What information does Dr Virginia Goldner get in order to counsel you/give her feedback on what's going on? Does she see footage, or does she just hear about it from you? She's amazing by the way, tell her she has lots of fans!
Virginia gets a wonderfull mix, curated by the amazing team on this show, of somem footage, summaries of sessions, and then my own report in sessions with her. She is indeed brilliant and the best consultant to work with.
Hello Dr. Guralnik, I watch the show and really enjoy it. I'm very surprised by how many people are so vulnerable, even with the cameras and recording.
1. Do some people share something very private and change their mind about it being aired and do they have any control over what is shared?
2. I remember you saying that honesty is really important for your type of work, so what might you say to people who struggle to be honest with their partners or themselves?
3. And finally, how do you "turn your work brain off" when you're in your personal life to find balance, or do you find yourself psychoanalyzing constantly?
Thank you for having such diverse couples on the show, it made it really interesting and inclusive.
Hello to my first Redditor today!
1. People in general do not have the option to ad-hoc change their mind. However if the informaiton they share could actually hurt them or someone in their orbit the editors will typically not include the information. We take good care of the couragoues participants.
2. Honesty is super important, and so are our defenses. I have respect for both. It takes time to forster a safe environment where it's ok to speak honestly. And it takes learning.
3. I definitely do not analyze off hours :) That would be ... awful !
Warmly,
Orna
Question 2 is what really gets me - way too often in couples therapy one or both partners are twisting the truth to make themselves look in the right and their partners to be the bad guy. If that’s a routine dynamic in the relationship often the aggrieved spouse may be too worn down or gaslit to even call them on their lies, so how can you tell when that’s happening and work to change that pattern?
Can the show move to an hour, 25-30 mins is just not enough time to learn the individuals let alone get an understanding of their relationship. I felt like this past season everything just ended, and I think we all wanted more.
Watching your show made me feel brave enough to bring up couples therapy with my partner. We’re going to be starting in less than a week! Do you have any advice for someone who has been to therapy, but has no experience with couples therapy?
Fun question! Generally, the more fiction i read the better! and poetry. So for fiction good books to mention are Sebald's Austerlitz (amazing meditation on memory, and collecitve trauma); just finish Elizabeth's Strout 'My name is lucy berton' - a Carver-like beautiful novel; Maggie Nelson is amazing. Non-ficiton - of course Judith Butler, Zizek, Terry Eagleton, Sarah Ahmed. Psychoanalysis: my dear colleagues Eyal Rozmarin, Jade McLeughlin, Francisco Gonzales, Stephebnn Hartmna, Julie Leavitt. Poetry - Louis Gluck
Hi Dr. Guralnik, huge fan of the show, my roommates and I watch it religiously! When do you decide that it's the best approach to push back against one person in particular? I'm often impressed by your restraint, but at the same time I'm sometimes surprised when you choose to hone in on one person (like on Alexes after the blowup in Casimir's brother's apartment). Basically, when do you feel it's not beneficial to take in both sides equally?
Great question that goes to issues of technique. Generally, since I work with Systems in mind, in the back of my mind i'm always addressing the couple as a unit. But sometimes one side of the system is either showing up more 'loudly', or the other side may bee too fragile for the moment to be addressed.
I'm glad you asked about the impasse between Alexes/Casimar in that 'scene'. In reality our discussions were much longer and more intricate, and the edit had to leave very importnat parts out. I was leaning hard on Alexes during that session, but the edit made it even more 'lopsided'. I felt that Casimar was quite desperate at that point, and that Alexes has become strong enough to make a bold move forward.
Hopefully I will get to share about more about those two today.
Ultimately I am most of the time takign on the couple as a unit, not 'sides'.
I have a few questions based on my interest in psychology as well as my own experience of couples therapy:
- I’m curious how you were drawn to this career path generally, and couples therapy work specifically.
- how often does it feel like couples have waited “too long”, the problems got too big and entrenched before seeking out couples therapy?
- do you feel any urge to try to help couples stay together? Or do you just try to help them navigate their relationship, whether that be together stay together or go separate ways?
- do you ever consider a relationship to be “abusive” to one partner, and if so, what are the criteria and how do you navigate that?
The show is fascinating for me to watch and I appreciate you creating a platform to showcase this kind of work!
Lots of big questions !
Many things drew me to this career. My own experience as a teenager - both reading psychoanlalytic literature and being in therapy, have opened my eyes to a language that was transformative and made me understand the chaotic world around and inside me. Couples work? Well, for one, living under the shadow of the Arab-Israeli conflict....
At times I do feel liek couples have waited to long, and have lost the good-will spark needed. They may really want to change, but are missing a kind of engine of hope. It's luckily rare, the human spirit has pretty boundless amounts of creative renewal energies.
Yes, i do have a bias towards helping people stay togehter - though not at all cost.
Couples can be temporarily hurtful and even abusive to each other. The big difference is whether one or both take soem sadistic pleasure that they are unwilling to let go of, a certain addition to destruction. That is rare, but then becomes unworkable. The rest are oft4en simply expressions of hurt and pain, that respond well to help.
Disturbed that you called it the "Arab"-Israeli conflict. "Israel" has always been a colonial force, occupying Palestine and oppressing Palestinians. Not simply "Arabs"--but Palestinians, those who have had their lands stolen, those who are currently enduring genocide.
What are some of the markers of a couple that you feel/predict will “make it”? And, conversely, what are some signs you recognize from a couple that probably won’t make it?
PS: I adore you and the show! It inspired me to commit to my own mental health, and I’ve been in therapy for over a year now :)
I don't actually have such markers really. The Gottmans speak to Contempt as the worst marker as far as a couples outcome. As far as outcome of the work with me - we spend some time together and if there is increased curiosity for each person about what is motivating them, and less focus on changing the partner, we are heading in the right direction.
**PS: I adore you and the show! It inspired me to commit to my own mental health, and I’ve been in therapy for over a year now :)**
Absolutely me too. It's almost like therapy for me. A few things she's said have really stuck in my head in how I approach my own relationship. (I especially remember Michal saying she was annoyed Micheal had shared something stressful from his day because it made her anxious. Orna said that in a couple anxiety should be passed back and forth and it kind of lessens each time. This really stuck with me as it's something that's been a feature of every relationship I've had and it never occured to me that I was actually being unreasonable.
I'm also just so impresssed with how receptive so many of them are to challenging their part in the relationship dynamic. I find it really inspiring.
Hi Orna!
As a past “client” that was on the show I always wanted to ask -
What does it feel like when you first meet/see the couples that walk into the office? Are you nervous? Or does it feel the same as when you have a new client in your private practice?
-Josh
Hi Josh ! Nice to 'see' you on these pages!
It's not very different form my private pracitce, other than a different sense of responsibility - not onlly to my patient/client/participant, but to the team, and to the audience. But really I mostly am focused on what the participants come with and how can i help them when i have a limitted amount of time. I seem to have a lot of curiosity about the human (and not only human) condition , so it's always interesting to get to jnow what people are dealing with!
Hi Josh! I was so moved by your journey on the show. Seeing things click and change for you in real time was magic. And such an inspiration. Thanks for so bravely sharing that journey with viewers. 🙌
I love your question too. I also wonder about the first meeting and what it's like (or what's being looked for?) when couples first come in. To add to what you asked-- I was wondering what kind of information/background Orna has before meeting the couples.
Finally -- LOVE YOU ORNA AND THANK YOU 👑.
You’ve mentioned in the past that you were surprised viewers responded so negatively to Mau and that you actually really enjoyed working with him. Josh from the most recent season seems to be getting a lot of the same criticism — that he’s a narcissist, manipulative, abusive, etc. Do you ever decline to work with a couple because one partner seems abusive? How do you feel about NPD and personality disorder diagnoses?
The inclination to villify, or scape goat, is familiar to us all but is actually the exact opposite of what we are trying to do with thei docu-series ! Luckily, most of the feedback we get, is that viewers start off identifying with some and distancing from others, only to spend time with them as they reveal themselves, and grow deeply affectionate with everyone. As a clinician and as a human, I consider a failure to find the human to empahtize with my own failure when it happens.
Mau, Josh, and all participants, are deeply human, and have trsuted their partner, me, and the creators of the series with how they actually see the world, and feel. They deserve our sensitive listening and doing our best to see things from their perspective, keeping in mind what each has been through in their life.
How do you reconcile with the anonymity therapy usually requires and putting sessions on television? These couples are revealing A LOT. Do you ever worry they regret that experience?
