“Couples therapy”—the words alone are enough to send many people running. But Orna Guralnik, the clinical psychologist and star of Showtime’s documentary series Couples Therapy, has people running to her office. She has become a household name as well as a watchful guide for couples as they navigate intimate and sometimes agonizing discussions, and for viewers as they watch these couples bare their souls—or refuse to do so. With her beloved dog, Nico, on her lap, Guralnik explained how she practices listening for the unconscious, the limits and the possibilities of televised therapy, and whether the psychoanalytic interview can teach even the most adversarial pairs, like warring nations, how to make peace.
Merve Emre: The psychoanalytic interview is a genre unto itself. I thought we could start by hearing you speak about it.
Orna Guralnik: The psychoanalytic interview is a very particular genre of interview. To start with this question of dehumanization and rehumanization, one of the things that happens in the beginning of a psychoanalytic interview is that the interviewee, the patient, starts off expecting to be less than human. They begin with a transference toward the clinician, assuming that they’re listening with a hermeneutics of suspicion. The patient thinks the clinician is going to pin them down into a less-than-human category.
One of the things that needs to happen for a real psychoanalytic interview to take shape is for the patient to feel themselves becoming rehumanized in the process of talking to the clinician, which is no simple task. What you try to do as a psychoanalyst when you’re interviewing is turn your ear to listen for things that are different than a regular conversation. You’re listening for the unconscious.
How do you listen for the unconscious?
You’re listening for what is not obvious to a person. As long as someone is speaking to you from a place that is well rehearsed, nothing’s happening there. You’re listening for surprises, for strange words that appear, for something that is more poetic. You’re listening for disruptions and surprises in the narrative.
I find it incredibly frustrating when I do an interview and I can tell that the person has come prepared with what they want to say. How do you encounter the prepared narrative? What are your strategies for disruption?
We need our defenses to be able to function in the world. To some degree, I want people to possess themselves while building a narrative, but I think of an interview as two people creating a field between them. You’re not sitting there and extracting facts; you’re creating a situation. To create that field, the interviewer must be in a state of mind where they’re willing to be surprised. Wilfred R. Bion talked about approaching any session without any expectations. You have to suspend judgment and what you want out of the interview and let things happen. All the ways in which you’re present will inform the patient’s feeling of what field they’re sitting in. Are they sitting in a dangerous place in which they will be diagnosed, judged, dehumanized, or are they in a place where both participants are willing for something to happen between them?
You have had clients on the show who come in very defensive. I feel a mounting frustration at the subject who can’t let the work happen. How do you work with that frustration?
For me, it’s part of the dance. If I’m met with a person’s defense, I’m sitting with the contours of who they are. I want to join them and make them feel respected and understood. I mold myself to the defensive structure, with an ear toward what else can show up. It’s amazing, if you’re listening, how much people are dying to shed all of those defenses and talk to you, if you find an opening. Most people just want to be found, and to speak from a place that matters to them.
I’m thinking about how difficult this is to do with couples. How do you teach people to listen deeply to each other, when adjusting to the contours of someone else’s defenses is not something many of us do intuitively?
There are a lot of pressures on couples that don’t exist outside of an intimate relationship. The first big way that people communicate better is learning how to switch from a mode of speaking, conveying, convincing, to a mode of listening and trying to understand. A different part of the brain is involved. A lot of what I do early in the work with couples is helping them distinguish when they’re talking and when they’re trying to understand not their own needs but the other person’s. When you do that, lots of things shift. The defenses go down. You can just talk. A lot of it is about shedding ego and intense desire from the situation. If you can approach the situation with less hunger and more humility, then so many things can happen.
My first impulse always is to win.
That’s a good impulse to have sometimes. There are situations where it’s not about all this good stuff that I’m talking about, it is about making a decision or deciding what’s right and what’s wrong.
I actually meant win in a slightly different way. I want to win the couple’s therapist over to my side. How do you interview two people who have the same competing impulse—that they both want you to be on their side?
