MOSF 17.6: Orna Guralnick, Showtime’s “Couples Therapy”, and the White Savior Complex

Memoirs of a Superfan, Vol. 17.6: Orna Guralnick, Showtime’s “Couples Therapy”, and the White Savior Complex

By Ravi Chandra. Posted on May 4, 2022

 I went down a rabbit hole of therapists and peeps,
in our eyes and on our streets.
I let my fingers do the walkin’
From Eye to Ass, I to S,
AA’s to Zzz’s,
from The Atlantic to the Showtime Shores.
From Musketeers to Musk and tweets.
(That last part was anti-climactic)
Gottlieb to Guralnik.
Brunch-lovers to Refuseniks.
Psychology Tuesday to Psychology? Someday…
Holy Cows to Hideous Toads.
Lord, let me not turn this rabbit hole into a fox hole.
Welcome to my ink and den.
Be my guest, be my guest.
All I want is warren peace.
We’re all Beauty, we’re all Beast.

Dr. Orna Guralnik in “session” with Desean and Elaine.

In season 1, episode 6 of the Showtime series Couples Therapy (2019), Desean and Elaine (the Black man and dark-skinned Puerto Rican American woman) disclose and explore at least the surface of racialized bias and trauma. The couple began this episode hammering out their differences over going out. Desean reveals he feels he receives biased treatment as a Black man. “It’s my choice to not give those establishments my hard-earned money,” he says. While Elaine is saddened by this, she also feels he should push through these feelings to enjoy “those establishments” with her. Orna Guralnik, the couples therapist of the series, finally, at long last, asks what should have been a central question from the get-go.

Orna: Do you have any thoughts about what it’s like to see a White therapist?
Desean: I don’t understand (he looks around the room, at his wife and Orna, seemingly sussing out the situation. He finally chooses to joke.) … You gonna put me into second place? (They all laugh.)
(Cut to the teacup scene from Jordan Peele’s Get Out, 2017.)
Orna: “Did you see Get Out?”
Desean: “If I see you with a teacup and a spoon!! (laughing) We’re gonna have problems!”
Orna: (Mock serious) Right.

 Orna seems to spontaneously bring up the film, and playfully joins in the humor, and at least a part of her (in her body language and facial expression) takes on the role of the menacing, megalomanic, manipulative White woman. Playful…right? Right? Hmmm.

Did you see Get Out?” I mean…really? You don’t think a Black couple has seen or heard of Get Out? And then where did you go with that?

I wasn’t there, but I didn’t find it funny. It felt “joking not joking” to me. Perhaps Desean (who seems to be a genius at code-switching as needed) has called this sitch from the get-go, and has decided to go along with it – for the benefit of his partner and hopefully the relationship, I assume. Life is short. Think positive. Do the best you can. Let’s see what happens when things get really uncomfortable…I mean, I’ve been there before. How bad could it be?


Objectives of this 7000 word essay, a caveat, and a note on what’s in the air:

  1. Educate, inform and hopefully entertain psychotherapists and the general public. Please recognize I write this in the spirit of compassion, to bring attention to the issues at hand which reach every corner of our professional and personal lives.

  2. Help readers recognize there are differences in therapeutic orientation which may affect therapeutic outcome. Under a particular microscope here is the field of classical (Freudian) psychoanalysis and its offspring, as embodied in the show Couples Therapy on Showtime.

  3. Help readers recognize there are differences between therapists’ personalities and their awareness of power and race, ethnicity, and culture dynamics which will affect therapeutic outcome.

  4. And in writing this essay, do my part in advocating for more conscience around these incredibly delicate matters, with Showtime, media makers, and health care professionals, and hopefully grow my own conscience in the process.

  5. I am quite aware that this essay requires a lot of you as a reader, and may take you to a headspace. I hope it also gets us closer to the heartspace as well.