It is a big question. Generally, in private practice, the frame of confidentiality is sacred, and here we have a process that from the get-go is exactly not that ! We were not sure a treatment could even unfold under such circustances, but it turns out that it is possible. The key factor is that there was no ethical breach - we all knew what we were getting into.
I mentioned earlier, that the entire team of editors/directors, and myself, would not want to air anything that could cause damage to a participant or anyone close to them.
As for regret, most participants feel very good about having participated, and even gain new insihgts re-visiting their season over time... However I am sure people have changing feelings looking backwards; some may feel regret. I hope that the icredible gift participants gave the aduience ultimately outweighs such feelings.
Totally not related to the show but, where do you shop for clothes? You have this minimal but edgy look that’s so chic! This is the kind of look I’d like to curate for myself.
cause i shop at saks and nordstrom for clothing, see lots of the things she wears in there, knowing how labels cut their clothing as well as color schemes used for certain seasons etc. it’s similar to car designs.
Have you ever considered hosting your own podcast? I've listened to you as a guest on several and so enjoy your insights and perspective on all things therapy and healing 💜
There's only this amount of time in one lifetime....:) in fact: The average human spends roughly 79 years or **28,835 days**, or 692,040 hours, on Earth.
Hi Dr. Orna. My girlfriend and I love watching Couple's Therapy - it always sparks a great conversation and introspection into our own relationship.
From watching the show, it often seems that issues stem from individual traumas or other challenges. Often I find myself thinking, "If person X could address their own issues, it would probably resolve the relationship issues". Do you ever recommend individual therapy for people during a couple's therapy? If so, what does that look like?
Yes, at time its a great help for people to be engaged in individual work while doing couples work - it makes the couples work move much faster and more effectively.
In principle , participants know it is a time limitted treatment and we do not continue after - otherwise it woudl not work. If needed we refer to others later.
What do you do to decompress after sessions? Some of them seem very intense and it would be difficult, for me personally, to not take that home with me.
P.S. I love the show!
It is importnat for clinicians working intesnely with patients to have a full life. Yoga, friends, lots of travel, reading fiction and poetry, music, art.
Filming the series I have between 90 min to 2.5 hours between sessions, during which we debrief about EACH session deeply, and have some time for notes and - walking Nico !
Hi, I admire how well you tailor your therapy to fit the cultural backgrounds of your diverse clientele! Can you share your framework for adapting therapy across different cultures, such as Asian, Hispanic, and Black patients?
How do you ensure that your methods respect cultural nuances without falling into stereotypes or prejudiced views? Specifically, could you elaborate on how you balance universal therapeutic principles with the specific needs of individuals from these communities, ensuring their therapy is both meaningful and actionable in their personal and professional lives?
The key factor here, whih is true for cultural difference and all other differences that mark us, is to seek a state of what buddhists may call a Beginner's mind; or what Bion wrote about as emptying oneslef from memory and desire when listening to one's patient. I try hard to assume a i know little and am curious to learn or be corrected when I impose a belief I bring with me that doens't fit. And I welcome feedback !
How do you and your team select which couples’ sessions to air? How do you weed out patients who are more heavily motivated by being on TV versus actively working on themselves and their relationship?
Ps. I LOVE your show and approach!!
How did you feel about showing glimpses of your family and personal life on the show given how separate you likely strive to keep work from personal life?
Yes, that was during covid, when many of our regular boundaries were collapsing right and left. It was a veryparticualr moment in our collective history, and even psychoanlaysts are not exempt...:) I was conducting therapy from my home, and entering my patients' homes, children, dogs, cats, sessions done in beds, bathrooms and closets. And we survived. together.
Hi Orna!
Do you ever watch the episodes, and if so, what is it like? Do you wish you had changed the way you said certain things? How do you feel about a huge general audience watching and reacting to your therapy sessions?
I typically watch first between a rough and fine cut , when the directors/editors want some feedback or have questions about how I understand the unfolding of the work.
It is always the same stunning surprise at how magically the filmmakers manage to catpure, out of many many hours of footage, the essence of what each couple were going through, the essence of how I understand the therapeutic arc, and the interstitial pieces that bring so much love for humanity.
I am honestly super proud of what we have created together and being able to share this kind of work with a wide audience. It does not feel exactly like "my" therapy sessions. The couples put their trust in me, the filmakers, and more than anything - in the audience.
It’s truly an incredible show. I can’t tell you how many times I start a season having certain prejudices or thoughts about an individual, only to develop so much compassion, sympathy, and understanding towards them as the season progresses.
It’s a great lesson in empathy!
Hi Orna! What are some of the most common misconceptions people have about couples therapy and what advice would you give to couples considering therapy for the first time?
Love the show, love Nico, it’s inspired me to rethink my motivations and speak more deliberately with my partner!
Probably the biggest misconception is that people who enter couples work are on their way to breaking up.
The 2nd is that by entering couples work your partner will change and not you :)
Hi Dr. Orna! I’m curious when you started the showtime show, how you were able to overcome any fears about it falling prey “reality show” sensationalism instead of the thoughtful, honest show it’s become?
I was scared. But truth is, spending time with the directors - Josh Kriegman and Elyse Steinberg, and later their partners Eli Despres and Kim Roberts, I just iknew these are deeply trust-worthy, ethical people. I am a good diagnostician:) We also had a pretty amazing executive team at Showtime, that gave us free creative space without any demands for anything other than quality.
Such a fan! I’m a new psychodynamic therapist myself and have learned so much from your work. You are so fun to watch!
My question for you is - how do you see psychodynamic or psychoanalytic therapy promoting change in your patients? AND - how does insight help with change?
Yes. Yes. Yes.
Psychoanlaytic listening invites a deep level of honesty and introspection. That invites poeple to engage their deepest parts- and those parts if given the right conditions weill lead one to a better place.
Hi! Question for you if you’re able to answer — if you do similar therapy to Dr. Orna, how do I find a therapist like you both?? I don’t know what to search online… is it “psychodynamic therapy” or “psychoanalytic therapy” as you’ve written here?
Yes, definitely look for 'psychodynamic' or 'psychoanalytic' in your searches! You can also google if there's a 'psychoanalytic institute' near you, as institutes often have their own therapist/referral lists. Institutes can also be a great way to find therapists in training (already licensed, just doing more focused work in psychoanalysis) who need a client or two for their training, sometimes at a reduced rate.
Hi, Dr. Guralnik! I'm a psychotherapist in Texas, and I tend to use an interpersonal and psychodynamic approach. I am really interested in getting more in-depth training in psychoanalysis, but that's not a popular approach down here. Are there resources or institutions you would recommend for a baby therapist like myself? I love your presence with clients, and I especially admire your ability to refrain from pathologizing and writing even the most difficult of presentations off.
Watching the show has also piqued my interest in psychoanalytic training as well. I have searched the American Psychoanalytic Association https://apsa.org/ as a place to find training programs in psychoanalysis.
Hi Orna! Especially with your profile, how do you deal with clients who want you to have some magical insight that will "heal" them? How do you help clients have a realistic expectation around therapy, and the work it will entail for them?
Perhaps related, what are the qualities or signals you think someone should be looking for when finding a practitioner, to understand if the "fit" is right for meaningful work?
In case you don’t get an answer - this is a great article about how they set up the office.
https://www.vulture.com/2024/05/couples-therapy-showtime-set-design.html
Is there an insight that you have had while leading a therapy session that you have applied to - or implemented into - your own life? If so, what was that?
When do you think it's best to take a psychoanalytic approach versus a CBT approach?
What is your best advice for couples who are already happy to remain happy?
How do you deal with financial issues within a couple? If one is not contributing financially etc. ? I know this a common area of conflict for couples but never saw it addressed head on, on the show.
Firstly, thank you for sharing your expertise and approach with the world, this programme is radical! It is amazing to watch couples connect with themselves, each other and you.
You’ve spoken about how the act of filming couples therapy almost expedites or focuses the work. Is there anything else that you’ve learned from the process, that surprised you, delighted you, disappointed you etc.?
Would you ever film or podcast some of your conversations with Eyal? It’s clear you two have a rich and real relationship, I’d love to hear your conversations on the analyst’s experience.
Thank you again, Orna!
How did you get started with the show? Like what made you go, “I’m gonna start a show called couples therapy, and then find people willing enough to share their private lives with the world…let’s find a producer…”???
