WORLDS #1 COUPLES THERAPIST Answers The Biggest Questions Couples Ask In Therapy | Dr. Orna Guralnik

Couples frequently present with communication problems, but Dr. Guralnik points out that communication is often a symptom rather than the root cause. The real challenge is navigating the "otherness" of the partner—the fundamental differences in habits, values, and emotional responses that inevitably arise when two distinct individuals come together. This otherness can be both a source of growth and a trigger for conflict, and learning to tolerate and work with it is central to a healthy relationship.

The Illusion of Communication Problems

One of the most common reasons couples seek therapy is the belief that their communication is flawed. Dr. Guralnik explains that while communication is the medium through which conflicts manifest, it is rarely the core issue itself. Instead, couples often struggle to address deeper emotional wounds or vulnerabilities, which leads to defensive and ineffective communication patterns.

She highlights that couples create narratives or "theories" about each other to justify their feelings and reactions, often blaming the partner for perceived shortcomings. These narratives serve as protective mechanisms to avoid confronting the discomfort of difference. Therapy aims to help couples recognize these patterns and move beyond them to engage with the real emotional content beneath the surface.

Navigating Otherness and Difference

At the heart of many conflicts is the challenge of living with someone fundamentally different. Dr. Guralnik describes this "otherness" as a source of both excitement and frustration. Differences in daily habits, values, and emotional needs can feel intrusive or threatening, leading to clashes that are less about the specific issue and more about the difficulty of accepting the partner’s distinct identity.

The conversation between Dr. Guralnik and the host illustrates this with relatable examples, such as differing approaches to hosting guests or household chores. These differences often trigger assumptions and judgments that escalate conflict. The key, she suggests, is learning to tolerate and respect these differences without immediately trying to change the other or assign blame.

The Role of Compromise and Collaboration

When couples face differences, the idea of compromise often arises. However, Dr. Guralnik expresses reservations about the term, associating it with a sense of loss or forced concession. Instead, she advocates for collaborative problem-solving, where partners work together to find solutions that genuinely satisfy both parties without feeling like either has sacrificed something essential.

This approach requires humility and a willingness to let go of rigid convictions. It also demands that couples view each other as equal partners with valid perspectives, rather than adversaries to be won over. Dr. Guralnik likens the couple’s dynamic to a political system, where the method of resolving differences—whether autocratic or democratic—shapes the health of the relationship.

Loyalties and the Influence of Family of Origin

A significant source of tension in relationships stems from conflicting loyalties, especially regarding family of origin. Dr. Guralnik discusses how partners often struggle to balance their loyalty to their own families with their commitment to their new relationship. This can create inner conflict, particularly when one partner feels hurt or triggered by the other’s family.

She emphasizes the importance of recognizing these conflicting loyalties and creating space for multiple, sometimes contradictory feelings to coexist. Therapy can help partners understand the complexity of these emotions and develop empathy for each other’s positions, rather than reacting defensively or invalidating the other’s experience.

The Challenge of Emotional Vulnerability in Men

Dr. Guralnik addresses the cultural and social conditioning that often makes it difficult for men to express emotions openly. Many men grow up with messages that discourage emotional expression, focusing instead on power, protection, and stoicism. This can create barriers to intimacy and understanding within relationships.

In therapy, she works with men to develop awareness of subtle emotional cues—physical sensations or behavioral patterns—that can serve as entry points to deeper feelings. By expanding their emotional vocabulary gradually, men can become more comfortable with vulnerability, which enriches their relationships and personal well-being.

The Dynamics of Blame and Accountability

Blame is a pervasive and destructive pattern in troubled relationships. Dr. Guralnik explains that couples often get stuck in cycles of blaming each other, which prevents genuine understanding and growth. To break free from this, she encourages individuals to soften their certainty about their own narratives and to turn curiosity inward.

By exploring why certain behaviors trigger intense reactions, partners can uncover unresolved personal wounds or unmet needs. This shift from externalizing blame to internal reflection opens the door to empathy and reduces the intensity of conflict, allowing couples to reconnect on a more compassionate level.

Money as a Symbol of Boundaries and Power

Financial disagreements are a frequent source of conflict, but Dr. Guralnik points out that money often symbolizes deeper issues related to boundaries, power, and identity. Couples wrestle with questions of "mine versus ours," which extend beyond finances to time, attention, and emotional investment.

She encourages couples to articulate their beliefs and ideologies about money openly, recognizing that these are shaped by personal histories and cultural influences. Bringing these often unspoken assumptions into the light allows couples to negotiate their shared economic life consciously, rather than letting money become a battleground for unacknowledged tensions.

Intimacy, Desire, and the Complexity of Sexual Connection

The conversation explores the nuanced relationship between intimacy and sex, noting that the two are deeply intertwined but not identical. Early in relationships, sexual passion often serves as a powerful bond, but over time, differences in desire and needs can emerge, requiring ongoing negotiation.

Dr. Guralnik stresses that what most people truly seek is the experience of desire—both feeling desired and desiring the other. This longing for connection and validation transcends mere physical acts and touches on fundamental human needs for recognition and worth. She also highlights the paradox that partners often make each other feel least desired, underscoring the importance of generosity and openness in expressing appreciation.

The Importance of Patience and Slow Growth

In a culture that prizes quick fixes and instant gratification, Dr. Guralnik advocates for patience and slow, deliberate growth in relationships. She likens psychoanalysis to a slow process that allows individuals and couples to explore their inner worlds deeply and gradually.

This slow unfolding fosters lasting change and richer understanding, contrasting sharply with the rapid consumption of information and superficial solutions common today. Couples who embrace this pace often find more sustainable satisfaction and resilience in their relationships.

Recognizing When to Stay and When to Leave

Not all relationships can or should be saved, and Dr. Guralnik acknowledges the difficult reality that sometimes separation is the healthiest choice. She recounts cases where abuse or deeply entrenched destructive patterns made continued partnership untenable.

However, she also notes that many situations that appear one-sided or exploitative often involve subtle, unrecognized contributions from both partners. Therapy can help uncover these dynamics and foster accountability, but when harm persists despite efforts, divorce or separation may be the necessary path to preserve individual well-being.

Markers of a Strong and Healthy Relationship

Finally, Dr. Guralnik offers insights into what characterizes a robust relationship. She suggests that mutual respect, adoration, and acceptance create an atmosphere where both partners can thrive. A healthy relationship allows for change and evolution, accommodating new iterations of each person over time.

She cautions against equating the absence of conflict with relationship health, noting that the ability to face and work through differences is a more meaningful indicator. Additionally, she emphasizes the importance of balanced dependence—having a network of support beyond the partner while maintaining the partner as the primary confidant for relationship matters.