  6. The questions raised are going to take some time to hold and work through. I respect everyone for taking whatever time they need. However, I don’t think what I’ve written can be easily dismissed. But please, be my guest, and take your time.

  7. Given what is in the air regarding SCOTUS and the leaked Dobb’s opinion by Justice Samuel Alito, I guess I am questioning “originalism” in psychiatry. The legal profession has their work cut out for them in dispelling their own delusions.


Desean should have his own show. He seems like one solid cat.

I mean, if anyone asked, I might have suggested Orna say, “well if that were happening then I would be the one with the problem. And that might be happening in really hidden ways. I honestly want to know because my goal is to be helpful and close, not powerful and remote.”

But Orna has in fact taken the seat of power, and she is (to my taste) remote, not only as therapist, but also as the de jure “star” of her television show. I mean, do you know any actual Black (or Asian, or Latinx, or Indigenous, for that matter) therapists who get their own TV show? I’m not sure if I know any who would want one. But White women are probably the target audience, right?

The Get Out tea cup scene happens, in this series documenting “actual therapy.” It’s happening right now, in all of our lives, so how could it not be happening in the series?

The teacup scene from “Get Out” in which the therapist/mother of the girlfriend (Missy Armitage (Catherine Keener)) hynotizes Chris (Daniel Kaluuya) with a teaspoon in a teacup – subordinating him to his ‘sunken place’ without willpower or agency.

Elaine has been reported to say “I think Dr. Orna saved our lives, saved our marriage. Definitely.” But herein lies the problem. The therapy and Orna Guralnik may have helped the couple, I’ll obviously take their word for it, but the couple should get the lion’s share of the credit for doing the work. Such as it was presented to them. Elaine’s statement echoes for me a problematic leitmotif of the series, which exists in life: the therapist as burdened savior, and here, a White Savior, who is unabashed in using her power with a Black husband and his dark-skinned wife, yet who consistently (and finally, admittedly, also in episode 6) defers to Mau who is arguably the most White masculine male in Season 1. (He’s been called “toxic,” someone who here teaches “a master class in gaslighting”) In fact, to my eyes on first viewing, Orna always defers to the Whitest, most stereotypically Masculine partner of each of the four couples, and contains, critiques, and sometimes even invalidates the feelings of the Blackest woman – usually the one with the most challenging and reactive emotional burden, without asking herself fully why the person who has been disempowered might have a challenging and reactive emotional burden. (I use the term “Blackest” metaphorically; while Elaine and Desean are the darkest-skinned couple in the first season, the other couples are a Latinx heterosexual couple and a White queer-trans couple. “Blackness,” “femininity,” and “Whiteness” and “masculinity” are my ways of framing the differential treatment I observed. Vulnerability and reactivity may be another, or a kind of “power” vs. relative powerlessness. To my eyes, the treatment differential extended through all the couples.)

There was, to my eyes in season 1, a gradient, a hierarchy, one which should make us deeply uncomfortable; one that goes to the ugly, inflamed wound of our diseased culture. We must not look away.

Elaine idealizes Orna for some good reasons – Orna is probably the first person who’s really listened to her, and in dialogue, helped her look at and understand her inner life in life-historical context. She doesn’t seem to have previously ever talked about or really faced the truly horrific things that have happened to her in life. Very few people turn away a passable meal when they’re starving. But Elaine has essentially been pushed to order Orna’s Chef’s Special, one in which Orna feels she can project confidence and make some difference, all under the gaze of a camera lens. Elaine appears dismissive about looking at the ways skin color and race have affected her, and Orna has no chops for exploring this in context of Elaine’s life. This is the tip of the iceberg of Orna’s potential missed opportunity, her blindspot and her bias.

Let’s be clear: Orna is no Julia Child. The meals served on this show did not pass this critic’s smell test, as either media or therapy. And unfortunately for Orna, as a Therapy Chef, you have to eat what you cook. I am genuinely concerned about what she’s putting in her own stomach. The show may be a preview of later dyspepsia and diarrhea.

