Book review: Egremont author delves into the history of the couch

"On The Couch-A Repressed History of the Analytic Couch from Plato to Freud," by Nathan Kravis of Egremont, is a beautiful volume of colorful and representative paintings, as well as curated drawings, photographs, cartoons, advertisements and journal covers that lay out the long cultural history of the couch as an iconic image of psychoanalysis and furnishing, long associated with dreams, intimate conversation, and rest and healing for the mind.

The question prevails, why is the couch so important in the decor of a psychoanalytic office, and how and when did this all start? The immediate answer is, nobody really knows, and, in fact, psychoanalysts are often "ambivalent" about the use of the couch in psychoanalytic practice. There seems to be no real provenance for its presence in the treatment. This is the point where the author begins the story and the ground-breaking research into a more satisfying answer for the use of a couch in psychoanalysis and its appearance in art, illustration and popular culture with so much recognizable meaning for both psychoanalysts and the general public.

Sigmund Freud said that he used the couch so as not to have to look directly at patients all day long, as well as to minimize any "transference" that might come with face-to-face talking. But while there is no clear clinical explanation, Kravis determined that "the only way to construct a coherent narrative of the origins of its use in psychoanalysis" would be to go back and look at the couch "within the social history of recumbent posture." The result is a collection of art and popular images of the couch throughout history, beginning with the Greek symposion and the Roman convivium through every era that depicts the couch in our western civilization on through modern advertising and magazine illustrations.

The result is a deeper and most illuminating examination of the couch in many past cultures, its evolution to how it functions in our world and its referential function in the psychoanalytic office. This book is thorough in laying out the art and images of deeply, yes, subconscious connections with how and why the couch has such significance in our time. The images are brilliant in both curatorial expanse and of very high quality reproduction.

The book examines the cultural and functional presence of the couch through a wide variety of references, in art, photographs of varied styles, some in famous analyst's offices, including Freud's, and poignant commentary on each illustration to best understand context and reason for its enduring presence in psychoanalysis. In the end, there is no clinical proof for the effectiveness of the couch in psychoanalysis, but the great, wide-ranging historical perspectives of its iconic imagery, and accompanying commentaries, demonstrate its importance: "The use of the couch can open the door to an oddly powerful discourse of the self that can't be had elsewhere."

Kravis is clinical professor of psychiatry at Weill Cornell Medical College, where he is also associate director of the DeWitt Wallace Institute for the History of Psychiatry, and Training and Supervising Analyst at the Columbia University Center for Psychoanalytic Training and Research.

Nathan Kravis will appear at the Bookstore & Get Lit Wine Bar for a reading and book signing at 5:30 p.m. Friday, June 15.

Colin Harrington is the events manager at The Bookstore & Get Lit Wine Bar in Lenox. He welcomes reader comments at

Read it

"On The Couch — A Repressed History of the Analytic Couch from Plato to Freud"

By Nathan Kravis

Publisher: The MIT Press

171 Pages