'People Said It Would Destroy My Career': Interview With 'Couples Therapy' Star Dr. Orna Guralnik

Psychoanalyst Orna Guralnik on what goes on behind the scenes of Showtime's 'Couples Therapy': How couples are picked, what gets edited out, and which issues are off-limits

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Psychoanalyst Orna Guralnik,
Psychoanalyst Orna Guralnik,Credit: Avishag Shaar-Yashuv
Gili Izikovich
Gili Izikovich
Gili Izikovich
Gili Izikovich

Michal and Michael, a married couple in their 30s, enter the clinic of psychologist Orna Guralnik and within minutes a vitriolic quarrel erupts between them. “Quarrel” is actually too grand a word for what’s going on there. If we assume that two sides are required for a quarrel as spectacular as this, we’re left with the term “monologue” – and in the case of Michal, it’s a monologue that’s seething with anger as well as emasculating. In a voice that turns furious, rapid-fire and fraught, Michal relates that she feels that she doesn’t have a partner. Their financial situation doesn’t bother her husband. She would like to have more children and to focus on raising them, but Michael, whom she’s known since the age of 21, refuses. In the one sentence he utters amid her torrent of insults, he explains that he prefers to enjoy life and not to devote himself, his energy and his time to a vague future.

Michal is enraged. The couples therapist, Dr. Orna Guralnik, is having a hard time managing the meeting. When a moment of calm presents itself, she puts a question to Michael. Where is he in all this emotion? What does the confrontation with his wife and children do to him? “I like it that she provokes me to do more and be better," he replies almost indifferently.

“As a couples therapist with a systemic orientation, I look at a couple not as individuals but as a system that is a couple,” Guralnik says, in a conversation with Haaretz. “If she is behaving like this, I don’t observe her and think ‘She’s behaving horribly.’ I think: ‘This couple... ’ There’s a system in which she is doing one thing and he is reacting to it – that is, enjoying it. She is doing something, he is doing something that generates it. For me it’s a detective puzzle: What is this music and what sustains it? What in the system creates this thing? Sometimes it’s actually the quieter ones who come out with something unconscious, and then the other – very often the woman – verbalizes it.”

The turbulent Michal-Michael episode opens the second season of “Couples Therapy,” on Showtime. It’s one of the more fascinating experimental documentary shows on this sort of subject in recent years. The new season is a further enhancement of what appeared on-screen in the previous season: a fusion of real couples with real problems undergoing lengthy therapy under the insightful guidance of Dr. Guralnik.

An American who lived for a time in Israel, Guralnik, 56, recently visited here to take part in the annual gathering of CoPro, the Israeli Content Marketing Foundation, which is one of the key opportunities for local film and TV creators to meet their international peers in order to explore possible collaborations. A local version of “Couples Therapy” is currently in production in Israel – another reason to speak to Guralnik about her project, which is perceived, at least on the face of it, as controversial both here and abroad.

A scene from “Couples Therapy.” “Thousands of couples are interviewed, so as not to choose the narcissists, those thirsting for social recognition,” says Guralnik. Credit: Courtesy of SHOWTIME

On paper, it seems like this sort of [therapeutic] format has no chance of working.

Guralnik: “I know, because how could it, right? I work in a psychoanalytic institute, and that’s where the program’s creators [Josh Kriegman, whose parents are therapists, and Elyse Steinberg] looked for a therapist and got to me. I did my undergraduate degree in Israel, in film, so I thought it would be nice to advise them, but when we met, there was a powerful click. It still seemed totally off the wall to me; I was very ambivalent. I wondered whether it was even possible to do therapy in front of cameras that would feel like therapy and not something else. I also had personal apprehensions: Would I be able to function in that situation? Is it something that’s right to do? From my point of view it was a risk. Some people said it would destroy my career.”

How could it really come out both authentic and respectful, and also interesting, if you put a camera into such an intimate situation?

“Exactly. Although I already knew the creators and knew who I was dealing with, I also had professional doubts – a very large number of ethical questions that had to be pondered.”