Maybe that’s too harsh. In Episode 10 (10!!!! Out of 10!!!!!), around minute 36 (out of 60!!!) Dr. Kirkland Vaughans, a highly respected Black psychoanalyst, is brought in as case consultant.

I wonder why they always call us in last. After the mess, and not to prevent it.

He puts it clearly but with great grace:

“I don’t think we can ever get around not enacting some of racialized trauma. I think if we do get around an enactment, it’s because we’re not there for them, and so the treatment is bland, it’s without substance, and therefore it does not facilitate growth in my opinion.”

Dr. Kirkland Vaughans

Dr. Norma Day-Vines, Associate Dean for Diversity and Faculty Development at Johns Hopkins University School of Education, researches and writes about “broaching” (or proactively raising) the issues of power imbalance and REC (Race, Ethnicity, and Culture) in therapy sessions. She posits a continuum of broaching behavior by counselors, from avoidant to continuing-incongruent to integrated-congruent to infusing, with the latter characterized by the counselor’s affirmative, anti-racist and anti-oppressive culture-creating activities outside the therapy office. I would say Orna is likely in the first two nodes on this continuum, and only in the second under some duress and perhaps conscience.

Caveat emptor.

Where were Dr. Vaughans or Dr. Day-Vines when we – I mean, Orna – needed them? And gee, pray tell, why doesn’t Dr. Vaughans have his own show? (Day-Vines is not a counselor herself currently, but she should have some kinda show for sure.) I would be extremely unlikely to want a show like this of my own, personally. The camera’s presence, and the idea of broadcasting a patient’s vulnerability, is a huge risk and interventional parameter. On the one hand, it could potentially be a kind of accountability and stimulus for further exploration of the subject matter, such as this review aims to be. On the other – therapy is a very private activity. You had to be there. What happens in presence and silence and connection and in the continuous reel of our lives is where the real action is. But that doesn’t make great Murrican TV.

Another horror movie happened on 1-6-22. My Facebook post from 1-6

What gets edited in or out will have an effect on all parties, and they may or may not be aware of these effects when they sign up. That’s including Dr. Orna Guralnik. (I bet she wasn’t expecting this review, amirite?) Worse yet, some people might be tempted to perform for the camera, for secondary gain of entertainment or other reasons. And what is the gain here, overall? I’m not sure I know. It’s true that there are some residency programs using the show as a teaching tool. There are some residents who say they have really enjoyed seeing “real, live couples therapy sessions!!!” So maybe there’s some benefit … but a whole brunch buffet of problems.

Let me do my best Chef Andrés’ World Central Kitchen impression, and serve up what I hope will be an amuse-boucheor even multi-course meal of insight spiced with what I hope is good humor, since the ingredients have unexpectedly landed on my immigrant doorstep.

New York Times front web page, Saturday, November 7, 2020

What I Saw at the “Palace”

Problem #1

The main difficulty I had with the series was that Guralnik and I don’t seem to share the same model for human beings, or for therapy. In short, here’s what I might say to a potential patient about my models for therapy and human beings:

“We will have an ongoing conversation in which we will build a therapeutic relationship, and through that conversation and relationship, it is my job to listen to you and understand you. When I think I understand something, I will let you know, though I almost always preface my understandings with ‘correct me if I’m wrong.’ If I think I have something in my tool kit that will help you, I will share it. All of us are vulnerable, including me. All of us experience suffering, disconnection, and unmet needs, and many of us experience wounds and trauma. All of us learn from and influence each other. Insights, relationship, and compassion help us grow and heal on our journeys of identity, belonging and wellness. I will seek to see you holistically, on bio-, psycho-, socio-, cultural, and spiritual dimensions. We are who happens to us and what we make of the happening. My goal is to be an ingredient for you on your journey. The unit of growth is we, and my goal is to be in this with you, for your benefit. Oh, and by the way, there are fees.”

