 nonclinical participants the Relationship Anecdote Paradigm Interview along with other questionnaires measuring level of empathy and reflective function. For half of the participants the interview was conducted face-to-face, for the other half the interviewer was behind the participants as they narrated the relational episodes required in the interview. The two groups were balanced in age and gender and did not differ in empathic and reflective abilities. The interviews were transcribed and analyzed applying the computerized linguistic measures of referential process developed by Bucci and colleagues. Results: The narratives of both groups showed above average referential activity scores indicating good levels of engagement and ability to symbolize the emotional experience, however, these scores were significantly higher in the non-face-to-face interviews. This setting, moreover, produced narratives with higher scores of reorganizing function, that is, they showed a greater search for personal meanings and reflections. At least for non-clinical people, the non-face-to-face setting has thus been shown to be more conducive to the processes of putting the emotions into words and working through, typical the talking care. The suggestions and implications for psychoanalytic practice coming from these results will be discussed.