The Star of Couples Therapy Is Its Incredibly Chic Therapist

Photo: Courtesy of SHOWTIME

Last weekend, in a single afternoon, I sped through every available episode of the new Showtime docuseries Couples Therapy. (The finale airs November 1.) The show effectively invites viewers to sit in on four real-life couples’ therapy sessions with Dr. Orna Guralnik, a practicing clinical psychologist in New York City. If that sounds uncomfortable to you — it is. It’s also addictive, juicy, and incredibly moving. I went into the show for the Schadenfreude, but by the end, I felt sympathetic toward everyone involved. (Yes, even Mau, the middle-aged man obsessed with his birthday and how his wife of 23 years should celebrate it.)

But the best part of the show, its through line and hero, is Guralnik, 55, who heard about plans for the series through her colleagues at NYU’s postdoc program. She initially expressed interest as a consultant, but the show’s directors liked her so much, they asked her to be the show’s couples therapist. And despite her repeated insistence that she doesn’t, in fact, know everything, I think she might know everything. There are things she said in passing on the show that I’ll probably remember for the rest of my life, like, “Sometimes you get to witness people transcend, like a phoenix rising … to do better than the cards they were dealt.” I mean, wow. She’s nonjudgmental, and a patient listener, but there are also a number of times when she tells one of her patients that they’re flat-out wrong about something they’ve just said — usually while holding up a hand adorned with cool, chunky jewelry. Guralnik is the most chic. She’s beautiful, and has an elegant arm tattoo, and has her adorable little dog, Nico, sit in on sessions with her. Her office — technically a soundstage replica — is overflowing with books and, I have to imagine, smells like cedar and vanilla. I was so taken with her that I Googled “how much school to become couples therapist,” as if having her job title might make me seem equally wise and sophisticated.

In the meantime, I will settle for having spoken to Guralnik over the phone.

You’ve said that you were initially hesitant to play an on-camera role in the show, so I’m wondering if you can tell me what made you change your mind.

[Filmmakers] Elyse Steinberg and Josh Kriegman and I had intense and very deep conversations about their vision for the project, and their interest in trying to capture the reality and the subtlety of psychoanalytic work with couples. Their honest curiosity, and the depth of their thinking about it, and their commitment to make it a true documentary were very appealing to me. I had some conversations with one of my mentors, Lew Aron, who was the director of the Psychoanalytic Training Institute I come from, and I expressed some of my concerns. He was very adamant that it would be an important service to the psychoanalytic community to create this counter-narrative about what actually happens in the treatment room.

You also included some of your sessions with your clinical adviser, which to me was maybe the most illuminating part. Was that something you felt was important to include?

They’re true documentarians, so they did research on me, asking me lots and lots and lots of questions about how I work and how I think about the work, and I told them one of the things I do, especially when there’s something pretty important I’m dealing with — like taking on [this show] — is I hire someone to make sure I’m thinking things through. They were like, Can we document it? I thought, why not, that’s an important piece of this.

I think seeing you with your adviser reminds viewers that you’re not omniscient, which is a trait I (and maybe a lot of people) have the bad habit of ascribing to authority figures. Do you find that clients come in wanting you to be the ultimate authority?

Yes — I think clients, like all of us, are ambivalent about that kind of fantasy. On one hand, people want someone who knows everything, someone who has the answers. On the other hand, deep down inside, no one wants to be told what to do, and everyone has to figure it out for themselves. The Lacanian analysts say the most important analytic work you can do is to disabuse yourself of the fantasy of the analyst who knows. By the end of the treatment, that’s where you have to land. It’s all inside you, not outside of you.

A lot of the sessions depicted on the show were about power struggles, and maybe especially between Annie and Mau, arguably the most challenging couple on the show. Do you ever feel like you’re an audience member to a couple’s power struggle, and maybe they don’t actually want to change anything?

Ha. That’s a multilayered question. First of all, yes, I think of couples as mini political systems. One of the pulls between people is often around power. I think power struggles often work defensively to mask other issues that people have trouble have getting to, other kinds of vulnerabilities, but the power struggles can be very real. They can be organized around gender politics, or class, race — there are all sorts of ways we organize our power struggles. And yes, sometimes these power struggles are entrenched, and people get addicted to them, and it’s sometimes hard to convince couples to see beyond the power struggle and to see, for example, Okay, maybe if I give up some of this power, maybe I’ll benefit in some other way. Maybe I’ll get more intimacy, and maybe not holding onto the victim position could be an incredible growth experience for me. People can hold on pretty doggedly to their power positions. You see that now in public discussions about white privilege.