Alternately, this is a good video summary of my work, attitude, and life history as dish, towel, and candle:

My “guest” is a living, breathing, thinking, feeling human embodiment of conditioned existence, as am I. Indeed, we might both be the equivalent of intersecting but widely parallel conditioned universes, brought together by circumstances beyond our understanding. How will we relate? How might I be helpful? (And unfortunately, our relationship to money is part of the mutual conditioning, a part which I do my best to keep at bay.)

Orna doesn’t come clean on any of this during the series. What I gather, though, is that she basically thinks there’s a surface to us, and something deeper. And mostly what’s deeper is this hideous, vile toad of shame, humiliation, suppressed history, and all-around nastiness which causes problems in our relationships and self-concepts. If only we knew and talked about The Toad Within™️, we could just clear it all up. So her methods are to evoke the toad, get it to croak its story, create a catharsis, and then have the person in charge of the inner committee decide if they want to still keep living The Toad Within™️’s story, or jump to the bigger story of “transcendent love,” meaning one in which everyone loves Orna, or finally sees her as the avatar of transcendent love she is. Ahem. Or is it Amen?

Well, personally, I just start out each session by asking my patient, “how’s the hideous, vile toad today?” (If they ask me, I just say “You’re looking at him. You tell me.”)

Who let the toad in? Who who who who who…

And as we all know, the whole point is to kiss the The Toad Within™️,  to turn it into a prince or princess. Start with slap, move to a tickle, end with a kiss. I mean, what else is self-compassion, after all?

On a more serious note, when I asked one of my beloved mentors, the late Dr. Seymour Boorstein, what the intention of therapy was to him, he said, simply, “to help the patient remove the obstacles to love and kindness.” One of the first questions he might ask me in a case discussion was, “do you love the patient? Because if you don’t love the patient, the therapy won’t work.” I always took it as an admonishment to work harder at loving my patients. But I’m no patsy or doormat, for better or worse.

Slide from one of the author’s presentations, on the common factors in therapy.

When I asked another mentor, “what’s your incentive?” he simply said “love.” But he was no doormat either. So the practice of love is a rather individual journey, in the frame of our collective cultural experience. All too many therapists hide behind technae, or rigid rules on doing therapy “right”, which might be handy on some level, and keep them safer from criticism by dyed-in-the-wool mentors, but invariably keep them from really being present in the room with their patients. Being overly cautious and withdrawn or even inhibited as a therapist, under the guise of maintaining “neutrality,” “objectivity,” or even “safety,” can and will be perceived as a form of objectifying power from patients (and colleagues) who are simply looking for human connection. This also deprives the therapist of human connection in this important nurturing relationship. If you’ve primarily experienced power as a therapist, relating through love – meaning being able to admit vulnerability and attend to the other party’s well-being – might not come natural. Therapy then becomes about essentially pathologizing the patient and remaining distant, getting them to really understand that they’re the ones with the problem, when in fact…

Hidden issues do often complicate or block our ability to love and be loved. To bypass these by jumping straight to admonishments or inspiration to love would be inane. As Seymour also told me, “you have to deal with what’s in the basement.” I’ve found that sometimes love (not The Toad Within™️) is actually in the basement, where it has been hiding from the hell upstairs. The make-or-break is in the how: how you perceive what’s in the basement, and how you relate to it. In unskillful hands, the patient will feel pathologized by how the therapist relates to what’s in the basement. I saw moments of this in Orna’s work with Elaine, in containing and critiquing Elaine’s emotions in a way she did not do with others experiencing similar conflicts.

If the therapist remains a distant and separate observer from the patient’s story and affect, unaffected and unmoved, or even a critic or judge, the patient’s story and affect remain split off and discordant from belonging and safety, which are the essential factors in the relief of suffering. Moments and continuities of need and nurture, understanding and warmth, are critical to the healing process.

