I tried it once with a psychoanalyst out of curiosity, it felt very unnatural. He does not typically conduct therapy with the client lying down but it is an option to do. I did not like it. It is supposed to help the client talk more freely but I had the opposite reaction - felt inhibited and uncomfortable. I was actually constantly thinking it's so weird that he is staring at me lying while I could not see him. I never had any problems talking in therapy sitting up.