Most people come into a couple’s session bringing their partner to me to say, Look what’s wrong with them. Ultimately, you want to evoke curiosity in each person about the other person and about themselves, rather than wanting something from the situation. When I listen to people, and they say something interesting—they’re mad that the person repeatedly doesn’t do the laundry, say—you can start hearing surprising things. You realize, for example, that this is reminiscent of something that happened in this person’s childhood. Something interesting happens out of the immediacy of what’s happening right now. I start asking questions, and suddenly a new thing flowers from this line of curiosity. Then we’re all fascinated by this story.
So curiosity is what rehumanizes, both in you and in each person about the other?
Yes, curiosity about what is human about the other person. They have a history, feelings, wishes. They were once children.
Why is it so hard to listen to those we know most intimately?
I said earlier that with intimate situations, there’s a lot of pressure. These relationships are loaded with different wishes, needs, frustrations, and histories that have become fossilized. It’s all so well-rehearsed. It’s hard to realize that every moment you’re interacting with another person, even if it’s a person you’ve lived with for thirty years, is a fresh moment. It loses that quality, even though it’s right there. When people take drugs or something like that, they’re taken out of that, and realize there’s a whole person right there breathing. But the accumulation of patterns makes us dull to that.
How can one have that effect of freshness without some sort of serious psychic rupture from reality?
Going to therapy does that. You introduce another person into the room; I’m the disruptor of these cumulative narratives that they carry about each other. I come with my own version of how to narrate things, and we rebuild a new story of what’s going on. One of my roles is to introduce new stories just by the fact that I’m there with a different mind. I have a theory that helps me reinterpret the stories that they come in with and consider new aspects of the story that they didn’t think about.
For example, with a couple that has been forever fighting about finances, I will introduce the question of what class they each come from. It sheds a new light on what the ongoing fight was about. So something new comes up, or there’s a transgenerational piece of history that they don’t know to think about, but when you introduce it into the story, it changes everything.
I cannot imagine wanting to do couples therapy in front of an audience. I would rather have sex in public. Why do you think people want their stories told that way?
Kinky. Most of the people in the show are a little older than the students in the audience, but they live in the public eye by the fact that they live on social media. So it’s not such a crazy stretch for people to do it in front of a camera, because they’re in front of a camera all the time. But some of the motivation for the couples is being in front of a camera, because it fortifies their story. It’s a way for them to reclaim a narrative with each other, and to get people to listen who have refused to hear them—the father that never accepted his son’s homosexuality, the mother who denied abuse. Subconsciously, they’re talking to people through the act of doing it on camera. For certain people, it has a profound healing property, owning the story.
You write wonderfully about depersonalization: the feeling a person has that, subjectively, she’s both inside and outside of herself. Couples therapy is the place where I feel most theatrical in my performance of self. I feel like I’m playing a character. I’m curious whether the camera encourages that kind of theatricality, and if so, what you do to get people back into themselves.
What’s different about couples therapy and individual therapy is that a lot of regular therapy is the patient talking about things and choosing and controlling what is said. In a couple’s situation, you’re in the action, it’s unfolding right there. Couples might be talking about fights they’re having at home, but then it emerges in the room. There’s no hiding. There’s no editing. Do the cameras add something to that? The intensity of what’s happening in the room is usually so strong that the cameras fade.
It’s interesting to hear you talk about it in terms of story, because there are the stories that people come to you with. Then there’s the story that you’re trying to help them cocreate with each other. And finally, on the show, there’s the story the showrunners are trying to tell. What happens when the stories collide?
Each season I have a different editor and director that I work with. They’re documentary filmmakers, so it’s not like reality TV. They don’t ask for anything, but they differ in how much I’m aware of their interpretation of what’s going on. I talk to them all the time—after every session, I explain what’s going on. I describe the arc of the treatment, and they ask questions and convey their opinions, trying to understand what’s happening in the room so they can edit well. Sometimes their way of understanding competes with my understanding. I’m dealing with the couple’s stories and my version of the story, and suddenly I have the editor’s version as well. Sometimes it feels oppressive, like there are too many cooks in the kitchen and it’s my dinner.
Did you know that would be a risk when you decided to do the show? What made you want to open your kitchen to other cooks?
When I was trying to figure out if I was going to do this, people warned me that it would destroy my career. But the head of my institute said, “The world needs to know what psychoanalysis really is. This is a chance to teach something.” Another friend of mine said, “All of the worries that you have, that you will make mistakes or not be a good enough therapist, that’s really the essence of what you can give.” I decided that I was just going to bring myself with all of my imperfections.
