Couples Therapy's Dr. Orna Guralnik on Season 2, Surviving a Pandemic, and Her Savior Complex

Couples Therapy's Dr. Orna Guralnik on Season 2, Surviving a Pandemic, and Her Savior Complex
Screenshot:Showtime (courtesy Showtime PR)

“We live in the little things,” Dr. Orna Guralnik observes during the second season of Showtime’s captivating vérité series Couples Therapy. The show’s enthralling realism seems to be based on this very principle. Everything you need to know about the series format is in its name: Each talky episode contains three excerpts of therapy sessions conducted by Guralnik, a psychoanalyst with her own private practice who teaches at NYU’s PostDoctoral Institute for Psychoanalysis and at the National Institute for the Psychotherapies. The conversations are often fraught and tense, but they are largely missing the emotional pyrotechnics that typically characterize reality TV DRAMA. This is drama with a small d, and the show’s willingness to let themes creep in and out, statements to hang in the air, and problems to go unresolved suggests a radical embrace of the quotidian.

The episodes are painstakingly assembled from the ground up. The sessions are shot in a special location that has been outfitted with hidden cameras. The couples have specifically signed up for the show’s treatment program, which deviates from Guralnik’s typical practice. For one thing, they are contracted for 20 weeks’ worth of sessions—Guralnik’s private work with her patients is theoretically indefinite. “Psychoanalysts kind of refuse to acknowledge time. We work as if you never die,” she explained to Jezebel this week via Zoom. (Covid-19 impacted this season’s filming and the time she spent with the couples exceeded 20 weeks, though they all completed their treatment with her eventually.) The very notion of broadcasting her work publicly is antithetical to Guralnik’s typical process. “Usually my work is utterly private and now it’s public. I cannot even tell you how strange it is,” she said. Additionally, Guralnik detects couples limiting discussions about their sex lives and children when they’re filming, which suggests that they’re holding back details that they don’t want broadcast to the world.

Nonetheless, Guralnik says she and her patients are able to get at the relationships’ major themes and do the work. This season follows three new couples as they grapple with issues like sobriety, motivation, and attraction disparity. Dru is more attracted to his live-in girlfriend than she is to him (this is brutally stated in an episode). Matthew is struggling to find enjoyment in sober sex with his boyfriend Gianni after years of combining sex with alcohol and drugs. And Michal seems to be at her limit with her husband Michael’s easy-goingness, which at certain angles looks like apathy. Because there is only time to present excerpts of their sessions, Guralnik works with Couples Therapy’s powers that be (Kim Roberts and Josh Kriegman direct, while Kriegman, Elyse Steinberg, and Eli Despres executive produce) to make sure the important stuff gets highlighted.

“It’s very involved teamwork between myself and the directors and editors,” Guralnik said. She also discussed the simultaneous process of making a show while counseling, how the pandemic has broadly affected relationships, and her own “savior complex.” A transcript of our conversation is below. It has been condensed and edited.

JEZEBEL: What do you make of the reaction to the first season, from a psychological perspective? Was it voyeurism, schadenfreude, or something more prosocial?

ORNA GURALNIK: It was kind of surprising how much people liked the show, and I did hear repeatedly that people binged on it. I don’t get it. How can you binge on this intensity of material? Therapy usually takes a long time. I don’t really have any way of proving it, but I think people may have started off watching the show thinking it may be some kind of schadenfreude or that they could voyeuristically take pleasure in someone else’s problems, but I think what happened to people repeatedly is they very quickly got drawn in and identified with each and every participant in the show, including me. I get a lot of mail from viewers literally from all over the world and I think that people went through their own mini therapeutic journey through identifying with the different participants on the show. I think it started off with one kind of impulse and ended up with a kind of better outcome.

You do your work and then that’s handed over to a creative team that has to make sense of it. You’re the expert in psychology and they aren’t. How does the editing strike you?

In my mind, what you’re asking about is the heart of what this series is, really, beyond what it looks like. There’s this crazy magical thing that happens. After every session with the couples, I sit and talk with one of the directors very, very deeply about the couple, about the process, about unconscious interpretations. In a way, I feel like I’m teaching the directors and editors how to think as psychoanalysts. What we’ve discovered throughout this whole process is that the way a documentary filmmaker thinks and the way an analyst thinks are very, very similar. To me, that’s been one of the beautiful discoveries of doing this project with this team. These are pretty incredible people. They’re very psychologically minded and tapped into very deep themes about what motivates people. Later when they start really editing the work, they come back to me with questions, deep questions about what’s going on for this couple or that couple. “Early on they started talking about this theme, and now they’re talking about this, how do you understand this?” It’s very involved teamwork between myself and the directors and editors.