In the end, there are no “good” and “bad” emotions. Just relationships. One’s relationship to one’s inner life, and one’s relationships to other people and the world around us. Therapy is a fantastic tool to help people in all of these categories, but if the therapist has blind spots or biases, and doesn’t see themselves or the patient in full context, “we’re gonna have problems!” And this is a mutual process. If the patient has extreme problems relating to their therapist, there might be very little the therapist can do in a weekly session. That latter might be the case with Mau, at least as we were able to view in this edited series – or perhaps Orna could have done more to be “in the room,” as I’ll discuss later.

But these are obviously not all “individual” issues, basements, blocks and complications. Our individual issues are always entangled with cultural, historical, and generational … quagmires. In fact, I would tell Seymour that it’s less of a basement than a collective swamp, and less a Toad Within™️ than perhaps an uncherished, misunderstood part of our collective psyche. As J. Krishnamurti said, “we do not think (or act) our own acts. We think (and act) the culture’s thoughts (and actions).” (Parentheses mine.)

So maybe Orna is not really trying to be Julia Child. Maybe this series can be viewed a cry for help from some uncherished part of herself or the collective psyche, and I’m answering the call with free, unpaid labor as part of my minority tax. Maybe she’s just representing a piece of the culture, thinking the culture’s thoughts and acting the culture’s actions, on its “best,” or at least most televised, therapy day.

The Sufi sage Nasruddin once took his mule to the market with a sign around its neck: “Not for sale.” He told passersby, “I just want to show you what I have to deal with.”

Problem #2

What’s worse, though, is that she seems to have a different model for herself as a therapist than she has for her patients as people. She never discloses her vulnerability to her patients, or even the effects her patients have on her in the room. This split might give her some kind of “analytic distance,” (the proverbial and nonexistent “blank screen”) but it also forces her to remain mildly to extremely distant from her patients, while being vulnerable in some ways with her supervisor Virginia and aforementioned case consultant Dr. Vaughans. She has to look unflappable and in charge. This fulfils some fantasies apparently. Here’s the opening line from the New York Times review of the show:

“I have the same dream as anyone else: For an erudite woman with chunky jewelry to rock me to my core with casual but tremendous truths. In the new Showtime series “Couples Therapy,” my dream has come true.”

An illustration of the Sufi sage, Nasruddin, riding his ass. Adobe stock image by illustika, licensed by Ravi Chandra

Do some White women dream of being putty in the hands of strong, beautiful, powerful White women with chunky jewelry? Yassir, you betcha. But seriously, gag me. I do NOT have this dream. I don’t even dream of rocking someone else to their core “with casual but tremendous truths.” I mean, I want to keep my friends and patients, not subordinate them to my “truth.” I mean, what are my patients’ truths? Isn’t that for them, not me, to discover?

I know, the reviewer, Margaret Lyons, may have written this for dramatic effect, like all the other sycophantic, gushing reviews (to be frank) – but half in jest, wholly in earnest, I think. She betrays the kind of idealization that vulnerable, and even lost, people can project on con artists, or perhaps a 3-year-old on their parent.

Gee, where have I seen that?

Even worse, some people rely on infantilizing others in order to retain power over them. More “here’s what to think,” as opposed to “let’s figure out how to think about this.”

Patrick Byrne is a pro-Trump millionaire who has tried to spread the Big Lie and overturn the election of President Biden in 2020. Here, he agrees to the binary posed by ProPublica journalist and Frontline documentarian A.C. Thompson: “If you’re right, you’re saving the country. If you’re wrong you’re destroying it.” On a perhaps smaller scale, these are the stakes of the models we use for human beings and therapy, especially when the therapist assumes total, heroic, savior power, which is by definition, the wrong model, as its starting point is the cheapening of power, control, agency, identity and humanity in the patient, and quite possibly, an eroded or shallow understanding of the bigger picture beyond the therapy hour. At least Orna can admit she is an inadequate hero – that gives some possibility for naming uncertainty and vulnerability, and being human, and not a reality-denying-robot-with-nothing-but-automatic-thoughts-of-certainty-and-knee-jerk-reflexes, arguably like Mr. Byrne. I guess Byrne is one kind of Talking Head. “And the days go by…” Photo from Frontline, “Plot to Overturn the Election, see references.

