Podcast Summary: "Dr. Orna Guralnik On 'Couples Therapy'"

Podcast: All Of It (WNYC)
Host: Alison Stewart
Guest: Dr. Orna Guralnik (Clinical Psychologist, Psychoanalyst, Host of Showtime's "Couples Therapy")
Air Date: August 19, 2025
Producers: Zach
Main Focus: Exploring the dynamics, challenges, and transformative potential of couples therapy, as seen on the docuseries "Couples Therapy," with insights from its star therapist, Dr. Orna Guralnik.

Episode Overview

This episode dives into the world of couples therapy — both in practice and as depicted in the Showtime/Paramount+ series. Produced during "Producer Picks" week, the conversation shines a light on what it's like to film real therapy, the value of having a therapeutic third party, and how couples overcome deep-seated relational blocks. The episode blends behind-the-scenes observations, exploration of specific cases from the show, call-ins from listeners, and Dr. Guralnik’s clinical wisdom, making it a profound look at love, conflict, and growth.

Key Discussion Points & Insights

The Reality of On-Camera Therapy

• Unique format: The show sets up cameras inside real therapy sessions, which initially shocked producer Zach but ultimately, "they found a way that it really works." (01:33)
• Intimacy and authenticity: The series demonstrates that therapy "is not so scary, it's not so painful," and allows viewers to witness the real work of repairing relationships.
• The value of a third party: Dr. Guralnik’s presence exemplifies how a mediator can "help bridge some of the gaps in understanding that can happen," even for long-term couples. (02:18)

Editing, Social Media, and Perspective

• Editing surprises: Couples, like Rod and Allison, actively discuss on social platforms how "surprised" they were about what was cut out: "They were in session for hours and hours... the rest of us only get to see what the producers... decided." (03:13)
• Fans’ engagement: A strong fandom for the show on Reddit and elsewhere provides community and discussion for both viewers and participants.

Dr. Orna Guralnik’s Therapy Approach

"Say More"

• Signature phrase: Dr. Orna’s frequent prompt "say more" becomes a meme and a therapeutic technique: "The simple sort of invitation to say more... I've started using say more as a way to invite people to share." – Zach (04:00)

Blocking the Exits

• Therapeutic containment: Guralnik urges couples to "block the exits," forcing them to face discomfort rather than flee (05:03):

  "People tend to use a lot of defensive maneuvers to avoid things that are hard to bear... those are all these exits that couples tend to use." – Dr. Guralnik (05:03)

Transference and Relating to the Therapist

• Psychoanalytic technique: The "transference" (how patients relate to their therapist) reveals much about couples’ dynamics:

  "It's a good indication of what's going on with them in terms of how they relate to me." (05:53)

In-session vs. Homework

• Integration of work: Therapy success is measured by whether "there's not going to be a big difference" between behavior in-session and at home (06:56).
• Early strategy: "Save the trouble between them to the session... at home do things that are more safe for the relationship." (07:10)

Case Studies from the Series

Katherine & Nick

• Mutual protection as barrier: Both brought childhood shame and tried to protect each other, but "that also blocked their development as individuals and as a couple." (09:16)
• Gentleness and blocks: Their care for each other "blocked their development… I helped them both address their own shame operations… express their care… by way of wanting to learn about each other rather than protecting." (09:16)
• Finances as proxy: Fights about money often mask deeper issues:

  "People often argue about things like finance... but often it's about something else... hiding underneath." (10:59)

The Ayahuasca Question

• Therapy vs. psychedelic journeys: Psychedelics can help, but "they don't always know how to use the material that comes up... that's why the work of integration and therapy is helpful." (12:18)

Rod & Allison

• Blind spots: Many couples, like Rod and Allison, are "clueless about [how they interact]" and how "the way they talk to each other gets them stuck."
• Surface vs. depth: Surface arguments often "conceal much deeper issues, issues like grief and change." (16:21)

Kyle & Mondo: Open Relationships

• Open relationships complexity: "Open relationships mean a lot to different people... I have to listen very carefully what people are looking for." (21:48)
• Empathic perspective: The ability to "see the world through your partner’s eyes is the challenge and the gift of a relationship." (23:20)

Listener Questions and Dr. Guralnik’s Advice

Encouraging a Reluctant Partner to Try Therapy

• Tactical encouragement: "You can just ask your partner to give it a try and give them full control over whether you continue... It doesn't hurt to try." (13:32)

Objectivity vs. Subjectivity in Assessing Needs

• Value of subjectivity: "I'm not sure being objective is exactly what we do in relationships... when we listen to ourselves and our partner, really listen, there's a lot of information." (14:32)

Panic Attacks and Burden on the Relationship

• Compassion-first approach: "First... start with compassion and care... panic attacks are quite easy to address if the person is in good therapy."
• On expressing one's own burden: "If that doesn’t work, you can use heavier technologies... but start with compassion." (20:51)

Is Couples Therapy for Everyone?

• Not universal: "I’m not a therapy-is-for-everyone, always type person... Therapy is appropriate when a couple is facing issues they can’t resolve themselves." (24:24)

Preventing Escalation in Relationships

• Biggest challenge: "The biggest issue... is that your partner is different from you... How do you really contend with difference? How do you relearn to see the world through the eyes of another person?" (25:44)

Notable Quotes & Memorable Moments

• On defensiveness:

  "People generally try to avoid discomfort... and they avoid their own and their partner’s discomfort. When things get tricky... they kind of shut it down." – Dr. Guralnik (09:16)

• On the idea of ‘the one’:

  "The feeling of having found the one is a wonderful feeling... but I don't think it's an expression of that one special person necessarily being out there. It's a state of mind." – Dr. Guralnik (17:43)

• On couples therapy’s value:

  "You get to actually see people in action... you get to see their blind spots and work on it in real time. It can be very exciting work." – Dr. Guralnik (08:03)

• On navigating relationship differences:

  "The biggest issue for people in a committed relationship is that their partner is different from them... How do you relearn to see the world through the eyes of another person?" – Dr. Guralnik (25:44)

• On panic attacks:

  "Panic attacks are also something that are quite easy to address if the person is in good therapy... help is really easy to find when you’re dealing with panic attacks." – Dr. Guralnik (19:36)

Key Timestamps

• 01:23: Producer Zach on initial impressions of the show
• 04:00: "Say more" and the value of inviting openness
• 05:03: Dr. Guralnik on "blocking the exits" in therapy
• 06:56: Difference between in-session and at-home work
• 09:16: Case study: Katherine and Nick’s mutual protectiveness
• 12:18: Integrating psychedelic experiences and therapy
• 16:21: Blind spots in Rod and Allison’s communication
• 17:43: Dr. Guralnik on the idea of "the one"
• 19:36: Advice for panic attacks impacting relationships
• 21:48: Thoughts on open relationships
• 24:24: Should every couple try therapy?
• 25:44: The importance of dealing with difference in relationships

Tone & Style

Throughout the episode, Alison Stewart maintains a warm, curious, and respectful dialogue, often gently rephrasing caller questions and allowing Dr. Guralnik ample space to elaborate. Dr. Guralnik’s tone is compassionate, reflective, at times playful, and always deeply thoughtful, reflecting her psychoanalytic background and belief in the transformative power of honest, supported exploration between couples.

Conclusion

This wide-ranging, nuanced conversation offers both practical takeaways and profound insights into the challenges and rewards of couples therapy. It demystifies the process, emphasizes curiosity over perfection, and affirms the idea that the core of relationship health lies in staying present, curious, and compassionate — with oneself and one’s partner.

For more, catch "Couples Therapy" now streaming on Paramount+.