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Alison: This is All Of It from WNYC. I'm Alison Stewart. In the docu-series Couples Therapy, viewers are offered a rare view inside the office of Dr. Orna Guralnik, where she helps her patients overcome some of the dynamics that make for relationships that feel stale or sour, maybe even hopeless. She helps her patients reconnect with the care and love and partnership that good relationships are supposed to foster.

The show can help us, as the viewers, recognize some of those factors in our own lives. The series is back with four new couples who present with issues like shame and gender trauma, deafness, queerness, and identity, and what it means for two partners who have different views on the idea of home. Joining me now to talk about it is clinical psychologist and psychoanalyst Dr. Orna Guralnik. Nice to speak with you again.

Dr. Orna Guralnik: Hi, Alison. Good to see you. Good to speak with you.

Alison: You use the phrase "block the exits, open up, and work it out." What changes about a couple's dynamic when you literally block the exits?

Dr. Orna Guralnik: I think generally people tend to use a lot of defensive maneuvers to avoid things that are hard to bear or things that cause them discomfort or shame, and it makes it hard for couples to deal with their issues when they keep exiting. Exiting, and that could be towards anything. It could be towards work, or it could be an affair, or it can be just avoiding the relationship. Those are all these exits that couples tend to use to avoid discomfort.

Alison: In the show, it's so interesting because we hear you talking with your own therapist, with a group of other therapists, about whether a patient trusts you or how they respond to you. What can you learn about how couples relate to each other with the way they respond to you?

Dr. Orna Guralnik: Interesting question. Generally, I'm a psychoanalyst, so one of the tools that we use to understand what's going on in our patient's psyche is what we call the transference, meaning how they relate to the therapist, which is really an indication of what's going on in them and what they project onto the person around them. In individual therapy, you do a lot of work in the transference. In couples therapy, it's much more here and there. I use that, but mostly I focus on their relationship. Sometimes it's a good indication of what's going on with them in terms of how they relate to me. Did that make sense?

Alison: Yes, absolutely. It's also interesting in this season because, or at least I recognized it more in this season, is you send people to go out into the world with their homework that they have to do. What's the difference between the work that happens in the room and the work that happens outside in their lives, their homework?

Dr. Orna Guralnik: If a treatment is good, ultimately, there's not going to be a big difference. Ultimately, what therapy is about is about internalizing whatever people learn in the context of a safe space, the session. Eventually, you want them to take it home, and it becomes a natural way of relating. Early on, what I ask people to do is to save the trouble between them to the session where we can unpack it and work on it gently, carefully without damaging the relationship, and then at home to do things that are more safe for the relationship, changes that will not necessarily induce a crisis between them.

Alison: Why did you choose couples therapy versus individual therapy?

Dr. Orna Guralnik: For the show?

Alison: Just in general, or do you do individual therapy as well?

Dr. Orna Guralnik: Oh, I do both. I'm a psychoanalyst, so I see plenty of individuals multiple times a week for long periods of time. I don't only work with couples. I'd say I probably see half-half couples and individuals.

Alison: What do you like about couples therapy?

Dr. Orna Guralnik: Oh, many things I like about it. First of all, even in their individual work, most of what people talk about is their relationships, whether it's their romantic relationships or with their parents or with their employers. Relationships is the stuff of life. What's really interesting about couples' work is that you get to actually see people in action, not only the way they think about it or talk about it, but you get to see their blind spots. You get to work on it in real time with them while they're in the room with you. It can be very exciting work.

Alison: My guest is Dr. Orna Guralnik. She is a clinical psychologist and psychoanalyst. We're talking about the new series of Couples Therapy. It's now streaming on Paramount+. Listeners, if you'd like to join this conversation, we want to hear how you overcame a persistent challenge in your relationship. Our number is 212-433-9692, 212-433-WNYC. Or if you have a general issue, you need to know the right words to start a conversation with your partner, perhaps we can help. Dr. Guralnik obviously can't help you with your deep personal issues, but there's a more general question that you have, you could give us a call. Our number is 212-433-WNYC, 212-433-9692.