Where have I not?

We all make idealizations. We don’t all accept or promote idealizations.

“Don’t worry!” they’ll say. “It’s not gaslighting! It’s gaspiration!!!”

I don’t think Orna quite gaslit anyone – but she wears chunkier jewelry, and aims to rock to the core, with people like Elaine, under a klieg light of a studio set. Know what I’m sayin’?

Didn’t I say I liked tickling The Toad Within™️?

Showtime’s Couple’s Therapy might best be seen as a therapy-selfie, illustrated here.

Some patients should be able to ask for a ribbit.

No, I don’t trust a distant, cold, or lukewarm therapist who basks in their power to “rock” their patients, above and beyond relating to them.

An aside: a personal story

I told my first therapist in an early session that I’d actually briefly met her before we started work together, when a fellow medical student introduced us in the hallways of Stanford Medical School. She vehemently denied this truth, and asked me why this was “important” to me. That opening was the beginning of her denying and invalidating many of my truths. When I told her I was thinking of taking some time off to travel to South Africa, she scoffed and told me that this inclination wasn’t mine. According to her, it was my friend’s, a guy who had just come back from Nepal. (Like, what???!!!) I suspected she just didn’t want to lose me as a patient, but she shat on both me and a dream I’d had for years. Luckily, I got to shake hands with Nelson Mandela despite her. And yes, this rocked me to my core. A Brown guy’s got dreams too.

 

I was an intern in the White House in 1993, during the summer of health care reform back then. My heart swelling, I said, “Mr. Mandela, it’s a great honor to meet you.” He gently said, “It’s a greater honor to meet you.” I broke into an ugly cry, with my mom standing right next to me.

When I described a deep conversation with one of my best friends which brought us closer emotionally, and my friend thanked me for helping her – this therapist shook her head and asked derisively with a snort “what are you doing?” as if I didn’t even belong in a psychologically helpful role as a friend.

Needless to say, my first therapist (analytically oriented, natch) didn’t seem to have a clue about working with racialized trauma, or the model minority and racial exclusion/perpetual foreigner myths and tropes, despite being Asian American herself. She didn’t have a clue about how marginalization exacerbates or even creates mental health challenges. She didn’t see my heart and soul – how desperate I was to feel helpful in the world, to feel worthwhile as a human being, despite presenting to her in significant distress. She didn’t see how eager I was to be liked by her. She didn’t really see my humanity. Perhaps she had to deny her own, to maintain a “blank screen.” To her, I think I was only a client, a customer, or “consumer” (in the 70s parlance) not a patient (in the original meaning, “one who leans”), or even a colleague-in-training. She wasn’t all-bad, and there are ways she definitely helped me and cared for me in some important ways, as I’ve said before (see MOSF 16.3 in references), but she was frequently condescending, over-confident to arrogant, and pathologizing. My subsequent therapists, all White or Jewish men, were hugely helpful, empathizing, and validating, and made a big difference in my life. No one rocked anyone to their core (unless I scared the crap out of them with my sitches and necessary, good trouble), but we, between us, we built out the bedrock of compassionate relationship, a bedrock which now extends through my patients, friends, and family, and which they themselves built out with all their relatedness.

No one does this alone. We are the bedrock we are looking for.

