I’ve seen everything as a counsellor. But Couples Therapy still has me gripped

Most people want their sessions to remain private, but a new TV show that lifts the lid on the process is compelling – and rewarding

Two weeks ago, as 2021 turned into 2022, my inbox was suddenly full of couples requesting counselling. It wasn’t that surprising because every year after Christmas, many couples have a meltdown. It’s the fatal combination of forced Christmas jollity and endless hours spent together that makes people realise they don’t know if they like or get on with each other any more. Throw in the confinement of Covid and you have perfect conditions for relationship breakdown.

So couples contact me. The journey starts as we delve beneath the veneer of the couple, going to places that most fear to go. Top of the problem agenda is usually sex, followed by money. But, at the heart of all this, is the desire for true intimacy combined with our deep fear of it.

Couples counselling is not easy work. With individual therapy there is one person sitting opposite me, but in couples therapy there are three of us, making the room a much busier place. Emotions fly around, exploding and then landing like small hand grenades.

In my years as a couples counsellor, I have encountered pretty much everything – the man who secretly loved dressing up when his wife was out, until she discovered him in her bra and knickers; the woman with two lovers in two different continents; the decades-married husband who turned from an international diplomat to ecowarrior leaving his wife confused and bewildered, and trying to persuade him not to move the family to a yurt. One man even came in brandishing a gun (unloaded) saying he would shoot himself if his girlfriend wouldn’t let him come home.

But for most couples, what happens in therapy stays in the room. It remains a mystery to anyone outside the consultation room – and sometimes it’s pretty mysterious even to those inside.

But now, we have Couples Therapy, a BBC Two programme that lifts the lid on this difficult and subtle process by showing psychologist Dr Orna Guralnik in session with couples. We see DeSean and Elaine (she shouts, he’s fed up), Mau and Annie (he wants more sex, she doesn’t) – and so on. Everything is here – drama, pathos, anguish, fun, shouting, weeping, making up, falling out.

The programme is, of course, compulsive viewing even though it’s obviously staged and the couples are most likely chosen because they are able to be eloquent, controversial, in-your-face and vulnerable.

This is not what couples counselling is usually like. Couples come into my room and then there are silences, repetitions, action and inaction. I have sat in on couples sessions when I was training, and at times it was like watching paint dry. The process can be painstakingly slow as couples struggle to articulate their feelings.

Yet Couples Therapy showcases couples (in the USA which, I think, makes it a fundamentally different experience) who seem happy to go on camera and open up about their intimate relationships – nothing is off limits.

They tell each other off, talk over each other, refuse to speak, get angry. It’s dramatic at times. This is not how I work with my couples – I encourage people to talk from the “I” position and to cut out naming, blaming and shaming. I don’t let my couples take cheap shots at each other. I also try to get them to recognise and change the “you did this” “well you did that” style of relating. Playground communication doesn’t get anyone anywhere.

Yet what makes the show so fascinating is that it does give us an insight in to how couples operate. Part of us is probably transfixed at the revelations of sex – or lack of it. Part of us is keen to take away some knowledge from the show. If Guralnik can get couples to open up and then give them some insights and advice on their relationship, maybe we can all take something from that. Most people probably cannot afford the fee of a top therapist such as Guralnik.

There’s also a healthy dose of voyeurism. We watch relationships unravel and, inside, many of us might think, “well, at least we’re not as bad as them.” And the cynical part of us is probably aware that those who participate in the show might have some motive for being on TV other than receiving the therapy.

But, although this is an American programme, we Britons are now far more open to having therapy than ever before. Every generation is coming to the couch. I have clients in their 70s and those who are teenagers. The ability to communicate is not correlated with age. Some teenagers are highly emotionally intelligent and able to share their feelings, others take a bit more time.

But there is a generational divide when it comes to couples. I find the under-40s see me before they have even got near a crisis point. They come, they say, because they value their mental health much in the same way that they value their physical health. They often come because they want to acquire communication tools, to head off conflict before it derails them. They are open to each other and genuinely curious.

Older couples seem to find this playful curiosity more difficult. I have met long-term married couples who seem to know very little about each other. When I once asked a man what he thought his wife’s sexual fantasies might be (they were struggling with their intimate connection), he looked utterly affronted. “I’d never dream of asking her that,” he said. “It would be very rude and intrusive.”

Yet I find most couples have an “energy” about them. Some say they never row (which, in my book, is not necessarily a good thing) and that their relationship needs “tweaking”. As sessions go on they turn out to be utterly terrified of opening up to each other. Others come in shouting and screaming but end up entwined on the sofa whispering and giggling like teenagers.

For me it’s endlessly fascinating. It’s not the work I expected to do – couples counselling is not for the fainthearted. But it’s as compulsive, as difficult, as enjoyable and rewarding as it appears to be on the television.

• This article was amended on 23 January 2022 to correct the spelling of Dr Orna Guralnik’s name.

Contributor

Lucy Cavendish

The GuardianTramp

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