What a Relationship Therapist Really Thinks About Showtime's Couples Therapy
As a longtime relationship therapist, my first reaction was to recoil when I heard Showtime was debuting a nine-part docu-series called Couples Therapy. It follows the sessions of four hand-picked couples over the course of six months.
The first rule of therapy is confidentiality. In this series, patients voluntarily surrender their privacy. I wondered how the analyst, Dr. Orna Guralnik, might subconsciously be influenced under the pressure of knowing her work would be judged by potentially millions of viewers? Would the clinical psychologist proffer pronouncements and verdicts rather than give patients the space to eventually discern connections and insights for themselves—the best under-pinning for lasting change?
Created by Josh Kriegman, Elyse Steinberg, and Eli Despres of Weiner fame, Couples Therapy is many cuts above reality show shock-schlock like LA Shrinks, VH1’s Couples Therapy with Dr. Jenn, and anything involving Dr. Drew. This new entry into the canon is not sensationalistic, but more in line with Dr. Esther Perel’s popular Audible podcast, Where Should We Begin?, which features one real couples therapy session per episode.
To cast the docu-series, more than 100 couples were auditioned, interviewed, screened—pick your preferred term—for the opportunity to participate in serious therapy, albeit therapy with a specific end date. The four couples chosen were married varying lengths of time, diverse in gender and backgrounds, and possessed a variety of issues, past traumas, and levels of psychological awareness. All genuinely wanted help—a few even declared on camera that this was their marriage’s “last chance.”
Full disclosure: I am no puritan when it comes to TV-therapy. Eight years ago I conducted a premarital counseling session with a mud-loving, beer-swilling engaged pair from Louisiana’s Bayou who were spending a month in a $4 million house in the Hamptons for CMT’s reality show My Big Redneck Vacation. But no one took this seriously—even the minister who married the couple the next day in front of their wealthy and refined temporary East End neighbors was solicited from the internet.
I binge-watched the entire Showtime series (available on-demand) and was blown away both by Dr. Guralnik’s ability and how much the producers were able to edit the episodes—each featuring two to three couples—into raw, moving, and very real therapy sessions.
While no substitute for therapy, the docu-series offers an education for viewers who will recognize themselves and hopefully glean lessons such the ones outlined below.
Dealing With Your Own Past
At the beginning of a therapeutic relationship, Dr. Guralnik often says, “Talk to me.” Yet she already knows the crisis—or at least the pressing issue—that has brought the couple to her office (the comforting space set is outfitted with hidden cameras) is rooted not in what is called the "presenting problem" but in how that presenting problem traces back to the patients’ individual histories.
I tell couples who come to me for treatment: “Your marital role models are your parents. And many of your triggers, impulses, defenses, and choices start with what you observed and experienced way back when. It’s essential to delve into the past in order to move into the future in a healthier way.”
For instance, Elaine and DeSean, together 11 years, began their therapy with Dr. Guralnik deadlocked and frustrated. Session after session, Elaine expressed hurt and anger that her husband rarely made time for her. In turn, DeSean felt no matter how much he gave, his wife could not be satisfied, and her neediness was driving him away. In the spirit of the movie Rashomon where eyewitnesses to a murder and rape recalled different scenarios, Elaine complained DeSean hadn’t brunched with her in months; he rebutted they’d brunched together 17 times in a row.
Dr. Guralnik helped Elaine finally realize she was viewing her present relationship through the lens of past traumas. Elaine had experienced a “volatile, violent, toxic” home life followed by a physically abusive relationship. She told her therapist and husband, “Being ignored feels like a punch in the face.”
Once this connection was made, Elaine could begin to understand and grapple with the past, rather than continually getting enmeshed in it.
Dr. Guralnik offered brilliant advice: “In these situations your partner can pull you back into the present and let you know this experience is different.” That’s partnership!
Moving Forward With Your Partner
In the first episode, Lauren and Sarah, a queer and trans couple married two years, shared a major dilemma with Dr. Guralnik. Sarah ached to have a baby but Lauren, having recently transitioned, wasn’t ready: “Suddenly I’d be a mom and I’m still adjusting to being a woman…”
While intellectually Lauren understood her wife’s stance, it didn’t fully resonate. Lauren said tearfully, “Sarah’s concerns were valid but not important enough to take away the one thing I want in this life. It felt selfish.”
Dr. Guralnik said, “Because of the intensity of your wish…Sarah’s concerns felt too threatening to your attachment to having a baby.”
As the couple grappled with this heartbreaking impasse, viewers saw the mirrored pain on each person’s face. Indeed, as Sarah tearily told her "side," Lauren tenderly wiped mascara crud off her wife’s face.
In this instance, TV-therapy provided a window to help couples see that a partner’s persisting in his or her different (if unintentionally hurtful) viewpoint was not an attack or due to lack of love, but the result of a bone-deep value or belief.
As I watched the episodes unfold, I recalled a couple who every time we tried a mirroring exercise—aimed at helping each person listen to the other’s opposing perspective—would alternately make faces and/or clench fists or slide angrily to the other end of the couch. I told them, “I wish you could watch yourselves so you could see how your ears are open but the rest of you is shut tight!”
Thanks to Couples Therapy and Dr. Guralnik, couples now have an opportunity to witness the consequence of perhaps the most important quality in healthy relating: empathy.
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