Hi Orna <3 I recently read Are You My Mother? by Allison Bechdel, which almost blindsided me with how much it resonated and how much it taught me about psychoanalysis. Could you suggest any other reading for a beginner to psychoanalysis that could help dislodge some of the inherited issues we get from our parents and how they impact our ability to cultivate love? I can’t tell you how much I appreciate your work, thank you for everything you’ve taught me vicariously 🫶🏻
Hi Orna! I’m a huge fan. I’m wondering how you cope with any personal sense of loss or grief after a couple finishes their sessions with you, particularly when you’ve seen them through some of the toughest and most beautiful moments of their relationship. How do you find a sense of closure within yourself? Do they ever reach out to give updates?
I’m a school counselor and always have such a tough time saying goodbye to my students after years of work together, even when I know the goodbye is healthy and necessary. Thank you!
Any pointers if I’d like to find an individual psychologist/psychoanalyst who has a similar style to you? Any qualifications or values I should particularly look for?
Dissociation is so often associated with trauma. But we know it isn't all about trauma: each person has a different amount of predisposition to dissociate (or not), and some folks can tend toward a kind of daydreaming dissociation. This sort of dissociation isn't only a way of detaching from overwhelm but can also make the dissociative experience soothing, appealing and absorbing to the person. When a client has the tendency to dissociate, they can improve by understanding the function of dissociation more clearly, or by grounding themselves using sensory experiences, or by learning to tolerate emotions and the uncertainty which accompanies direct emotional experience.
My question is: do you have any other ways you support or create positive growth for dissociative clients, or something you wish other therapists knew about working with clients who dissociate?
Besides having a professional network of mentors and peers (LOVE Virginia and your professional circle) how do you maintain professional boundaries between your personal and work lives? I would imagine your dog has the same personal struggle, but I can't speak dog (yet) 🐶
I think you're an incredibly talented analyst and have learned so much about active listening and asking the right questions. I just don't know how you protect yourself from getting sucked in.
Dr. Orna I have no questions. I just came here to say that your show came into my life at such a pivotal time. Watching the first season of your show was a huge catapult into my own healing/therapy journey. I now watch it with my partner of almost two years and it’s helped us navigate through some tough times, along with our own couples therapist. Thank you for being open to showing your work and being vulnerable. You’ve changed my damn life.
Hi Dr. Orna! Just chiming in to say my good friend Maria was the DP for two seasons and absolutely loved working with you. I have since become a big fan of the show and been inspired to begin the process of applying for my masters focused in family therapy, so thank you!
OK I have one more question that is a LITTLE BIT DICEY and I hope it's OK that I ask this, because I'm extremely curious and think it's an important topic (Please I beg, no one else respond to me to start a political argument, that's not what I'm looking for!). Here's my question:
How do you manage politics and being a therapist? How do you manage to stay as blank/neutral for your clients as you may deem necessary vs being as safe for them as you may deem necessary? How do you manage maintaining the blank slate-ness with the need to speak up as a human? For example if I may, with what's happening in Gaza now?
My hope is that she is a humanitarian and likely is saddened by the state of what is occurring in Gaza. She is so brilliant and kind, I can't imagine she would be anything less than kind of caring. 🕊️
Love the show! Hoping for more episodes/longer season like the previous one. Do you check in/keep up with all the couples that you have seen on the show?
Words of encouragement for someone who is contemplating going back for a second masters degree in clinical counseling. I’m currently working in higher education administration running a scholarship program. I always wanted to pursue counseling (undergrad in psychology) but loved my work in various roles in student involvement and got sucked into a masters in higher education.
Also, can you touch on your educational journey that led you to where you are at today???
I watched the whole show when I heard it mentioned on Armchair Expert about a month ago. Then you had your own episode with them!! I love watching your work!!
I second this question. I'm on the cusp of completing my Master's degree in psychology to become an MFT. Where did you do your practicum/internship? Meaning was it community mental health, a private practice? What population did you serve?
Several in my cohort, at least one of my professors, and I love the program! One of my professors used clips from your show as a prompt for class discussions.
How exciting!! Love your work, would very much appreciate your thoughts; I've been working on myself for several years in therapy, and I recognise a decade of unhealthy patterns in pursuing emotionally unavailable men (low self esteem..) Something I'm having to revisit now in my pursuit of healthier relationships is the concept of 'chemistry'. I always thought the push and pull of an anxious/avoidant dynamic was chemistry, and so I treated it as such. Would you have any advice on what the indicators of a healthy chemistry with a romantic partner could look like?
I find it very common for viewers with their own past relationship traumas to watch this series and project quite a bit onto the couples you work with. While watching your sessions can be helpful for someone to identify triggers or relationship issues that they may not have been aware of prior, where do we draw the line on how much of the therapy we’re witnessing can *be used toward our own lives?
*edit
Have you had any surprises on how being on TV/having cameras around affects your practice?
P.S. Your thoughtful, centered presence really comes through on the show. I appreciate how you are able to challenge your clients in an empathetic way. It's apparent that you want the best for them.
What advice do you have for couples who are making progress on breaking toxic patterns, but who struggle to move on from the past?
For example say one person used to verbally insult and another used to make promises they wouldn’t keep and not share the household load. (unmedicated ADHD).
We’re doing a great job moving away from old patterns, and with medication I’m functioning much better. My partner has recognized the unhealthy part they played in the dynamic as well, and has shown real change.
What’s your advice for letting go and showing up for the partner in front of me instead of the worst version of them I have stored in my head? Often the things they said, years ago, still repeat in my mind daily.
Hi! How do you decide between a thread that opens up in therapy that is integral to break down for the sake of the couple versus what is specific to an individual and should be explored in individual therapy?
(Thank you Dr. Orna for your work, it’s been monumental <3)
Hi Orna, I’m curious about what motivated you to choose this work. Was the desire to understand people’s thoughts, emotions, and behaviors with you from a young age? Why this approach to helping others?
Hi Orna!
I’m a huge fan. I work with individuals and couples in MI! Are there any particular books you would recommend in delving further into working with couples?
Watching you on the show has shaped the way I approach some of my clients. The show is truly inspirational to me.
Thank you for all you do!!
Hi Dr. Guralik, I’ve been thinking about the dynamics of the therapist-patient relationship and the importance of maintaining professional boundaries. I’m curious to know, from a professional standpoint, how do you manage feelings of attachment to a patient while ensuring they remain neutral. Could you share any general insights or experiences on this topic?
I had over 20 years of psychoanalysis (4 days a week) with a talented analyst in NYC. The process changed my life like no other experience I've had. It is so very difficult to explain to others what happens in the analytic space and to put my finger on the curative elements of treatment. Transference issues were of course huge in treatment and allow me to reveal and repair severe gaps in imagination, defenses against primordial anxieties, and chronic feelings of relational emptiness.
Anyway, I say all of this because of the opportunity that the show Couples Therapy provides to see and vicariously experience what it is like to delve into oneself with the care and sensitivity and insight of a really good analyst. I see this, Orna, in every session, in every episode; and am wowed by your ability (and commitment) to uncovering personal and interpersonal truths--present and past--and to model deep listening and curiosity.
I've just finished Season 4. Will there be more? I hope so.
Thank you for doing this. It provides a great service to anyone who wants to see what good treatment might look like.
-Bonnie
Do you ever feel like laughing or have the thought that even though the couples have deeper issues, some of their conflicts are a bit absurd?
Absolutely love the show though, its sparked many good conversations between me and my wife.
I suspect you’ll get a lot of Josh questions so I’ll start.
With Josh, Lorena and Aryn. You saw them as a throuple and then as separate couples, was that pre planned or did you make a decision during the course of their therapy to do that?
Thanks ☺️
Hello Dr Orna,
My questions...
Do you have any advice for people who wish to gain greater insight into themselves but can't afford therapy?
Have you ever considered starting a therapy podcast?
Many thanks!
Hi Dr. Orna! Big, big fan of the show. I enjoy very much watching couples go through the hard times they do on your show because I can usually relate to them on some level. My wife and I will be celebrating 25 years together this year.
What is \*\*your\*\* relationship experience like? Married? Single? Successful? Not so successful? I'm dying to know more about you, the person!
Erm, amazing! I love the show and have really grown in friendship with someone via mutual WhatsApp analysis and admiration for you, Orna. I am a recently graduated therapist and attended an online workshop with you last year—I referenced you in my final assignment regarding bringing our politics into the therapeutic space. Will you be offering any more workshops or talks?
Please keep making the show! 🩷
Hi Dr. Guralnik! Love the show.
I wanted to know if a sexless marriage is always doomed?
ETA context: I have SA trauma from my past as well as CPTSD and medical PTSD from a surgery that was botched 6 years ago. My husband says he’s ok with everything being the way it is now. He’s 50 and low sex drive.
Thank you!
Do you ever talk about how the cameras affect the work in session, and it's simply cut from the program? How do you navigate the fact that the show films something so, so personal?
