Entire books could be written about eye contact, but for the sake of brevity, let’s limit our consideration to eye contact in the therapeutic context. Except even before that, we must zoom out and understand the cultural context in which therapy is taking place. Eye contact means different things in different cultures. In Asian cultures, too much eye contact can be off-putting, or even disrespectful. Meanwhile, my father was very clear when I was a young boy, that politeness consisted of looking someone in the eye and giving them a firm handshake.
In the therapeutic context, this issue of eye contact is heightened because of the power differential that exists naturally between client and therapist. Even for a therapist like me, who does his best to “get on the same level” as the client, there is the unavoidable fact that the client is the focus of the work. The client is the one revealing personal information, whose problems are being worked on. This necessarily means that the two people are not “in it together” as equally as could be.
It is sometimes difficult for the client to reveal such personal information, and put him or herself in such a vulnerable position, while being seen by someone else. This is why the couch has had some appeal, ever since the beginning days of psychotherapy. In addition to allowing the client to relax, the couch breaks the tension of sitting opposite someone and having to play the “eye game,” as I call it. It can allow the client to speak more freely, and almost always it allows the therapist to listen more creatively (e.g., listening to the tone instead of the content). However, while some people feel constrained by the “eye game,” others are comforted by it. They like to see that their therapist is there and listening to them. People can feel isolated on the couch. They wonder what their therapist is doing, if he or she is really listening.
In my own therapy—and even in my individual supervision—I use the couch. But when I am discussing something that is threatening to me, I usually sit up, with my back to the wall (the couches are flush with the wall). My line of sight is then perpendicular to my supervisor or therapist. I like this as another option because it allows me to see them out of the corner of my eye, but not look directly at them. For the other things I talk about that are not so threatening, I enjoy laying down, relaxing, and letting words spill from my mouth with a freedom hard to achieve elsewhere.