In practice, “Couples Therapy” is at the very least riveting television, with several components that seem mutually contradictory. The participating couples are chosen out of thousands following a rigorous winnowing process. Guralnik doesn’t physically meet them until they enter the “clinic,” which is a pleasant, well-furnished room, equipped with a network of cameras that are hidden behind a one-way mirror that surrounds the room. The filming takes place in New York.

The patients, called “participants” here, undergo therapy lasting 20 weeks, out of which nine, half-hour episodes, overflowing with a whole spectrum of emotions, are edited and distilled, and at moments of lucid insight can change reality. The real therapy that goes on here – there's no other way to see it – is serious, dignified and totally free of sensationalism. But the ethical problems start with the use of the term “participants” rather than “patients,” with all that each of those fundamentally different categorizations entails.

“One of the things we – the crew and I – like to think about together is the parallel between documentary projects and psychoanalysis,” Guralnik says. “It looks like something else but it’s not. A journalist also places himself in a situation in which he tries to ‘read’ an interviewee. A documentary filmmaker arrives with a camera and wants to show the truth and convey it.”

On the other hand, television is a judgmental medium with a thrust toward the sensational.

The real therapy that goes on here – there's no other way to see it – is serious, dignified and totally free of sensationalism.

“Yes, but there’s an important distinction here. There’s the Showtime network, there’s the production company, and there’s me. I am a therapist with an ideology and with a certain intentionality as to how I do therapy. They are documentary filmmakers and they too have a certain intentionality and conceptions of therapy. Showtime is engaged with television but gave us almost complete freedom. They didn’t intervene and didn’t try to move it or push it into one sort of place or another. From my perspective, all the considerations of ‘television’ play out in a world that is unconnected with our world in the clinic. It doesn’t impinge on our world.”

Guralnik was born in Washington, D.C. to parents who were studying and working in the United States, and who returned to Israel when she was 7. From then until she began her graduate studies, she lived in Israel, obtaining a degree in film at Tel Aviv University along the way. For her doctoral studies in clinical psychology she returned to the United States, completing her Ph.D. at New York University; she was also trained in psychoanalysis, becoming a well-known therapist as well as a researcher. But even though “life happened and since then I’ve been there,” in Brooklyn, raising a family with her partner and their children, and furthering her career – she says she's “closely tied to Israel, with lots of relatives in the country.”

Foundation of respect

Our meeting, in a café in north Tel Aviv, isn’t marked by the hesitant caution that often accompanies becoming acquainted with non-Israelis. In the CoPro event she took part in, she had talked about her work and the series, and about the boundaries its creators had to adhere to. And apropos the question of boundaries, I wondered – to what extent were they set in advance? Are there subjects which from the outset will clearly not be aired in the television program?

“The rule, and the point of departure, is respect,” she says. “This clinic is structured so that whoever is there – everyone: lighting person, cameraperson, director – treats the participants like patients. They need space, support and concentration during their experience, and everything is devoted to that without trying to give them a direction. They also treated me in the same way. After each session, the crew gathers to talk, to understand the process and to ask what I need. It’s never an attempt to exert influence. I suppose that deep in my consciousness, I still remember that there are people around us, but my concentration is not focused on the room and what happens in it. I’m not thinking about TV, absolutely not.”

Are there subjects that are off-limits?

“Yes. We won’t go into deep conversations about a couple’s children, for example; the children did not give their consent to be a subject. We had a couple who were coping with a suicidal adolescent. We couldn’t take the risk, and even though they really wanted to participate in the program, we turned them down. In this season, there’s a serious issue about the how the father of one of the participants responds to his coming out of the closet. A very heavy story. We did accept him, knowing it was complicated. There was also an issue with the father of another participant. In other cases, when it wasn’t essential for the therapy itself, we removed things during the editing, in order not to involve those who hadn’t consented.”