Originally, when I started working with Josh Kriegman and Elyse Steinberg, who came up with the idea, they were very respectful and promised me that we were just trying to capture what happens in a session. They really did that for the first few seasons; just a quiet presence. But as I spent time with them and with the other directors, they became, in a way, trained analysts. I created a Frankenstein. They feel more confident about what we’re doing together, which is beautiful, because the edits are getting richer, but I also have more opinionated cooks in my kitchen.
Did you ever feel like one of them had a better read of the couple than you did?
Totally. The camera can be looking at the face of someone and seeing a whole story that I don’t see.
What is the role of Nico in therapy?
Nico, my dog, is an essential part of my therapy sessions. There’s this Winnicottian term of the “transitional object” mediating between fantasy and reality. She introduces this unmediated, loving presence that transcends language. The preciousness of the pure, emotional, simple way of being allows me to see things in my patients, people who are defended or very angry. Suddenly they’re soft with her, and they’re smiling. She’s a real blessing.
It wouldn’t work if she didn’t have that face. Through the show, you’ve become a public, beloved figure. I’m curious how your experience of transference dynamics, in the therapy room and in the world at large, has changed.
There are a lot of dimensions to it. In Couples Therapy, most people have seen the show, so they arrive with a baked-in transference. They think I’m an oracle, and that I’m going to cure them. This magical transference serves as a very powerful engine. It accelerates the treatment. When I make an intervention, they really listen. They want to be good patients. It gives me a kind of power that I don’t usually have, the power of TV transference. Most of the time, that’s good for a short-term treatment, where I’m working with people for fifteen to twenty weeks. If it was a long-term treatment, the bubble would burst.
With my private practice, it’s different. I have people that I’ve worked with for years before I did the show. My private practice is really my life’s work.
As for the world, it’s adorable. I came into this bizarre position of being on TV late in life, so it hasn’t changed much about how I experience myself, but I have lovely talks with people on the street who come up to me saying that our show has really helped them.
What about your countertransference response? When people come to you thinking, She’s going to save my marriage, or, This is the last stop on the road to divorce? How does that affect your feeling toward them?
I don’t believe in that transference. I know that I’m just myself. I haven’t experienced myself as a magical person, sadly. But it’s like a Tai Chi move, I harness that transference as long as I can. Most of the time, I can do something effective with it, but not always. There are plenty of situations where, ultimately, I don’t deliver the big ask. Either the couple separates or they can get to this point but not that point, and it’s okay. It’s real life.
When we spoke last, you had just come back from a European trip where you had been asked to take some of the tactics on display in the show and apply them to politics. You’ve written about how the deep listening that you model can address questions of humanization in broader political contexts. I’m curious to hear you speak about that.
I was invited to an EU peacemakers conference where different organizations that mediate peace processes or ceasefires are thinking about how to incorporate psychological thinking into the work that they do. There are a lot of parallels. It’s surprising how in these bloody, long-standing conflicts, it seemingly is about religion, or water, or history, but the forces that make or break the resolution have to do with humanization. People, as a group, can be humiliated and dehumanized for a very long time, and it doesn’t matter if you offer them homes or money or to rebuild under dehumanizing conditions. Thinking about Palestine now, what they want is their dignity and some sense of justice. The human spirit lives in the group. When you go deep, it’s very hard to separate individuals from their collective belonging. A group, a country, a nation, a rebel group, they function with basic needs of recognition, needing to be seen as humans with purpose, dignity, and a point of view. That is the element that makes or breaks the resolution of a conflict.
How much efficacy can that kind of humanization have when faced with the naked desire for power, for resources, for land, for geopolitical advantage? Can humanization really work when the forces of capital and the state have their boots on our necks as powerfully as they do?
I think we’re all caught up in that question—to what degree will humanization resolve the problem of power? In many cycles of history, that vanishes and the death drive and the need for power take over. But at the end of the day, humanization and restoring the ethics of humanization is where we need to go, and where we eventually land.
I believe, with the couples that I work with, no matter how hard they’re fighting, they want to find the essence of respect and love for each other. It doesn’t have to be romantic love, but some way to respect the human being in each other.