The way a documentary filmmaker thinks and the way an analyst thinks are very, very similar.

It’s funny that you mention parallel minds. There’s a point in this season where you tell someone to “keep going.” You’re saying that as a clinician but as a viewer invested in the drama of it all, I had the same thought.

Right. There’s something that we do for each other as humans: We witness and we want to know.

As you’re working with them, is there anything in your head about the fact that cameras are rolling? In addition to treating people, you’re making TV. Does that guide you at all?

That might be something peculiar about me doing this: I don’t watch TV. I don’t understand anything about the TV world. I don’t know any celebrities. I sometimes watch a couple of shows with my kids, but I don’t watch TV so I don’t have TV in my mind. But, you know, I’m an academic, so I write and I teach. So I have this idea that part of what I’m doing is not only working with a couple but I’m, in a way, trying to convey a certain lesson to whoever’s interested—whoever’s reading my stuff or watching this. I do have a certain kind of teaching mode in mind that goes beyond the specifics of the work with one couple.

On the other side, is there anything to be said for the patients experiencing the Hawthorne effect? Do you find that the fact that this is being filmed for television affects them at all? Does anybody say, “I’ll tell you this but I do not want this on TV…”?

It doesn’t happen in real-time, but I’m sure on some level there’s something of that happening. For example, people don’t get into a lot of details about their kids. There’s a limit to what we talk about in terms of things like sex or money. There’s a certain kind of privacy or dignity that people preserve and I don’t press people to go in certain directions because it’s going to be in public. So there is a certain way that the fact that it’s ultimately public information that it contains what is talked about. But I do think that the themes of what people are working on are not affected. I think it’s more maybe the edges of where people go. I don’t think it affects the spine of the treatment, but I think it affects the extremities.

The show films for 20 weeks. Is that at all typical of your off-camera treatment cycle?

No. The show’s concept was a 20-week treatment. It’s very different from how I work. There are certain treatments that are designed as short-term treatments. There are certain manualized treatments that are 12-week treatments or 20-week treatments. That’s not how I work. Psychoanalysts kind of refuse to acknowledge time. We work as if you never die. I’m not used to this kind of time-limited modality. It was interesting to me to try to experiment with it and see how it affected the treatment.

You approached all of these limitations as challenges without fear that they might somehow inhibit treatment?

There were plenty of fears. More than fears: uncertainties. In that sense, I’m very lucky to be working with people who are true documentarians. They approach the work the way an analyst approaches the work, which is, “Let’s see what happens. We’re interested even if it fails. It doesn’t have to be one thing or another. We’re going to be here and create a situation and see how it unfolds.” There were lots of things we weren’t sure of. “Is this going to work at all? How is this going to affect treatment?” You just kind of do the work and see what happens. I didn’t know what 20 weeks would be. The first season we were shooting, it was this very interesting thing for me because we had 20 weeks but then suddenly when we hit the 12-week mark, a lot of the treatments suddenly reached almost like a neat place that you could have stopped the treatment there. I was thinking to myself, “Wow, I guess that’s why a lot of the short-term treatments end up being 12-week treatments.” There is suddenly this 12-week mark where things get pulled together. But I didn’t know that was going to happen in advance.

We’re interested even if it fails.

One thing I love about this show is that it’s content to let things go unresolved and leave subjects to hang in the air. That part of it feels very not TV to me. There’s an elliptical nature of the show that dovetails so well with the therapeutic process.

I totally agree. That’s one of the things we talk about when we’re not just talking about the work itself, just the incredible parallels between being a documentarian and being an analyst. Constantly what you’re trying to do is open things up to see what happens rather than force a certain outcome. In my language, that’s how you give the unconscious space to show itself. In a documentarian’s language, I guess, that’s how you let life kind of show itself.

During this season, you comment that one way covid affected couples is that it diminished people’s exit strategies. For a period, at least, many of us were locked in place in every facet of our lives. I wonder what else you’ve noticed, not just with the couples on the show but in general, in terms of the challenges the pandemic posed.

There are many. Starting from the fact of people being locked down together and because of this no-exit situation, they were forced to contend with this irritation that is another person—another person’s otherness constantly there in a way making you question your own ways. Whenever someone does something different from you, the mind tends to go toward, “Who’s doing it right, who’s doing it wrong? Who’s doing it better?” There’s always some kind of dilemma that erupts when there’s too much otherness right in your face. That’s been a major thing. Then there are the very different coping mechanisms people have to fear, anxiety, risk—everything that has to do with the virus itself and the ways of coping with it. People are very different in terms of: Are they going to think a lot about all the risks involved and prepare for it and think about worst-case scenarios and really burrow into the fear and possible loss in it? Or are people going to generate a whole kind of other defensive strategy which is avoidance, bravado, denial?

