Ask Dr. Juan: Do I have to Lie on the Couch in Therapy?
Dear Dr. Juan,
I’ll be honest, I’ve never really been sold on therapy. It always felt like something other people needed, not me. I’ve always dealt with things on my own, or at least tried to. Talking to a stranger about my feelings just sounds kind of awkward and not really my thing. But lately I’ve been more stressed, more on edge, and my partner keeps telling me it might actually help. After a lot of nudging, I finally said I’d try it, mostly for them.
Still, I don’t really know what I’m walking into, and I can’t stop picturing those scenes from movies with the couch and the therapist quietly analyzing everything. It just makes me feel even more unsure. So before I go, I have to ask: Do I have to lie on the couch in therapy?
Sincerely,
Not Sold Yet
Dear Not Sold Yet,
Great question, and one I hear more often than you might think. The short answer is no, you do not have to lie on a couch. In fact, most therapy today looks a lot more like two people sitting in chairs having a conversation. The “couch” you’re picturing comes from an older style of therapy that isn’t how most therapists practice now. You get to sit where you’re comfortable, and more importantly, you get to show up as you are, even if that includes feeling skeptical, awkward, or unsure.
What stands out to me even more than the couch question is how you describe getting here. You didn’t wake up one day thinking, “I’d love to talk about my feelings with a stranger.” You were nudged by someone who cares about you, and something in you was willing to say yes, even if reluctantly. That matters. Therapy isn’t about being the kind of person who believes in therapy. It’s about being curious enough to look at what’s not working and open enough to see if something could feel different.
You don’t have to perform, impress, or even know what to say. You can walk in and say exactly what you wrote here: “I’m not sure I believe in this, and I feel weird being here.” That’s not a bad start, it’s an honest one. And honesty, even the reluctant kind, is often where meaningful change begins.
Dr. Juan
