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Spatial ideas are all-pervasive: they underlie verbal reasoning and are fundamental to the way we think, feel and behave. This study focuses on the physical expression of the internal processes and its application to psychotherapy, with particular reference to the work of child psychotherapist Margaret Lowenfeld. The author argues that how we perceive the external world and our place in it reflects our inner emotional landscape, and that our early strategies for resisting gravity to attain the upright position are transferred to our concepts of self-worth, power and independence. She uses case material to reinforce her proposition that physical and psychological ideas which develop during childhood are intimately related, and that in order to help distressed children, we must gain a fuller understanding of this relationship.