A scene from “Couples Therapy.” Credit: Showtime

On the other hand, when it comes to children, for example, the very fact of their parents’ appearance on the screen can be a problem for them. The boy or girl will see something there from their family’s private life, and that could affect their own privacy.

From the outset thousands of couples are interviewed, so as not to choose the narcissists, those thirsting for social recognition.

Dr. Orna Guralnik

“Privacy is a complicated matter,” Guralnik observes. “I assume that I am too immersed in the story to present definitive conclusions, and I admit that I don’t completely know where I stand on questions of privacy. In general, privacy is a different thing today than it was in the past. My feeling is that for the participating couples, the idea of a loss of privacy, such as happens with the show, underscores their problems but it doesn’t create or distort them. We follow up and talk with them after the series is broadcast, simply to protect them. My impression is that they have a different approach to the exposure – that it's an important part of telling their life story, perhaps in the same way a memoirist does.

“From the outset thousands of couples are interviewed, so as not to choose the narcissists, those thirsting for social recognition. I think about myself: In my regular world I am a very private person, and I didn’t get into this because I wanted fame, but I write and I teach, so that I have a certain urge to tell a story that interests me. I assume that if the participants would see the result and feel that they were distorted in the process – their feelings would be very grim. Fortunately for us, the team succeeds in telling the right story. Often in therapy, we go more into sexuality, into explicit talk about money, the nitty-gritty. We don’t do that here. I don’t get to the root of these subjects – I protect their privacy.”

It’s almost surprising that it remains authentic and serious. Last month the new season of the American version of [the Israeli drama series] ‘In Treatment’ started, and The New York Times headlined its review: “‘In Treatment’ thinks you could use a session, America.”

Guralnik smiles: “That’s something we felt. The production started during the Trump period, with the terrible divisiveness that came from above, when everything was built on totally cynical mechanisms of divisiveness whose whole point was to rule. We had a general aspiration to be among those who were countering division and hatred. Not to divide, [but] to act with compassion, by extending a hand to the Other. There is no such thing as someone being ‘the Other.’ From the start, we knew there would be diversified casting, ethnic diversity, people from all kinds of classes, genders, sexual preferences. We had a feeling that it was necessary to take a position.”

A scene from “Couples Therapy.” Credit: Courtesy of SHOWTIME

Moving molecules

At present, along with work in her private clinic and the TV show, Guralnik is busy collecting material for a book about relationships and about their connection to a couple’s political, social and personal backgrounds.

“It’s impossible to separate those three elements,” she says. “In mixed couples, for example, let’s say Israeli-Palestinian ones, it’s very clear. There’s a quarrel over who will load the dishwasher, but the quarrel over the dishwasher is also about all the rest. Very few people come from exactly the same social class, from the same village, as it were, and even if they do, when it’s a man and a woman, gender politics also enters into it. Every couple has a political system that they have to regularize between them, and the arguments between them change all the time in the wake of political changes, struggles for human rights, for women’s rights – all the time and according to the spirit of the time. It’s interesting to look at how the past year in the United States and the Black Lives Matter movement changed the dialogue between couples, even without their noticing.”

That was very much apparent in the coronavirus special the program did. One of the couples experienced tensions stemming from changes in the discourse about race. She’s black and he’s a white police officer, and it seemed as though you were meeting the whole of American society in the clinic.

“The dialogue between that couple changed completely, and opened up in the wake of current events. The idea is that everything that seems to us to be self-evident raises suspicions for a psychoanalyst. The self-evident conceals things that are anything but self-evident. One of the things I had so much fun with in the series was that suddenly a lot of people [i.e., the crew] were with me and I could actually talk about patients with them. That never happens to me and it’s tremendously liberating,” she laughs.

“It was really terrific to hear people’s opinions about the process. There are moments in therapy when suddenly I grasp something and the patients are willing to listen, sometimes the timing is good, mutual, and then there’s an experience in which in my mind’s eye I genuinely see the system reorganizing. The molecules move in a different way. Something changes and they’re already not the same thing. The detective puzzle is solved.”

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