What do you do with a couple that’s sort of unevenly interested in being there? Do you get lots of people where it’s clearly one person’s idea to get therapy and the other was dragged in with them?

It’s not unusual that one person kind of pulls the couple into treatment and the other is kind of reluctant. I try to connect with each member of the couple, and in the way I relate to the couples, I convey that the couple itself is my patient, not one of them. That’s often quite appealing to people, because they’re like, “Oh, it’s not me against them, it’s us that need help.” There’s something for the couple to gain from the work.

In the show, you said something to your adviser about how couples tend to come to therapy in a crisis. Do you think couples should come to therapy sooner, or more preventatively? 

There’s no one way to do things. Couples often come when they’re in crisis, but I also have couples that I’ve seen for years that are not coming from any crisis, but are coming because the way people live nowadays makes it hard to carve out space to just reflect on what’s going on, and it’s just a matter of living an examined couple’s life. Some people come just for a little bit, they don’t really want other people in their business and they just come in for crisis intervention and then do the work at home privately. Some people stay for a while, and some people see it as an integral part of living this kind of life. Obviously, some people don’t ever come to couples therapy and find other ways to deal with what’s going on with them.

I’m guessing you might not be able to answer this question, but if you had to put a percentage to it, how many of the couples do you see that you think should definitely break up?

Definitely break up? A very small proportion. I feel like couples should break up if they’re really harming each other. If there’s serious and incalcitrant abuse — of course, physical abuse is one thing, but even if it’s just a dynamic that isn’t movable, then I do feel like it shouldn’t go on. But most people don’t want to be stuck in that, and really try to move on and get better. I don’t have fixed ideas about which couples should stay together or not. People live very complicated lives in all sorts of arrangements and I really don’t think one size fits all. People can be very creative with how they do their couplehood or their family life. I work with people where they’re at.

Relatedly, I think I went into the show with immediate impressions about some of the people, like, “This person is clearly the problem,” but by the end I found everyone sympathetic. To varying degrees maybe, but my take on each person became so much more complex.

I’m so happy you say that. You might look at a couple and think, I could say this or that, but then you get to know the people and you get to know the complexity, and you’re like, Oh, I understand now why this is complicated. You can generate a lot more understanding and compassion and less judgment. I think the tendency to judge is usually erroneous.

I have a couple more fangirl-ish questions for you if you don’t mind. A friend of mine also watched the show recently, and we were talking about how chic you are and how great all your jewelry is. Are you into fashion? How did you decide what you were going to wear on the show?

No, I’m not a big fashionista at all. I have a certain aesthetic but I’m not a big shopper. There were some funny moments with the show because — they’re documentary filmmakers, so no one was into fashion, and once in a while I’d come to the set, and they’d be like, “I don’t know, can you maybe buy another shirt? This isn’t working on camera.” Or like, “What about your hair?” I’m not very good with this stuff. I wore clothes out of my closet so I’m glad you liked them. Someone actually emailed me asking me about my jewelry which is funny to me.

What’s your skin-care routine like? 

I can tell you I learned how to put on makeup for the show. I wash my face in the evening and I put some kind of … maybe rosehip oil, in the morning?

That’s it??

That’s it. And for this show I put makeup on, which, believe me, was a steep learning curve for me. But I can do it now, I like it.

Can you tell me more about your adorable dog Nico, who sits in sessions with you?

She’s here now. I bring her to the office. She’s usually with me, though not every day — she has pretty intense separation anxiety, so if I have to leave the office for a meeting, I can’t leave her here. So those days she’s home. She’s really quite an extraordinary creature. She’s very good with patients: very gentle, very emotionally attuned to people. I’ve had situations where people have cried in the office and she came up to them and put her head in their lap.

Are you hearing from a lot of people who want to come to you for therapy now that the show has aired?

Yes. I’m hearing from a lot of people, all across the country. I think the show hit somewhere very needed at this point in time. With the political environment we’re living, I think the show touched a nerve. People are relieved to see people talk honestly with each other, and work toward problem-solving.

The Star of Couples Therapy Is Its Very Chic Therapist