Relationship Problems? A Couples Therapist Answers All of Your Questions… and More

Dr. Orna Guralnik

Dr. Orna Guralnik of Showtime’s “Couples Therapy” is here to help get your relationship back on track

Have you ever had a question about your relationship and thought, “Gosh I really wish I could ask a couples therapist?” Well you asked, and we got answers from the very best of the best— Dr. Orna Guralnik.

Dr. Guralnik is best known for helping couples solve their problems in a very unconventional setting… on television. She is the therapist at the heart of Showtime’s acclaimed docuseries Couples Therapy, where she gently guides couples through some difficult conversations which ultimately lead to incredible breakthroughs. You can find all episodes of Couples Therapy on Showtime On Demand and in all Showtime apps. In the meantime, below Dr. Guralnik speaks with us about how to find the right therapist for you and your partner, what it actually means to decide to go to therapy, and what happens when bickering becomes an issue. 

KCM: How do you begin to find a therapist that fits BOTH partners?

Dr. Guralnik: Generally, a couples therapist treats the ‘system’, or ‘unit,’ which is the couple. When a couple spends some time with their therapist, they should come to feel like they, as a unit, need help. Typically, a couple will move from attributing their difficulties to one person’s ‘”issues” to thinking more about the dynamic that has fossilized between them and look for ways to unpack it together. If, over time, it does not feel that way, e.g. if it seems like the therapist is aligning with one versus the other or exacerbating an already-existing competitive vibe, it may be good to pause and reflect together on whether the treatment is going well.  Some couples pull hard for “splitting” and competition, which needs to be addressed directly with the therapist.  

Do most couples who seek counseling still end up splitting up?

Absolutely not! Couples seek treatment for many reasons. Some come when they are really on the brink, but many come because they are stuck in repetitive cycles, which they realize they can’t break on their own; they honestly want help. Some couples come as a “prophylactic” measure, knowing themselves and knowing relationships can be challenging and can trigger old patterns; they want to become more self-reflective and cooperative before things escalate. And some couples simply need the support and “holding environment,” which couples work provides — a safe space where they can regularly talk about things, especially when living very demanding lives that leave little time for it. Many couples find therapy very helpful — both in deconstructing patterns and deepening their experiences with each other, with the rest of their family, and with themselves.

Is the “honeymoon phase” really a thing, and can that feeling wear off?

Falling in love and becoming deeply enamored and preoccupied with one’s partner is a very special and precious experience that allows for many amazing things to happen to us. People relax their boundaries, take risks, become more open and vulnerable, and get in touch with deep joys and hopes. This is indeed the honeymoon phase that creates a very powerful glue that helps people with later chapters in their development as a couple and maybe family. This phase, at some point, indeed changes and morphs into different stages of maturing: Recognizing and dealing with difference, with the loss of some idealization of self and partner, with limits. These are all important aspects of maturing. The later chapters in a couple’s life may be less idealistic. However, they provide depth and an accumulation of history and trust, which are full of their own satisfaction and meaning.

 What is your advice for couples that get caught up bickering over the small stuff?

 Bickering is typically some amalgam of using one’s partner to work through one’s own discomforts, moods, anxieties and frustrations, and it’s an expression of deeper issues, of which the couple has not found a language to address. People are prone to pulling in their partners to enact their own unprocessed stuff whether local frustrations or deeper feelings, which they have not found a way to work through. Focusing on small irritants (who better than the person right in front of you?) can be a distraction or a transfer of blame away from the self. That kind of bickering is best addressed through spending some time alone and doing some self-analysis. (This also can be done in therapy and through honest conversation with trusted friends…).

 When the bickering is a symptom of deeper unspoken issues between the couple, it is best to set aside a series of honest conversations. Strike while the iron is cold! As in wait until it is not happening in real time, but when both partners are calmer, to start these conversations.

 Can couples see the same therapist together as well as apart?

 I strongly advise against mixing. A couple’s therapist should ideally see the couple as a single unit and not engage in individual work with the participants as well. It is important to respect the frame and boundaries around each “unit of analysis” or “unit of treatment” and not compromise that. Despite the temptation to be the one-stop provider and the omnipotence in that sentiment, there can be many more complications than benefits to messing with such boundaries. I typically do not ever have individual sessions with members of a couple I am seeing. I also do not see friends of my patients for similar reasons.  Good boundaries promote safety and trust for everyone.

This interview has been edited and condensed for length and clarity.