Let's talk about the couples on the show, Katherine and Nick. They both have deep-seated trauma from their childhood, hers from being overweight, his from being ridiculed because he was questioning his sexual identity. You observe in the beginning that you can feel they're both trying to protect each other, even in the session, a little bit. How does it happen that one partner's instincts about what it means to express care or to protect can actually wind up being counterproductive?

Dr. Orna Guralnik: It goes back to what we started this interview with in terms of like exits and people generally try to avoid discomfort. They avoid their own discomfort, and empathically they feel their partner's discomfort, so when things get a little tricky or shaky, they shut it down often rather than go there. They do it with each other. Nick and Katherine, they came into their marriage both with a lot of hesitation, shame-based kind of protectiveness, and they were gentle with each other.

In certain ways, adorably gentle with each other, very caring, but it also blocked their development as individuals and as a couple, and that's how they started their work. I helped them in the work. I helped them both address their own shame operations, loosening up those operations and allowing themselves to get more curious about each other and express their care for each other in a different way, by way of wanting to learn about each other rather than protecting each other.

Alison: There's this funny moment, oh, funny, it's a moment when Nick says he gets really a little upset with her about finances in the relationship. When something like that happens, there is the issue of finances, but there's something else going on as well. How do you unpack it so that people can realize the finances are one thing, but here's something else to consider?

Dr. Orna Guralnik: As a psychoanalyst, our whole training is all about reading what's underneath, the stuff that is not necessarily conscious or more motivated by hidden motivations. You have to respect people's defenses and go nudge them a little bit beyond what they're comfortable with, yet not overwhelm them. Open up a little space there to ask what might be there in addition to the thing that you're fighting about?

Could there be something else there that you're not quite conscious of that we want to think about? People often argue about things like finance or division of labor, or even when people argue about sexuality, often it's about something else. There are often other issues that are hiding underneath those more explicit content areas.

Alison: Nick and Catherine come to you after attempting to work on this experience through Ayahuasca, having an experience like that. How does that enter your approach to know that a couple has tried something aside from therapy before getting to you?

Dr. Orna Guralnik: I'm promiscuous that way. "Anything that helps," I'm like, "Bring it on," anything that will help you. You probably know, many people now are trying out psychedelic medicine to bypass certain defenses and bypass their own limitations. Sometimes it's great. It really does open up a door for people to material that they didn't have access to.

The problem with just leaning on psychedelics, there are all sorts of potential problems with it, but one of the problems is that they don't always know how to use the material that comes up for them while they're doing whatever Ayahuasca journey or whatever journey they went through. They don't necessarily know how to use it later and incorporate it in a more consistent way in their lives. That's why the work of integration and therapy is helpful. With Catherine and Nick, it was super helpful to start with them right after they did that journey because they were very open, and they had access to material that was hidden from them before.

Alison: We've got a question here that says, it's a text that says, "How can I encourage my partner to attend therapy with me? He's very averse to it."

Dr. Orna Guralnik: It's not an unusual question for couples. You can just ask your partner to give it a try and give them full control over whether you continue with it or not. It doesn't hurt to try something. If it doesn't work for them, it's not a good idea.

Alison: Let's talk to Lori, who is calling in from Brooklyn. Hi, Lori. Thank you so much for calling All Of It. You're on the air.

Lori: Hi. Thank you for taking my call. My question is, how do you know if you're being objective when you're evaluating your partner's meeting of your needs and getting out of the way of being selfish in terms of that evaluation, if that makes sense?

Alison: She's asking, how can you be objective in the relationship without appearing to be selfish?

Dr. Orna Guralnik: I'm not sure being objective is exactly what we do in relationships. I think, in a way, we want to be very subjective, and I don't mean subjective in terms of being distorted. I think when we listen to ourselves, and when we listen to our partner, really listen, there's a lot of information that is available. Again, it goes back to the idea of employing defenses versus trying to really get to the truth of the matter. When you're honest with yourself, you check in with your very subjective gut feelings, and you open honest conversation with your partner on how they're feeling. Plenty of information is available to you to know if this is a relationship that is good for the two of you.