There’s always some kind of dilemma that erupts when there’s too much otherness right in your face

One of the things that’s been really meaningful for me, witnessing what’s been going on during this past year has been how much the illusion of the individual being separate from their community or from the political system has been completely broken down. The way we totally depend on each other, literally, like, “I will only be safe if you wear a mask,” or, “If someone in China is getting something it’s going to come my way,” the way we are so much more dependent on each other than we’d like to acknowledge. And then all the systems that differentiate us and make it possible for us to work together to create the scientific community, create a vaccine together, or treat each other as enemies, that’s been huge for people. The illusion of burrowing into one’s individuality has been shattered. For me, that’s very important. I think people have become different people in response to that. I think that’s one of the reasons the Black Lives Matter movement got so much momentum finally this year. It had something to do with the bigger thing that was happening to everyone on this planet.

Do you find that you take a different approach with queer couples?

I take every couple as it comes. There are specific things that people of any kind of identity group bring with them. You saw in the first season with Sarah and Lauren. There’s a lot more pressure on a queer couple. There’s a lot more risk and animosity that can come their way from certain parts of the world. Or this season with Matthew and Gianni. Matthew’s father had a very traumatic impact on his early life because of his homophobia. Those are particular issues that come with queerness but it’s about the struggle to exist as a person with dignity like anyone else in the world. In that sense, it’s important to make room for that to be part of the conversation, as it would be with any socio-political issue that infiltrates a person’s lived-in experience.

There’s a part of Season 2 episode where Matthew and Gianni discuss watching an old video of a fight they had, and you ask to watch it. Later with your advisor Dr. Virginia Goldner, you reflect and chalk up that request to your savior complex. Is that savior complex something that you find coming up a lot? How do you deal with it? It strikes me as being warranted in some ways—people are asking you to help them save themselves at least.

Myself and others in my field, to some degree we’re motivated to become analysts or therapists because of some kind of impulse to repair or fix. There’s this word in Hebrew, in Judaism called tikkun, repairing. Repairing the world somehow. To some degree it’s a wonderful impulse. It’s what makes all of us do good things. It’s kind of the source of altruism in people, but there’s a limit to it. Beyond a certain limit, you can get pulled into some kind of omnipotent fantasy that you can make certain kinds of changes that you can’t. At some point you have to recognize what you’re capable of and what you’re not and come down with some humility and also take care of yourself. When you’re going too far in the savior fantasy, you do no good for anyone. I’ve been in that situation with patients. People have to find their own way.

You can get pulled into some kind of omnipotent fantasy that you can make certain kinds of changes that you can’t.

It blows my mind to think of your process. In my own therapy, I’ve wondered about the human experience of sitting across from me and having to endure my talking. Is my therapist bored? Am I annoying? Do they dislike me? I assume you have feelings like this…

Of course!

So it just requires a sort of ambidextrousness to keep it at bay while honoring it? That’s what you do in your peer work, right?

Basically what we’re talking about here is what I like to call an “as if” space. Like when you’re in an analytic space, you’re talking about the thing itself but also not. Everything you’re talking about is kind of a symbol of something else or a stand-in for something else. If you’re talking to your therapist and your therapist is getting annoyed with you, they’re not really just getting annoyed with you. It’s like a play session. It’s like you’re bringing something to figure out what it is. It’s not just the thing itself, it’s something to work on and figure out what is that about.

It requires a ton of patience on your part, no?

Yeah, patience and it’s a certain practice of looking at things not as the concrete thing they are but as representing something else. There’s this great Italian analyst that talks about listening to a patient as if they’re reporting a dream. Everything exists within a symbolic quality.

That’s Freudian, right?

It’s not only Freudian. Freud was an incredible genius in starting in motion this way of thinking. But being a Freudian nowadays involves other things that people in my school of thought are not. But there is something that is connected to Freudianism in the sense that you listen to things as symbolic, as not only the thing itself.

This question might be self-defeating given the elliptical nature of your work and the show that we discussed, but is there a way to put a bow on things in terms of what you’ve learned concretely over the course of this season, whether about human nature or yourself?

With time I’m always changing how I think about people. I don’t stay the same. Maybe the only thing I could say about this last season has to do with going through the pandemic with the couples and with my patients in private practice, which is that I’ve had to, because of the way we’re working nowadays, relax the frame, as we call it. Relax a certain level of boundaries and accept a certain coarseness into my private life, that my technology fails or time takes on this weird quality. I can be suddenly late for a season or extend a session beyond usual. There’s a certain kind of imperfection or humanity that has made its way into the treatment and I realize it’s actually OK.

Season 2 of Couples Therapy premieres Sunday, April 18 on Showtime

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