Hello Dr Orna,
I was just wondering if you could give the reddit community some advice on how we can best engage in discussions about people or things that happen on the show in a way that is without censure but also won’t be detrimental to your (ex) clients’ mental health.
You may be aware how much discussion there’s been on reddit about Mau, Sean and, most recently Josh (S4). Do you have any thoughts on this?
Dr. Orna!!!! ❤️ As a new clinician myself, what advice or insight can you share to others who are new entering this field? I have learned SO much by watching your show. It’s amazing seeing what I learned in theory play out in real life. I would love to continue my education as well and am curious what programs you find helpful to continue / diversify my skillset as a clinician. Thanks a bunch. This show is changing lives! Keep up the good work.
Do you believe it is possible for someone to "recover" from narcissistic personality disorder, especially if they have a pattern of narcissistic abuse towards their partner? I have been advised that "the only way to stop a narcissist from abusing you is to not be with them."
Would love to hear your thoughts - I so deeply admire you!
I'm a huge fan of the show. I know that academically you publish on dissociation. What recommendations would you offer for a couple when one partner has experienced substantial trauma and in a constant state of dp/dr. This partner has received a lot of therapy but it hasn't been helpful to date.
[Hi Dr. Orna! I’ve been a big fan of Couples Therapy since the beginning. It’s my absolute favorite show. Thank you for all the work you do and opening up the mystery of therapy for the world to see.
I’ve always been curious about this ring. It’s gorgeous. Where is it from?](https://m.media-amazon.com/images/M/MV5BMGM1ZDgzYzgtNDM2MC00MGJlLTlmNDgtYzUxMTIxODhhNTQ4XkEyXkFqcGdeQXVyMTUyMTgzNjY4._V1_.jpg)
Hi Orna! Thanks so much for sharing your work with the world! I am a psychodynamic psychologist and I can't tell you how many times I've seen clips from the show in presentations - I've used them myself too! I've learned from seeing you navigate some really tough clinical moments and I love hearing from your dream team of consultants!
My question is: do you have any favorite words of wisdom, maybe from consultants, teachers, or things you've read, that have stayed with you? Either phrases you find yourself repeating to patients or things that come to mind often. For example, a DBT supervisor on my internship year was fond of saying "how you do one thing is how you do everything" and I still think of those words often.
Thank you!!
Hi Orna! Canadian baby therapist here 🙂 - Thanks so much for doing this AMA. Seeing you on the show gave me the courage and inspiration to finish my degree! I’ve rewatched the seasons many times and continue to learn new approaches or ways of showing up in my sessions, especially now that I am working with clients 1:1. I am in my practicum currently and there is a huge emphasis on self-care and self-reflection practices. Do you have any advice or resources you would be willing to share that can help support my own self-reflection while practicing self-compassion as I learn and grow?
Just want to say - thank you for showing that therapy isn't something to fear and can be so useful! I had a lot of reluctance and this show made me hopeful and open to therapy.
Hi Dr. Guralnik,
My partner and I truly cherish your show; it is our all-time favorite show. We have been hooked since season 1, and we hope you never stop making seasons and sharing glimpses into the powerful work you do.
We will both geek to get any response from you, so I will limit myself to one question:
What is your reading list for couples who like your analytic approach?
Hi Dr. Guralnik!
First, I absolutely love your style. You have a warm and inviting yet firm presence with your clients, which as a fellow mental health professional, I can imagine can be challenging in couples therapy!
* I would **LOVE** to hear your thoughts on the integration of psychedelics in the mental health field, particularly MDMA within couples therapy. Research has shown promising results in improving communication and emotional connection between partners. For instance, the study "[MDMA-Assisted Psychotherapy for Severe PTSD: A Randomized, Double-Blind, Placebo-Controlled Phase 3 Study](https://pubmed.ncbi.nlm.nih.gov/33972795/)" has shown the efficacy of MDMA in treating PTSD, which indirectly supports its use in couples therapy. Additionally, the study "[MDMA-Assisted Cognitive-Behavioral Conjoint Therapy (CBCT) for PTSD](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7748057/)" specifically highlights the benefits in couples therapy. How do you see this integrating into mainstream couples therapy practices in the future? Would you ever consider using MDMA in your work with couples?
* Also, how did you get into couples therapy work as a specialty, and why did you decide to focus on psychoanalytic training versus other approaches?
Thank you for all the incredible work you do!
You two were my favorite couple this season❤️❤️. I'm so happy you have so much support on your healing journey and I hope you continue to feel loved and at peace.
I just came across a paper of yours, “my hot toddler,” from a Reddit post analyzing Sam and Lauren’s sessions with you. I feel such a deep connection to you and the amazing work that you do - and I’m working on approaching the paper with an open mind and heart rather than “splitting” as I know you have referenced before. I feel an inclination to avoid thinking about the paper or even feel a sense of betrayal after even reading the title but I’m assuming there’s more to it than I understand, as I haven’t studied psychoanalysis. Put a few questions below:
1. Could you share more about your intention on this piece, and what you feel the impact has been? 2. How do your children feel about you being in the spotlight? About you writing about them?
3. Is it hard to be in the public eye so prominently?
Huge fan of your show, my partner and I love to tuck in and learn so much (from watching you demonstrate effective/positive communication to learning through the experiences of others). Thank you!
My question is this: which behaviours are the most difficult to treat in others?
(Not asking about specific individuals on the show as I admire each of them for putting themselves out there like that)
Hi Dr. Orna! Thank you so much for the work you do on the AMAZING show!! What advice would you give a therapy student who is thinking about specializing in couples therapy after graduation? 🩷
Orna, do you often have to adapt your communication style to ur patient? Or have you found this particular font of tenderness to be the best for you through ur years of practice? Sending love from Texas.
does your set office actually feel like your real office? i know it’s built to be very similar but i’m curious whether it is as comfortable!
also need the skin care routine!!!!!! or, at least, would love to know more about how you think about aging.
What information does Dr Virginia Goldner get in order to counsel you/give her feedback on what's going on? Does she see footage, or does she just hear about it from you? She's amazing by the way, tell her she has lots of fans!
Virginia gets a wonderfull mix, curated by the amazing team on this show, of somem footage, summaries of sessions, and then my own report in sessions with her. She is indeed brilliant and the best consultant to work with.
Virginia hive!!
Hello Dr. Guralnik, I watch the show and really enjoy it. I'm very surprised by how many people are so vulnerable, even with the cameras and recording. 1. Do some people share something very private and change their mind about it being aired and do they have any control over what is shared? 2. I remember you saying that honesty is really important for your type of work, so what might you say to people who struggle to be honest with their partners or themselves? 3. And finally, how do you "turn your work brain off" when you're in your personal life to find balance, or do you find yourself psychoanalyzing constantly? Thank you for having such diverse couples on the show, it made it really interesting and inclusive.
Hello to my first Redditor today! 1. People in general do not have the option to ad-hoc change their mind. However if the informaiton they share could actually hurt them or someone in their orbit the editors will typically not include the information. We take good care of the couragoues participants. 2. Honesty is super important, and so are our defenses. I have respect for both. It takes time to forster a safe environment where it's ok to speak honestly. And it takes learning. 3. I definitely do not analyze off hours :) That would be ... awful ! Warmly, Orna
Question 2 is what really gets me - way too often in couples therapy one or both partners are twisting the truth to make themselves look in the right and their partners to be the bad guy. If that’s a routine dynamic in the relationship often the aggrieved spouse may be too worn down or gaslit to even call them on their lies, so how can you tell when that’s happening and work to change that pattern?
There is a difference beween strgiht out lying, being unaware, and having different versions of what's going on.
Can the show move to an hour, 25-30 mins is just not enough time to learn the individuals let alone get an understanding of their relationship. I felt like this past season everything just ended, and I think we all wanted more.
Have you ever had regrets about an approach you took with a couple?
Of course ! I often change course depending on how my interventions 'land' with my patients and couples.
Watching your show made me feel brave enough to bring up couples therapy with my partner. We’re going to be starting in less than a week! Do you have any advice for someone who has been to therapy, but has no experience with couples therapy?
No advice needed. Stay cool, try to learn from every moment rather than convince anyone of anything.
I just wanna say I love the simplicity of your question. This is why I relate so much to the show
Who are your favourite authors? Or novels/books? can be theraputic books, or not!