Alison: We are talking about the Paramount+ series, Couples Therapy. It just dropped a whole batch of new episodes. My guest is Dr. Orna Guralnik. We'll have more after a quick break. This is All Of It.

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Alison: You're listening to All Of It on WNYC. I'm Alison Stewart. Dr. Orna Guralnik is our guest. She's a clinical psychologist and psychoanalyst. You can watch her on the Paramount+ series, Couples Therapy. I want to ask about Rod and Alison. There's a lot of growth that goes on with Rod and Alison. He's quiet, kind of mild manner. She's sort of brash and artistic. It's really interesting because she doesn't understand the way that she talks to him. She's kind of yelling when she talks to him at first, and she's kind of interrupting all the time. How often do you find that you have clients who aren't aware of themselves like that?

Dr. Orna Guralnik: A lot.

Alison: A lot?

Dr. Orna Guralnik: We all have blind spots about how we interact and ways in which we influence our partners without awareness of it. That's why we get stuck in all sorts of dynamics. Alison and Rod were a wonderful example of that in the sense that it was both so obvious, what was going on. They were, in a way, in the beginning, clueless about it, but they were also very open-hearted and willing to go through the process and learn really fast.

They're a great example of how both the way they talk to each other gets them stuck in a certain dynamic. Also, speaking to what we were talking about earlier, you can see how the surface of what they're talking about is concealing much deeper issues, issues like grief and change that they were each going through, that their bickering was getting in the way of their really being able to address.

Alison: We have an interesting question. This text says, "What is your opinion on the idea of the one, you finding the one person in your life?"

Dr. Orna Guralnik: I think the feeling of having found the one is a wonderful feeling. I think it's a feeling that one can generate when one opens one's heart to someone outside of them. I don't think it's really an expression of that one special person necessarily being out there. I think it's a state of mind where you're willing to assign that kind of trust and love to someone else.

Alison: Let's take a call. This is Tara, who's calling on line two from East Brunswick. Hi. Thank you so much for making the time to call today.

Tara: Hi. Thank you for taking my call.

Alison: Sure.

Tara: My question is, I have a husband, and we've been married for quite some time. I guess I'm seeking to find out how to speak to him. He has panic attacks that don't allow for him to drive very far at all, and it's so overwhelming. When we do talk about it often, it brings up a lot of emotions in me because I feel like we're not-- I don't know. I just feel overwhelmed. How do I talk to him, but be gentle on him, but just let him know that we need to do something about this because it affects every aspect of our relationship?

Alison: Thank you so much for calling. What advice would you give Tara, talking to her husband, who can't drive because he has these panic attacks?

Dr. Orna Guralnik: Tara, first of all, I hear the compassion and the gentleness with which you're trying to address this, which your husband is lucky for that. I hear that. Panic attacks are both really hard for the person going through it and for the people around them. Panic attacks are also something that are quite easy to address if the person is in good therapy. Your husband is, in a way, wasting very precious time not getting help.

The question is how to bring him to the door of a good therapist. I would say to him, "Look, you're suffering. I care. I'm suffering with you. Why don't we just try? Give it a try." Some combination of a good therapist, a good either cognitive behavioral therapist, or if there are other issues involved, a more psychoanalytically oriented therapist, and then there are medications that help with panic. Help is really easy to find when you're dealing with panic attacks. It's a very well-known issue.

Alison: Is it helpful for Tara to tell her partner how all the driving is weighing on her?

Dr. Orna Guralnik: That's more of a guilt tripping. I would start with more just compassion and care, which I heard in her voice. If that doesn't work, then you can use heavier technologies in terms of influence, but I would start with compassion.