And – we all lean. Mutually, not hierarchically, with the doctor carrying all the weight. Real talk: the patient (and the people who love them) carry the weight of their lives. Patients lean on their doctors, and doctors are tasked to help them. If they love their patients, doctors may end up bearing some significant weight, in terms of thinking and caring about them when they are in distress. But doctors do in fact lean on each other, other relationships, and their patients as well. We are in interdependent relationships as far as therapy is concerned. If the doctor must always wear the “doctor mask”, and never be human, the therapy is lost.

But Orna. Orna. Dr. Orna. Orna confesses she feels totally and ultimately responsible, burdened and inadequate in her work. Well, first of all, feeling inadequate and even lost is a regular part of this very difficult work. But Orna is essentially the burdened White savior, and the show is her cross and resurrection. So she has effectively accepted her own idealization, which primes her to accept the patient’s idealizations (technically, in the form of the transference). And once this collusion is locked in, everyone just needs to look busy, play along, and keep Orna happy, presumably until her second coming – err, second and third seasons. (The third season drops May 13th, 2022.)

The kicker is that this “Savior Complex,” if you will, makes it harder to actually help your patients.

Adobe stock image by Krakenimages.com, licensed by Ravi Chandra

Problem #3

If Orna is the White Savior to Elaine, then she’s Mau’s patsy. Mau is a White guy, married to Annie, a White-appearing woman. Annie complains, and Mau demonstrates, repeatedly, that he is dismissive, insensitive, and doesn’t really care about her feelings. Those pesky feelings are her problem, not his. And besides, he makes it clear, he’s provided a comfortable life for them and their children, now teenagers. Annie and Mau have never lasted more than 3 sessions with any previous couples therapist, and under the Showtime spotlight – I mean, Orna’s fantastic work ­– they last 10. (I am joking. I don’t know really which of the two is more or less responsible for the pair lasting 10 sessions.)

Mau seems to subscribe to a delusional belief of our individualistic, Heterosexual White Male centered culture – that everyone is totally responsible for their own emotions. What Annie is going through is just her problem. She just has to take what he does and make the best of it because that’s the way of the world and that’s pretty much what he says he had to do. And just look at the results, ma!!! Sure, it might be a powerful survival mechanism for unyielding times, but true survival and growth depend on nurture and relationship, so the myth of “self-regulation” is naïve at best, cruel and abusive at worst. (See references.)

What becomes crystal clear early on is that Guralnik defers to Mau. She also takes his side on several occasions against Annie’s pesky feelings. Much later, Orna confesses to her supervisor Virginia that she is consciously doing this so that Mau will stay in the therapy. “I have to sacrifice Annie to stay tuned to Mau’s way of speaking.” His personality may have some hypnotic, or flooding, stimulus for her. Maybe he is a controlling type. He also has the power in the room, she ascertains, and for Orna, the person with power must be appeased.

Toad or toady? Strategem or internalized oppression and suppression, because the one she really has to “save” is the White man (because he has the power to save or reject her) even if she has to throw his wife (and herself) under the bus. Orna has been entranced by a delusion, a co-created delusion, perhaps even a folie à deux.

American masculine culture “plays with” and showcases aggressive dominance in the individualistic hero myth. Is Batman a hero – or trauma, grudge and resentment turned into a vigilante savior myth? There are lines he doesn’t cross … or are there?

You. Cannot. Make. This. Shit. Up.

Who’s gaspirating who now? Does she think she’s creating “bedrock,” Bedlam, or is she simply bedding time while the malignancies of White Supremacy, toxic masculinity, and marginalization grow?

How many of us are worth throwing under the bus to protect White feelings?

No, seriously, I do have compassion for Mau. He has had some horrendous experiences in life – of abandonment, neglect, and physical and emotional abuse by his parents, no less. (Annie reports a history of multiple sexual traumas, for which Mau says he’s sorry he wasn’t there “to protect” her. So he’s the “Dirty Jesus” in this scenario, perhaps with Savior pretensions himself.) But his coping mechanisms seem to include being silently terrified of his own vulnerability, being controlling and dismissive of others, and totally unable to accept that a woman who he feels he must “protect” can’t be protected from him. No woman would need protection from him, after all, as he actually proclaims himself “the best” husband. That’s his story and everyone has to stick to it, or … look out.