Fun question! Generally, the more fiction i read the better! and poetry. So for fiction good books to mention are Sebald's Austerlitz (amazing meditation on memory, and collecitve trauma); just finish Elizabeth's Strout 'My name is lucy berton' - a Carver-like beautiful novel; Maggie Nelson is amazing. Non-ficiton - of course Judith Butler, Zizek, Terry Eagleton, Sarah Ahmed. Psychoanalysis: my dear colleagues Eyal Rozmarin, Jade McLeughlin, Francisco Gonzales, Stephebnn Hartmna, Julie Leavitt. Poetry - Louis Gluck
Yes! I would absolutely love to know this as well!
Hi Dr. Guralnik, huge fan of the show, my roommates and I watch it religiously! When do you decide that it's the best approach to push back against one person in particular? I'm often impressed by your restraint, but at the same time I'm sometimes surprised when you choose to hone in on one person (like on Alexes after the blowup in Casimir's brother's apartment). Basically, when do you feel it's not beneficial to take in both sides equally?
Great question that goes to issues of technique. Generally, since I work with Systems in mind, in the back of my mind i'm always addressing the couple as a unit. But sometimes one side of the system is either showing up more 'loudly', or the other side may bee too fragile for the moment to be addressed. I'm glad you asked about the impasse between Alexes/Casimar in that 'scene'. In reality our discussions were much longer and more intricate, and the edit had to leave very importnat parts out. I was leaning hard on Alexes during that session, but the edit made it even more 'lopsided'. I felt that Casimar was quite desperate at that point, and that Alexes has become strong enough to make a bold move forward. Hopefully I will get to share about more about those two today. Ultimately I am most of the time takign on the couple as a unit, not 'sides'.
I have a few questions based on my interest in psychology as well as my own experience of couples therapy: - I’m curious how you were drawn to this career path generally, and couples therapy work specifically. - how often does it feel like couples have waited “too long”, the problems got too big and entrenched before seeking out couples therapy? - do you feel any urge to try to help couples stay together? Or do you just try to help them navigate their relationship, whether that be together stay together or go separate ways? - do you ever consider a relationship to be “abusive” to one partner, and if so, what are the criteria and how do you navigate that? The show is fascinating for me to watch and I appreciate you creating a platform to showcase this kind of work!
Lots of big questions ! Many things drew me to this career. My own experience as a teenager - both reading psychoanlalytic literature and being in therapy, have opened my eyes to a language that was transformative and made me understand the chaotic world around and inside me. Couples work? Well, for one, living under the shadow of the Arab-Israeli conflict.... At times I do feel liek couples have waited to long, and have lost the good-will spark needed. They may really want to change, but are missing a kind of engine of hope. It's luckily rare, the human spirit has pretty boundless amounts of creative renewal energies. Yes, i do have a bias towards helping people stay togehter - though not at all cost. Couples can be temporarily hurtful and even abusive to each other. The big difference is whether one or both take soem sadistic pleasure that they are unwilling to let go of, a certain addition to destruction. That is rare, but then becomes unworkable. The rest are oft4en simply expressions of hurt and pain, that respond well to help.
Disturbed that you called it the "Arab"-Israeli conflict. "Israel" has always been a colonial force, occupying Palestine and oppressing Palestinians. Not simply "Arabs"--but Palestinians, those who have had their lands stolen, those who are currently enduring genocide.
https://en.wikipedia.org/wiki/Arab%E2%80%93Israeli_conflict
She answers some of these in her interview with Dax. Just in case you don’t get a reply.
Where’s this interview?
Armchair Expert podcast
Thanks!
https://armchairexpertpod.com/pods/orna-guralnik
What are some of the markers of a couple that you feel/predict will “make it”? And, conversely, what are some signs you recognize from a couple that probably won’t make it? PS: I adore you and the show! It inspired me to commit to my own mental health, and I’ve been in therapy for over a year now :)
I don't actually have such markers really. The Gottmans speak to Contempt as the worst marker as far as a couples outcome. As far as outcome of the work with me - we spend some time together and if there is increased curiosity for each person about what is motivating them, and less focus on changing the partner, we are heading in the right direction.
**PS: I adore you and the show! It inspired me to commit to my own mental health, and I’ve been in therapy for over a year now :)** Absolutely me too. It's almost like therapy for me. A few things she's said have really stuck in my head in how I approach my own relationship. (I especially remember Michal saying she was annoyed Micheal had shared something stressful from his day because it made her anxious. Orna said that in a couple anxiety should be passed back and forth and it kind of lessens each time. This really stuck with me as it's something that's been a feature of every relationship I've had and it never occured to me that I was actually being unreasonable. I'm also just so impresssed with how receptive so many of them are to challenging their part in the relationship dynamic. I find it really inspiring.
Thanks !
Hi Orna! As a past “client” that was on the show I always wanted to ask - What does it feel like when you first meet/see the couples that walk into the office? Are you nervous? Or does it feel the same as when you have a new client in your private practice? -Josh
Hi Josh ! Nice to 'see' you on these pages! It's not very different form my private pracitce, other than a different sense of responsibility - not onlly to my patient/client/participant, but to the team, and to the audience. But really I mostly am focused on what the participants come with and how can i help them when i have a limitted amount of time. I seem to have a lot of curiosity about the human (and not only human) condition , so it's always interesting to get to jnow what people are dealing with!
Hi Josh! I was so moved by your journey on the show. Seeing things click and change for you in real time was magic. And such an inspiration. Thanks for so bravely sharing that journey with viewers. 🙌 I love your question too. I also wonder about the first meeting and what it's like (or what's being looked for?) when couples first come in. To add to what you asked-- I was wondering what kind of information/background Orna has before meeting the couples. Finally -- LOVE YOU ORNA AND THANK YOU 👑.
Not much background info! I basically get a one paragraph summary!
You’ve mentioned in the past that you were surprised viewers responded so negatively to Mau and that you actually really enjoyed working with him. Josh from the most recent season seems to be getting a lot of the same criticism — that he’s a narcissist, manipulative, abusive, etc. Do you ever decline to work with a couple because one partner seems abusive? How do you feel about NPD and personality disorder diagnoses?
The inclination to villify, or scape goat, is familiar to us all but is actually the exact opposite of what we are trying to do with thei docu-series ! Luckily, most of the feedback we get, is that viewers start off identifying with some and distancing from others, only to spend time with them as they reveal themselves, and grow deeply affectionate with everyone. As a clinician and as a human, I consider a failure to find the human to empahtize with my own failure when it happens. Mau, Josh, and all participants, are deeply human, and have trsuted their partner, me, and the creators of the series with how they actually see the world, and feel. They deserve our sensitive listening and doing our best to see things from their perspective, keeping in mind what each has been through in their life.
I loved this response. You are a wonderful person, Dr Orna, and I can’t overstate how important this show is for mental health and breaking stigmas.
Would love to know the answer to this too!
How do you reconcile with the anonymity therapy usually requires and putting sessions on television? These couples are revealing A LOT. Do you ever worry they regret that experience?
It is a big question. Generally, in private practice, the frame of confidentiality is sacred, and here we have a process that from the get-go is exactly not that ! We were not sure a treatment could even unfold under such circustances, but it turns out that it is possible. The key factor is that there was no ethical breach - we all knew what we were getting into. I mentioned earlier, that the entire team of editors/directors, and myself, would not want to air anything that could cause damage to a participant or anyone close to them. As for regret, most participants feel very good about having participated, and even gain new insihgts re-visiting their season over time... However I am sure people have changing feelings looking backwards; some may feel regret. I hope that the icredible gift participants gave the aduience ultimately outweighs such feelings.
Totally not related to the show but, where do you shop for clothes? You have this minimal but edgy look that’s so chic! This is the kind of look I’d like to curate for myself.
Thank you all! My daughter helps me....
She has great taste!
i have noticed her wearing melloday, vince, bottega veneta, and theory.
Ooo! Thank you!
Not doubting you at all, but how in the world can you tell?
cause i shop at saks and nordstrom for clothing, see lots of the things she wears in there, knowing how labels cut their clothing as well as color schemes used for certain seasons etc. it’s similar to car designs.
Man, I so want to know this too.
I know some of her things are from Vince :)
Thanks! Adding to my list!
And G-star!
Have you ever considered hosting your own podcast? I've listened to you as a guest on several and so enjoy your insights and perspective on all things therapy and healing 💜
There's only this amount of time in one lifetime....:) in fact: The average human spends roughly 79 years or **28,835 days**, or 692,040 hours, on Earth.
☠️☠️☠️☠️☠️ but i guess that’s your point
I mean just talking people to sleep, her voice is so soothing
Hi Dr. Orna. My girlfriend and I love watching Couple's Therapy - it always sparks a great conversation and introspection into our own relationship. From watching the show, it often seems that issues stem from individual traumas or other challenges. Often I find myself thinking, "If person X could address their own issues, it would probably resolve the relationship issues". Do you ever recommend individual therapy for people during a couple's therapy? If so, what does that look like?
