All my sessions are in the "lie down" position on the couch. For the first year or so, I absolutely refused to do it (it seemed creepy to me). Now, it is always the couch. I haven't sat in the chair since the first time I used the couch.

This works for me because acknowledging that he is physically in the room brings immediate nausea. So, if I see his shoe out of the corner of my eye...uggghhh.