Alison: This says, "I can credit my individual therapy with saving my marriage. A lot can be done in a relationship if you're open and honest with yourself." Thank you for sending that text. Let's talk about Kyle and Mondo. When they show up in your office, Kyle, who is deaf, has given Mondo a little bit of an ultimatum that he wants to have an open relationship when they first show up. What do you hear when you hear the words open relationship as a therapist?

Dr. Orna Guralnik: I don't yet know what I'm hearing. Open relationships mean a lot to different people. They can serve different functions. People use it in different ways. Some people want open relationships when almost it's like a sexual orientation. They're non-monogamous somehow by nature. Some people try to employ an open relationship to address an issue that they don't know how to resolve between the couple, as a way to bring in some kind of either other person or other dimension of the relationship.

Some people use open relationships, hoping that that will solve something that it's not really about that, and it's just a step on the way out. I have to listen very carefully what people are looking for when they're talking about open relationships, and then how do they compare? People want different things and need different levels of safety versus excitement, safety versus openness in their relationship. Some of it is a matter of negotiation, developing trust, learning a new language.

Alison: It's interesting. There's this moment for Kyle and Mondo, where there's an opportunity for Kyle has to be worried about Mondo, not vice versa. Where's the value of those times when the shoe is on the other foot and a couple's ability to understand each other?

Dr. Orna Guralnik: Developing the capacity to really see the world through your partner's eyes is the challenge of a relationship and the gift of a relationship. Kyle and Mondo were just wonderful, and being able to do that with each other and being open to really-- If you watch them on the show, you'll see that they listen to each other really carefully. Funny to say, listen, because Kyle is deaf, but listen really carefully to each other and learn from each other. They really appreciate the difference between them and extend a lot of sympathy and empathy to each other, and they grow a lot as a couple.

Alison: Let's take Taylor in Manhattan. Hi, Taylor, you're on the air.

Taylor: Hi. Thank you for taking my call. Huge fan of Dr. Orna. I just was curious if you recommend couples therapy for all couples, no matter how long the relationship has last, or if it's something that, if it's not broke, don't fix it. That's what I have the feeling.

Alison: What do you think?

Dr. Orna Guralnik: People often ask me that question. I'm not a therapy is for everyone always type person. I think therapy is a very particular endeavor to take on. It's expensive. It takes time. It takes a lot of resources and effort. I think you should use it judiciously. It's not for everyone. It's certainly not all the time. I think therapy is appropriate when a couple is facing issues, they try to work on it themselves, and they realize that they're getting stuck, that they're not able to resolve it themselves, then it's a good idea to bring in a therapist. Otherwise, we all have plenty of resources available to us that do not require therapy.

Alison: What advice would you give to folks who are in relationships to help them navigate some of the things that you've seen snowball into bigger issues?

Dr. Orna Guralnik: That was a little general. Can we--

Alison: Are there certain things that people who are in relationships should be aware of, should acknowledge before it gets out of hand? Does that make more sense?

Dr. Orna Guralnik: It's so general. That question is life itself.

Alison: [laughs]

Dr. Orna Guralnik: Life unfolds, and there are a lot of issues that we face as we live with our partners. The biggest issue that people face when they're in a committed relationship is that their partner is different from them. It could be a difference in terms of what they need, what they want, it could be a difference in values, it could be just a difference in how they see the world. I guess my biggest advice, and I'm basically writing a book about it, is how do you really contend with difference? How do you learn to see the world through the eyes of another person?

Alison: Paramount+ is where you'll see the series Couples Therapy. They have just dropped a new season. My guest is Dr. Orna Guralnik. Thank you so much for your time today. We really appreciate it.

Dr. Orna Guralnik: Thank you, Alison, and good luck to WNYC.

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Alison: Coming up on the show tomorrow, New York Times critic Kyle Buchanan has just returned from Cannes, and he joins us to talk about this year's slate of films from the big directors to the big prizes. I'm Alison Stewart. I appreciate you listening, and I appreciate you. I will meet you back here next time.

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