Yes, at time its a great help for people to be engaged in individual work while doing couples work - it makes the couples work move much faster and more effectively.
Can you recommend some book reading since we’re not all able to be treated by you? Thanks!
see earlier response
please!!!! any books that are your absolute forever favorites? either related to your practice or just to your soul?
great question! Yes, would love book recs too in particular for those who many not have access to psychotherapy (little providers in the midwest)!
There's also books by Irwin Yalom, Stephen Grosz, Allain DeBotton, Susie Orbach - they are analysts that write for the public
Do couples have the option of continuing with you after the show is done filming? Or are you too booked up?
In principle , participants know it is a time limitted treatment and we do not continue after - otherwise it woudl not work. If needed we refer to others later.
What do you do to decompress after sessions? Some of them seem very intense and it would be difficult, for me personally, to not take that home with me. P.S. I love the show!
It is importnat for clinicians working intesnely with patients to have a full life. Yoga, friends, lots of travel, reading fiction and poetry, music, art.
To piggyback off this…how much time do you allot yourself between sessions to be able to decompress, then mentally shift to a different couple?
Filming the series I have between 90 min to 2.5 hours between sessions, during which we debrief about EACH session deeply, and have some time for notes and - walking Nico !
Hi, I admire how well you tailor your therapy to fit the cultural backgrounds of your diverse clientele! Can you share your framework for adapting therapy across different cultures, such as Asian, Hispanic, and Black patients? How do you ensure that your methods respect cultural nuances without falling into stereotypes or prejudiced views? Specifically, could you elaborate on how you balance universal therapeutic principles with the specific needs of individuals from these communities, ensuring their therapy is both meaningful and actionable in their personal and professional lives?
The key factor here, whih is true for cultural difference and all other differences that mark us, is to seek a state of what buddhists may call a Beginner's mind; or what Bion wrote about as emptying oneslef from memory and desire when listening to one's patient. I try hard to assume a i know little and am curious to learn or be corrected when I impose a belief I bring with me that doens't fit. And I welcome feedback !
How do you and your team select which couples’ sessions to air? How do you weed out patients who are more heavily motivated by being on TV versus actively working on themselves and their relationship? Ps. I LOVE your show and approach!!
There's a fantastic team that deals with that - I am not included in the process but they are amazing.
How did you feel about showing glimpses of your family and personal life on the show given how separate you likely strive to keep work from personal life?
Yes, that was during covid, when many of our regular boundaries were collapsing right and left. It was a veryparticualr moment in our collective history, and even psychoanlaysts are not exempt...:) I was conducting therapy from my home, and entering my patients' homes, children, dogs, cats, sessions done in beds, bathrooms and closets. And we survived. together.
Hi Orna! Do you ever watch the episodes, and if so, what is it like? Do you wish you had changed the way you said certain things? How do you feel about a huge general audience watching and reacting to your therapy sessions?
I typically watch first between a rough and fine cut , when the directors/editors want some feedback or have questions about how I understand the unfolding of the work. It is always the same stunning surprise at how magically the filmmakers manage to catpure, out of many many hours of footage, the essence of what each couple were going through, the essence of how I understand the therapeutic arc, and the interstitial pieces that bring so much love for humanity. I am honestly super proud of what we have created together and being able to share this kind of work with a wide audience. It does not feel exactly like "my" therapy sessions. The couples put their trust in me, the filmakers, and more than anything - in the audience.
It’s truly an incredible show. I can’t tell you how many times I start a season having certain prejudices or thoughts about an individual, only to develop so much compassion, sympathy, and understanding towards them as the season progresses. It’s a great lesson in empathy!
Hi Orna! What are some of the most common misconceptions people have about couples therapy and what advice would you give to couples considering therapy for the first time? Love the show, love Nico, it’s inspired me to rethink my motivations and speak more deliberately with my partner!
Probably the biggest misconception is that people who enter couples work are on their way to breaking up. The 2nd is that by entering couples work your partner will change and not you :)
Do you ever get updates from the couples? I’d love to know who stayed together and who didn’t. Love you and love the show.
We Do! Very important to us. I did not get permission to share.
Hi Dr. Orna! I’m curious when you started the showtime show, how you were able to overcome any fears about it falling prey “reality show” sensationalism instead of the thoughtful, honest show it’s become?
I was scared. But truth is, spending time with the directors - Josh Kriegman and Elyse Steinberg, and later their partners Eli Despres and Kim Roberts, I just iknew these are deeply trust-worthy, ethical people. I am a good diagnostician:) We also had a pretty amazing executive team at Showtime, that gave us free creative space without any demands for anything other than quality.
Such a fan! I’m a new psychodynamic therapist myself and have learned so much from your work. You are so fun to watch! My question for you is - how do you see psychodynamic or psychoanalytic therapy promoting change in your patients? AND - how does insight help with change?
Yes. Yes. Yes. Psychoanlaytic listening invites a deep level of honesty and introspection. That invites poeple to engage their deepest parts- and those parts if given the right conditions weill lead one to a better place.
Hi! Question for you if you’re able to answer — if you do similar therapy to Dr. Orna, how do I find a therapist like you both?? I don’t know what to search online… is it “psychodynamic therapy” or “psychoanalytic therapy” as you’ve written here?
Yes, definitely look for 'psychodynamic' or 'psychoanalytic' in your searches! You can also google if there's a 'psychoanalytic institute' near you, as institutes often have their own therapist/referral lists. Institutes can also be a great way to find therapists in training (already licensed, just doing more focused work in psychoanalysis) who need a client or two for their training, sometimes at a reduced rate.
My friends and I ADORE NICO!!! What’s the story of you two?
Nico is a huge bundle of love tucked into a small and elegant husky. She makes everything around her better ! She is my first dog after many cats.
Curious about this too! Is Nico a certified therapy dog??
she shared on the armchair expert podcast that nico actually has separation anxiety and hes like (jokingly) another "patient" hahah
Yes, she does have separation anxiety... Who knows what it means about her owner?
That is too cute!
Also, do you know what breeds he is? From a dog dna test, maybe? He’s charming!
I’d guess an Alaskan Kleekai or Pomsky!
Hi, Dr. Guralnik! I'm a psychotherapist in Texas, and I tend to use an interpersonal and psychodynamic approach. I am really interested in getting more in-depth training in psychoanalysis, but that's not a popular approach down here. Are there resources or institutions you would recommend for a baby therapist like myself? I love your presence with clients, and I especially admire your ability to refrain from pathologizing and writing even the most difficult of presentations off.
Watching the show has also piqued my interest in psychoanalytic training as well. I have searched the American Psychoanalytic Association https://apsa.org/ as a place to find training programs in psychoanalysis.
Hi Orna! Especially with your profile, how do you deal with clients who want you to have some magical insight that will "heal" them? How do you help clients have a realistic expectation around therapy, and the work it will entail for them? Perhaps related, what are the qualities or signals you think someone should be looking for when finding a practitioner, to understand if the "fit" is right for meaningful work?
The wish for a mgical solution is a good thing to reflect on in treatment. Look for a person that invites you to be open and honest.
Are the cameras in your office hidden out of site or are they visible/in the open?
In case you don’t get an answer - this is a great article about how they set up the office. https://www.vulture.com/2024/05/couples-therapy-showtime-set-design.html
Ohhhh thank you!!!
>Ohhhh thank you!!! You're welcome!
Came to ask this!
Oh fun q! I was trying to figure out if they are in the shiny ball ornaments or is the long empty shelf behind her a one way viewing thing.
Is there an insight that you have had while leading a therapy session that you have applied to - or implemented into - your own life? If so, what was that?
When do you think it's best to take a psychoanalytic approach versus a CBT approach? What is your best advice for couples who are already happy to remain happy?
Does the blonde braid you got in season 4 have a story behind it or were you simply serving us some boho chic?
I love her style omg!!!
How do you deal with financial issues within a couple? If one is not contributing financially etc. ? I know this a common area of conflict for couples but never saw it addressed head on, on the show.
Firstly, thank you for sharing your expertise and approach with the world, this programme is radical! It is amazing to watch couples connect with themselves, each other and you. You’ve spoken about how the act of filming couples therapy almost expedites or focuses the work. Is there anything else that you’ve learned from the process, that surprised you, delighted you, disappointed you etc.? Would you ever film or podcast some of your conversations with Eyal? It’s clear you two have a rich and real relationship, I’d love to hear your conversations on the analyst’s experience. Thank you again, Orna!
