A Couples Therapist Reaction to Showtime’s “Couples Therapy”

Dr. Orna in Showtime’s “Couples Therapy”; image courtesy Showtime.

The Problem with Most TV Therapy

Therapy shown on TV has traditionally walked the line between professional ethics violations and melodramatic reality shows. From Dr. Phil’s charming ‘no-nonsense’ attitude that parades ‘real’ folks in a near constant crisis stream, to the dramatized view of therapists as mysterious and broken healers with very few boundaries in shows like “Private Practice” or “House, M.D.”, therapy in popular media is often “Big Brother” with more books and furrowed brows. Of course I watched them all (and loved them) but thinking that Dr. Phil’s show has given an accurate depiction of the therapy process is like watching "Grey’s Anatomy” and thinking I am ready to perform my first triple bypass surgery. 

“Couples Therapy” Synopsis 

Then in walked Showtime’s mini-documentary series “Couples Therapy” which advertises itself as real therapy that follows a set of four couples as they work with a licensed therapist. Immediately, the tone of the show struck me with its realism and sharpness. The couples in the show are actually couples, made up of people sitting uncomfortably in the waiting room, fidgeting with their clothes, whose self-conscious, nervous laughter fills the silence. Dr. Orna, a quiet and somewhat unassuming woman with a fiercely direct presence, introduces herself as a psychoanalyst who will be leading the sessions. The couple’s names are shown to the viewer, they walk into the room, and the session begins. It's being recorded and so some level of performance is present, but the thrust of the show is just what the title suggests: bringing the viewer into a specific session of couples therapy. 

As a couples therapist, I was transfixed. The show finds a way to capture the magic and alchemy of the therapy room with a clear sense of respect for the process and all of those involved. The issues that are talked about range from the exploration and processing of childhood trauma, potential personality disorders, sexual disconnection, to the dissolution of relationships. These couples are real and bring their real problems to the therapy room hopeful for real solutions. Couples talk over each other, shut down, scream, say hurtful things, cry, all while Dr. Orna puts on a masterclass of therapeutic intervention. I quickly saw parts of myself and my relationships in the couples while also marveling at the uniqueness and particularity of the human experience.

The Self of the Therapist

The show’s genius rests squarely on Dr. Orna. Instead of presenting her as the enigmatic guru, unreachable at the top of some mountain, the documentary clearly tracks her process. She frequently narrates what she is noticing in between sessions and shows footage of her working with her clinical advisor and peer advisory group. Instead of having all the answers, Dr. Orna leans into the mystery of human change and transformation. She gets frustrated. She gets confused. She asks for help. Dr. Orna, is ultimately portrayed as a real, breathing, feeling person, just as all therapists are. “Couples Therapy” at its core, asserts that therapy is a human process, where humans meet together and try to find a way out of stress and suffering and towards happiness and meaning. This process is messy, non-linear, and quite often painful. But it works. The viewer sees the impact that the therapeutic process has on the couple and the therapist and it feels genuine and quite often precious.  

What Therapy Is and What Therapy Isn’t

“Couples Therapy'' differs from other depictions of therapy in popular media in that it showcases actual, evidenced-based, psychoanalytic intervention in practice. Dr. Orna may present her process as one of realization, discovery, and continued effort towards a better approach but she is nonetheless doing highly intricate treatment. From a professional standpoint, her integration of best practice in sessions is clear and a breath of fresh air for the genre. Not every therapist will run a session like Dr. Orna (and they shouldn’t) but her sessions demonstrate what a high quality session of couples therapy could feasibly look and feel like. The show provides an example of the process, across a period of time, without skipping over the painful parts or emphasizing the successes. It's fundamentally about understanding the human experience, not exploiting it purely for entertainment’s sake. And it is captivating. 

When considering coming to therapy, it can be difficult to imagine what the process will be like, how it will feel, if it will be worth it. Part of this hesitancy, I think, comes from the kinds of popular stories we have in our cultural awareness about what therapy is. We know that our therapy won’t happen on national television, but what if it feels humiliating or exploitative? What if my therapist is an unreachable jerk or fails to demonstrate appropriate ethical boundaries? While these stories are possible, it is important to have parallel stories that depict some of the better possibilities as well. Maybe, like in Dr. Orna’s sessions, you will experience a sense of presence and connection with your therapist that is both comforting and empowering. Maybe you will understand why you do some of the things you do with startling clarity. Maybe you will learn to see and even to love yourself and your partner all over again (or for the first time!). 

Therapy Can Be For You Too!

If you don’t know what therapy could look like apart from a studio audience and A-list actors, I suggest watching an episode or two of “Couples Therapy”. You will see people talking and a lot of questions; probably some tears as well. But keep watching and see if you can catch the sparks of realization, the moments of magic where change happens, or the deepening of heartfelt connection that makes the therapeutic process so powerful.

If you too would like to try out actual therapy, in all its messy, wonderful, human glory by yourself or with partners, we would love to journey alongside you. Visit our couples counseling page or schedule a free consultation with one of our therapists to talk with us about how we can help.


Written by Conrad Frommelt, M.Ed., BCBA

Conrad is a clinical intern specializing in relationships and sexuality with Pivotal Counseling, LLC. He sees clients online and at both the Greeley and Fort Collins, CO offices. To learn more about him or see more of his blog articles, you can visit his bio page.

Pivotal Counseling, LLC is the leading provider of relationship and sexuality counseling to people on the northern front range and throughout Colorado and Wyoming. We help people from their pre-teen years to their post-retirement years to have happier and healthier relationships with themselves, their sexuality, and their loved ones.