I feel like I used to have a satisfactory layout for years but haven’t since found a consistently comfortable arrangement. I like to have a fairly thick pillow or two under my head to accommodate my bad shoulder, a pillow between my thighs to avoid chafed skin, and a pillow for hugging - also mostly for my shoulder.
The head ones tend to get distorted really quickly and it’s really difficult to find a good hugging pillow.
My oldest pillow is about fifteen years old and was one of my first purchases in my own home - it’s the one I now use to avoid skin chafing. Back then it was for my head.
I didn’t know European pillows were different, though I suppose I shouldn’t be surprised.
edit: s/about/avoid/