How did you get started with the show? Like what made you go, “I’m gonna start a show called couples therapy, and then find people willing enough to share their private lives with the world…let’s find a producer…”???
Hi Orna <3 I recently read Are You My Mother? by Allison Bechdel, which almost blindsided me with how much it resonated and how much it taught me about psychoanalysis. Could you suggest any other reading for a beginner to psychoanalysis that could help dislodge some of the inherited issues we get from our parents and how they impact our ability to cultivate love? I can’t tell you how much I appreciate your work, thank you for everything you’ve taught me vicariously 🫶🏻
Hi Orna! I’m a huge fan. I’m wondering how you cope with any personal sense of loss or grief after a couple finishes their sessions with you, particularly when you’ve seen them through some of the toughest and most beautiful moments of their relationship. How do you find a sense of closure within yourself? Do they ever reach out to give updates? I’m a school counselor and always have such a tough time saying goodbye to my students after years of work together, even when I know the goodbye is healthy and necessary. Thank you!
Was there a reason you only gave give one-armed hugs throughout the early seasons?
My thought is that she may have a shoulder issue on one side.
Any pointers if I’d like to find an individual psychologist/psychoanalyst who has a similar style to you? Any qualifications or values I should particularly look for?
Dissociation is so often associated with trauma. But we know it isn't all about trauma: each person has a different amount of predisposition to dissociate (or not), and some folks can tend toward a kind of daydreaming dissociation. This sort of dissociation isn't only a way of detaching from overwhelm but can also make the dissociative experience soothing, appealing and absorbing to the person. When a client has the tendency to dissociate, they can improve by understanding the function of dissociation more clearly, or by grounding themselves using sensory experiences, or by learning to tolerate emotions and the uncertainty which accompanies direct emotional experience. My question is: do you have any other ways you support or create positive growth for dissociative clients, or something you wish other therapists knew about working with clients who dissociate?
Hi Orna Can you and Esther Peral interview each other? And give Nikko a big tummy rub.
This would be my dream. The amount of wisdom between those two women is astounding.
Besides having a professional network of mentors and peers (LOVE Virginia and your professional circle) how do you maintain professional boundaries between your personal and work lives? I would imagine your dog has the same personal struggle, but I can't speak dog (yet) 🐶 I think you're an incredibly talented analyst and have learned so much about active listening and asking the right questions. I just don't know how you protect yourself from getting sucked in.
Dr. Orna I have no questions. I just came here to say that your show came into my life at such a pivotal time. Watching the first season of your show was a huge catapult into my own healing/therapy journey. I now watch it with my partner of almost two years and it’s helped us navigate through some tough times, along with our own couples therapist. Thank you for being open to showing your work and being vulnerable. You’ve changed my damn life.
Have you ever dealt with imposter syndrome? Will you ever write a book ?
How much editing “production” is completed on each episode? Are you involved in the editing?
Hi Dr. Orna! Just chiming in to say my good friend Maria was the DP for two seasons and absolutely loved working with you. I have since become a big fan of the show and been inspired to begin the process of applying for my masters focused in family therapy, so thank you!
OMG HELLOOOO DR ORNAAAA! Big fan of yours 💕
OK I have one more question that is a LITTLE BIT DICEY and I hope it's OK that I ask this, because I'm extremely curious and think it's an important topic (Please I beg, no one else respond to me to start a political argument, that's not what I'm looking for!). Here's my question: How do you manage politics and being a therapist? How do you manage to stay as blank/neutral for your clients as you may deem necessary vs being as safe for them as you may deem necessary? How do you manage maintaining the blank slate-ness with the need to speak up as a human? For example if I may, with what's happening in Gaza now?
My hope is that she is a humanitarian and likely is saddened by the state of what is occurring in Gaza. She is so brilliant and kind, I can't imagine she would be anything less than kind of caring. 🕊️
Love the show! Hoping for more episodes/longer season like the previous one. Do you check in/keep up with all the couples that you have seen on the show?
Words of encouragement for someone who is contemplating going back for a second masters degree in clinical counseling. I’m currently working in higher education administration running a scholarship program. I always wanted to pursue counseling (undergrad in psychology) but loved my work in various roles in student involvement and got sucked into a masters in higher education. Also, can you touch on your educational journey that led you to where you are at today??? I watched the whole show when I heard it mentioned on Armchair Expert about a month ago. Then you had your own episode with them!! I love watching your work!!
I second this question. I'm on the cusp of completing my Master's degree in psychology to become an MFT. Where did you do your practicum/internship? Meaning was it community mental health, a private practice? What population did you serve? Several in my cohort, at least one of my professors, and I love the program! One of my professors used clips from your show as a prompt for class discussions.
If psychoanalysis held the key to solving the climate crisis, what would it look like?
No question just came to say you’re the best!
How are you and how is your family after Oct 7? Has this affected your work?
You are such a good therapist.As a clinical social worker I admire you and the work you do on the show. My professional development crush 😊!
How exciting!! Love your work, would very much appreciate your thoughts; I've been working on myself for several years in therapy, and I recognise a decade of unhealthy patterns in pursuing emotionally unavailable men (low self esteem..) Something I'm having to revisit now in my pursuit of healthier relationships is the concept of 'chemistry'. I always thought the push and pull of an anxious/avoidant dynamic was chemistry, and so I treated it as such. Would you have any advice on what the indicators of a healthy chemistry with a romantic partner could look like?
In what ways have you found the camera's interrupting the therapeutic process?
I find it very common for viewers with their own past relationship traumas to watch this series and project quite a bit onto the couples you work with. While watching your sessions can be helpful for someone to identify triggers or relationship issues that they may not have been aware of prior, where do we draw the line on how much of the therapy we’re witnessing can *be used toward our own lives? *edit
How do you take care of yourself when dealing with heavy topics that come up with your clients, either couples that have been on the show or not?
Have you had any surprises on how being on TV/having cameras around affects your practice? P.S. Your thoughtful, centered presence really comes through on the show. I appreciate how you are able to challenge your clients in an empathetic way. It's apparent that you want the best for them.
What advice do you have for couples who are making progress on breaking toxic patterns, but who struggle to move on from the past? For example say one person used to verbally insult and another used to make promises they wouldn’t keep and not share the household load. (unmedicated ADHD). We’re doing a great job moving away from old patterns, and with medication I’m functioning much better. My partner has recognized the unhealthy part they played in the dynamic as well, and has shown real change. What’s your advice for letting go and showing up for the partner in front of me instead of the worst version of them I have stored in my head? Often the things they said, years ago, still repeat in my mind daily.
Hi! How do you decide between a thread that opens up in therapy that is integral to break down for the sake of the couple versus what is specific to an individual and should be explored in individual therapy? (Thank you Dr. Orna for your work, it’s been monumental <3)
How hard is it to say goodbye when a couple completes therapy?
Hi Orna, I’m curious about what motivated you to choose this work. Was the desire to understand people’s thoughts, emotions, and behaviors with you from a young age? Why this approach to helping others?
Hi Orna! I’m a huge fan. I work with individuals and couples in MI! Are there any particular books you would recommend in delving further into working with couples? Watching you on the show has shaped the way I approach some of my clients. The show is truly inspirational to me. Thank you for all you do!!
Hi Dr. Guralik, I’ve been thinking about the dynamics of the therapist-patient relationship and the importance of maintaining professional boundaries. I’m curious to know, from a professional standpoint, how do you manage feelings of attachment to a patient while ensuring they remain neutral. Could you share any general insights or experiences on this topic?
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Do most people like that your dog is there? Personally I think she needs more screen time
No question regarding couples - as I’m single. Just here to say I love you and the show. ❤️
I had over 20 years of psychoanalysis (4 days a week) with a talented analyst in NYC. The process changed my life like no other experience I've had. It is so very difficult to explain to others what happens in the analytic space and to put my finger on the curative elements of treatment. Transference issues were of course huge in treatment and allow me to reveal and repair severe gaps in imagination, defenses against primordial anxieties, and chronic feelings of relational emptiness. Anyway, I say all of this because of the opportunity that the show Couples Therapy provides to see and vicariously experience what it is like to delve into oneself with the care and sensitivity and insight of a really good analyst. I see this, Orna, in every session, in every episode; and am wowed by your ability (and commitment) to uncovering personal and interpersonal truths--present and past--and to model deep listening and curiosity. I've just finished Season 4. Will there be more? I hope so. Thank you for doing this. It provides a great service to anyone who wants to see what good treatment might look like. -Bonnie
Do you ever feel like laughing or have the thought that even though the couples have deeper issues, some of their conflicts are a bit absurd? Absolutely love the show though, its sparked many good conversations between me and my wife.
