Dr. Orna Guralnik serves on the faculty at NYU and the National Institute of Psychology, and is the co-founder of the Center for the Study of Dissociation and Depersonalization at the Mount Sinai Medical School. She lectures and publishes on couples therapy treatments and culture. She sat down with Thrive Global to answer questions about what couples face in today’s evolving world, ways to work through these conflicts, and new tools available for the modern day relationship.
Dr. Guralnik is widely known for starring in the popular docuseries Couples Therapy, where she deftly guides couples through real-life therapy sessions. Season four recently debuted and is currently available to stream on Paramount+ with the SHOWTIME plan. Dr. Guralnik was also recently named the chief clinical officer of OurRitual.
Q: How did you get into working as a couples therapist?
A: I got into couples therapy in several different ways. First of all, by training, I’m a psychologist and a psychoanalyst, and I worked mostly with individuals. One of the central issues that preoccupy people in their individual work is their relationships. It’s very important to hear people’s subjective experience of their partnership. But it’s a very different thing when you’re with both partners in the room, you get a very different perspective on what’s going on. Being able to intervene on the level of the couple is a different kind of work that I find interesting and important.
Q: What excites you the most about therapy still?
A: Well, generally I love my work. People are endlessly interesting and creative; they are problem solvers. People have incredible capacities to both create complicated situations for themselves, but also to transcend and work through their troubles. As a psychologist, it’s endlessly moving to see people find ways to overcome their issues, or their partner’s difficulties, and be generous so they can love better. It is inspiring.
Q: What would you say are the biggest challenges couples face today?
A: First of all, a lot is placed on the couple’s unit. It’s a relatively isolated kinship unit. People don’t live with their extended families, they’re more isolated from their community. Plus, there is an extreme lack of infrastructure and welfare support or state support for young families. So, there’s a lot placed on the unit of the couple. Then you have the combination of responsibilities, economic pressures, and the wish for one’s partner to be your best friend, romantic ideal, and sexual partner. It’s a lot to put on one unit.
Q: Does couples therapy really help? Is there data that shows it really does help when it comes to having a healthy relationship?
A: According to a VeryWell Mind survey, 94% of couples say it is worth the investment and 83% say it is a priority in their relationship. So data shows that it helps, but it doesn’t always help. Sometimes it’s too late. Sometimes the therapist is not the right therapist. Sometimes it just exacerbates the friction between people. It doesn’t always help, but often it helps a lot. And by help, I don’t necessarily mean everyone that goes into couples therapy is going to end up together, happily ever after. It helps people have a containing space where they can think and talk through whatever’s on their mind, which sometimes is very hard to do without that space.
Q: Do you feel that couples have more problems now more than ever, and why is that if that’s the case?
A: This is somewhat related to what I said about the pressures on couples now. I think there are particular pressures on couples now. I would add to that the specific political environment that we’re living in where things are so extremely polarized, and people are invited to think in very black and white, simplistic ways rather than a complex nuanced manner. This exacerbates conflict. We are living through a particularly difficult time. On the other hand, there are many positive sources of influence that help couples nowadays. I think feminism has done a lot of good for couples. I think political movements like the queer movement, Black Lives Matter – all movements that have helped couples develop a more sophisticated language to talk to each other about their differences.
Q: What exactly changed that people seem to be more open to not only going to therapy but just talking about it in general in normal conversation?
A: I know that our show, Couples Therapy on Showtime, and other shows that depict therapy much more directly had an impact. We learned of a study done by the USC Norman Lear Center that showed our show had a serious impact in terms of legitimizing talking about and pursuing therapy. But we’re just part of a movement.
Q: So what tools do couples have if they can’t go to traditional in-person therapy?
A: One of the reasons I was quite excited to join the platform OurRitual is because I think OurRitual is a really good example of several tools that are available now for couples. Let’s say for couples that are not necessarily in the throes of some terrible crisis, but need some help and support, and don’t have the resources or the time to go see an individual therapist. There are online options where people can join when they have the time, follow the structure of the program space through which they talk to each other about things that they wouldn’t otherwise talk about and develop a language to understand things they didn’t understand in the past.
Q: Would you mind sharing thoughts on the effectiveness of online compared to traditional? Is there a difference?
A: I think it’s a little bit of comparing apples and oranges. I think they could work well in tandem. Individual work, or working in person with a therapist, you can go into much more depth and crisis or combustive situations that might be hard for a couple to deal with only through an online portal, or on their own. I think when things get really complicated and intense, it might be better to be in therapy. On the other hand,for the purpose of expanding communication about issues, whether it’s intimacy or conflict or just differences, I think these online portals can be super helpful and require much less resources.
Q: What advice would you give to a couple using an online resource that don’t want that traditional setting?
A: Choose a good online program that’s not just selling superficial easy fix slogans. Choose content that is substantial, well-researched, steeped in true psychological theory, content that is built by people who are properly trained.
Q: What ways do you think accessibility through these different online digital platforms is changing the stigma around seeking help in relationships?
A: The fact that it’s more accessible is making people less defensive and more comfortable around psychological language. Self-awareness does not need to be a humiliating or guilt-inducing experience, it can actually be interesting and creative.