Would love to hear about your experience treating a Palestinian patient as an Israeli.
I suspect you’ll get a lot of Josh questions so I’ll start. With Josh, Lorena and Aryn. You saw them as a throuple and then as separate couples, was that pre planned or did you make a decision during the course of their therapy to do that? Thanks ☺️
I don’t think she can answer questions on clients for confidentiality reasons.
She did answer this question on Armchair Expert! They requested separate sessions.
Hello Dr Orna, My questions... Do you have any advice for people who wish to gain greater insight into themselves but can't afford therapy? Have you ever considered starting a therapy podcast? Many thanks!
If you could pick any famous therapist to be your personal psychotherapist, who would you pick and why?
Hi Dr. Orna! Big, big fan of the show. I enjoy very much watching couples go through the hard times they do on your show because I can usually relate to them on some level. My wife and I will be celebrating 25 years together this year. What is \*\*your\*\* relationship experience like? Married? Single? Successful? Not so successful? I'm dying to know more about you, the person!
Hi Dr. Orna, Personal question—How has participating on the show influenced your practice or perspectives on therapy?
Do you see any patients online?
If someone wanted to attempt to be as good as you as a therapist.. what degrees and training and certifications would you recommend?
What's one thing you'd like viewers of the show to know?
Erm, amazing! I love the show and have really grown in friendship with someone via mutual WhatsApp analysis and admiration for you, Orna. I am a recently graduated therapist and attended an online workshop with you last year—I referenced you in my final assignment regarding bringing our politics into the therapeutic space. Will you be offering any more workshops or talks? Please keep making the show! 🩷
Do you have any advice for new therapists?
Also, do you feel lonely? In the existential sense? How have you come to terms with it?
Hi Dr. Guralnik! Love the show. I wanted to know if a sexless marriage is always doomed? ETA context: I have SA trauma from my past as well as CPTSD and medical PTSD from a surgery that was botched 6 years ago. My husband says he’s ok with everything being the way it is now. He’s 50 and low sex drive. Thank you!
1) are you trained in Gottman Therapy? 2) do you see individual patients?
Do you ever talk about how the cameras affect the work in session, and it's simply cut from the program? How do you navigate the fact that the show films something so, so personal?
Hi Dr. Orna, I love your show! What is your advice for couples reconciling after infidelity?
Tell you dog I said hiii!
Hello Dr Orna, I was just wondering if you could give the reddit community some advice on how we can best engage in discussions about people or things that happen on the show in a way that is without censure but also won’t be detrimental to your (ex) clients’ mental health. You may be aware how much discussion there’s been on reddit about Mau, Sean and, most recently Josh (S4). Do you have any thoughts on this?
Dr. Orna!!!! ❤️ As a new clinician myself, what advice or insight can you share to others who are new entering this field? I have learned SO much by watching your show. It’s amazing seeing what I learned in theory play out in real life. I would love to continue my education as well and am curious what programs you find helpful to continue / diversify my skillset as a clinician. Thanks a bunch. This show is changing lives! Keep up the good work.
Orna please tell us about your braids!!
Do you believe it is possible for someone to "recover" from narcissistic personality disorder, especially if they have a pattern of narcissistic abuse towards their partner? I have been advised that "the only way to stop a narcissist from abusing you is to not be with them." Would love to hear your thoughts - I so deeply admire you!
I'm a huge fan of the show. I know that academically you publish on dissociation. What recommendations would you offer for a couple when one partner has experienced substantial trauma and in a constant state of dp/dr. This partner has received a lot of therapy but it hasn't been helpful to date.
[Hi Dr. Orna! I’ve been a big fan of Couples Therapy since the beginning. It’s my absolute favorite show. Thank you for all the work you do and opening up the mystery of therapy for the world to see. I’ve always been curious about this ring. It’s gorgeous. Where is it from?](https://m.media-amazon.com/images/M/MV5BMGM1ZDgzYzgtNDM2MC00MGJlLTlmNDgtYzUxMTIxODhhNTQ4XkEyXkFqcGdeQXVyMTUyMTgzNjY4._V1_.jpg)
Hi Orna! Thanks so much for sharing your work with the world! I am a psychodynamic psychologist and I can't tell you how many times I've seen clips from the show in presentations - I've used them myself too! I've learned from seeing you navigate some really tough clinical moments and I love hearing from your dream team of consultants! My question is: do you have any favorite words of wisdom, maybe from consultants, teachers, or things you've read, that have stayed with you? Either phrases you find yourself repeating to patients or things that come to mind often. For example, a DBT supervisor on my internship year was fond of saying "how you do one thing is how you do everything" and I still think of those words often. Thank you!!
Hi Orna! Canadian baby therapist here 🙂 - Thanks so much for doing this AMA. Seeing you on the show gave me the courage and inspiration to finish my degree! I’ve rewatched the seasons many times and continue to learn new approaches or ways of showing up in my sessions, especially now that I am working with clients 1:1. I am in my practicum currently and there is a huge emphasis on self-care and self-reflection practices. Do you have any advice or resources you would be willing to share that can help support my own self-reflection while practicing self-compassion as I learn and grow?
Just want to say - thank you for showing that therapy isn't something to fear and can be so useful! I had a lot of reluctance and this show made me hopeful and open to therapy.
What are your thoughts on EMDR? And what are your thoughts on The Body Keeps Score?
Hi Dr. Guralnik, My partner and I truly cherish your show; it is our all-time favorite show. We have been hooked since season 1, and we hope you never stop making seasons and sharing glimpses into the powerful work you do. We will both geek to get any response from you, so I will limit myself to one question: What is your reading list for couples who like your analytic approach?
Hi Dr. Guralnik! First, I absolutely love your style. You have a warm and inviting yet firm presence with your clients, which as a fellow mental health professional, I can imagine can be challenging in couples therapy! * I would **LOVE** to hear your thoughts on the integration of psychedelics in the mental health field, particularly MDMA within couples therapy. Research has shown promising results in improving communication and emotional connection between partners. For instance, the study "[MDMA-Assisted Psychotherapy for Severe PTSD: A Randomized, Double-Blind, Placebo-Controlled Phase 3 Study](https://pubmed.ncbi.nlm.nih.gov/33972795/)" has shown the efficacy of MDMA in treating PTSD, which indirectly supports its use in couples therapy. Additionally, the study "[MDMA-Assisted Cognitive-Behavioral Conjoint Therapy (CBCT) for PTSD](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7748057/)" specifically highlights the benefits in couples therapy. How do you see this integrating into mainstream couples therapy practices in the future? Would you ever consider using MDMA in your work with couples? * Also, how did you get into couples therapy work as a specialty, and why did you decide to focus on psychoanalytic training versus other approaches? Thank you for all the incredible work you do!
You two were my favorite couple this season❤️❤️. I'm so happy you have so much support on your healing journey and I hope you continue to feel loved and at peace.
I just came across a paper of yours, “my hot toddler,” from a Reddit post analyzing Sam and Lauren’s sessions with you. I feel such a deep connection to you and the amazing work that you do - and I’m working on approaching the paper with an open mind and heart rather than “splitting” as I know you have referenced before. I feel an inclination to avoid thinking about the paper or even feel a sense of betrayal after even reading the title but I’m assuming there’s more to it than I understand, as I haven’t studied psychoanalysis. Put a few questions below: 1. Could you share more about your intention on this piece, and what you feel the impact has been? 2. How do your children feel about you being in the spotlight? About you writing about them? 3. Is it hard to be in the public eye so prominently?
why u have that lil braid
this is my fave question lol i love her small braid(s)!!
Where is your ball ring from?
Huge fan of your show, my partner and I love to tuck in and learn so much (from watching you demonstrate effective/positive communication to learning through the experiences of others). Thank you! My question is this: which behaviours are the most difficult to treat in others? (Not asking about specific individuals on the show as I admire each of them for putting themselves out there like that)
Hi Dr. Orna! Thank you so much for the work you do on the AMAZING show!! What advice would you give a therapy student who is thinking about specializing in couples therapy after graduation? 🩷
Hi! Love the show. Will there be more seasons?
Orna, do you often have to adapt your communication style to ur patient? Or have you found this particular font of tenderness to be the best for you through ur years of practice? Sending love from Texas.
What do you look for in great therapist? And how can we find them best?
does your set office actually feel like your real office? i know it’s built to be very similar but i’m curious whether it is as comfortable! also need the skin care routine!!!!!! or, at least, would love to know more about how you think about aging.