“What is it about the dark? What secrets does it hold?”

“Filling in” an asshole (i.e. telling them what’s up) is a much more active process than filling in a hole. The asshole doesn’t want to be filled in, and contorts itself in resistance to stubborn realities. The body and mind become rigid, unable to let go of their own crappy views. As I wrote during the Trump presidency, “God’s having diarrhea/so the asshole’s in charge.” (36 Views of San Francisco: what to do, what to do, June 29, 2018.) Everything just gets tight and restricted. Maybe a butt plug or disimpaction will do the trick, but a lot of times it can feel like your head is doing all the work against their sphincter, a Sphinx of a sphincter at that. A Royal Ass. When assholery is considered the prime accomplishment of the dominant culture…”we’re gonna have problems.” Now, everyone’s got an asshole, and I’ve needed to be an asshole in key moments. I’m no doormat, as I said earlier. But I don’t wear an asshole on my head, like a Raccacoonie. (Gratuitous Everything Everywhere All At Once reference.) The asshole is not in charge of me. I tend to give assholes a problem, just by giving ‘em a look-see. I become a psycho-gastroeneterologist. I am frequently up against a twisted tightness that just needs to let go, accept change, accept me and people like me. Not all the assholes are white men, but in the life of the culture they’ve been the pacesetters. Victory lies in not giving a pass to the asshole’s toxicity by becoming part of the human centipede.”

– Unpublished work-in-progress (apologies to the faint-of-heart)

Assholes, sociopaths, and psychopaths share these four defenses:

  1. Admit nothing.

  2. Deny everything.

  3. Make counteraccusations.

  4. Never apologize. Make it the other person’s fault, always.

Oh, and a fifth:

  1. Do bad things.

Perhaps Mau has faced a Hobson’s Choice. He could either

  1. Risk going into his vulnerability for the hope of change, growth, and depth (while contending with a fear of annihilation, perhaps)

Or

  1. Avoid vulnerability by taking power, dismissing his own vulnerability and the vulnerability of others, and demanding to be idealized.

How do we all choose? Some of us have less choice than others. Equal Justice Initiative’s Bryan Stevenson says that we get to our embodiment as humans with proximity to suffering. It takes a lot to get close to this material, even emotionally. But trust me, everybody will feel how distant you are from suffering, because that will be proportionate to how distant you are from them.

1/6/22 tweet.

People who can’t control their own distress try to control others.

What if Orna had said this:

“You know what, Mau…I feel like if I say the wrong thing you will turn on a dime and quit therapy. Then I might feel a bit abandoned. Maybe I’m feeling a little of what Annie might be feeling. Or maybe what you might have felt when no one cared about you as a child.”

This is called being in the room. This is proximity to suffering. Orna is not in the room. She’s on a prayer mat next door, praying she won’t lose her patient (or perhaps a good camera angle on him), but losing the game because she can’t keep her eye on the ball, what Michael Balint called “the basic fault,” or the dearth of love in early life relations. Instead, Orna allows the fault to mistake itself for bedrock, and from there it gaspires, enchants, and erupts.

1/6/22 tweet on the “permission structure” by Maggie Haberman

The vulnerability in the room, not the grandiosity, needs an ally in Orna. The abandonment, the insecurity, the craving need. You know, that thing that most of us feel at some point in our lives, or carry all throughout. In subordinating, power-based relationships, only the boss’s feelings matter. And this trio has colluded to keep the boss as happy as possible. The boss doesn’t want to hear your simper or yammer. And the boss, in this case, is not Mau, but his toad or mule, Nasruddin’s mule, not for sale, but here to be shown off.

It turns out both Annie and Mau are married to an ass. And neither of them is a rider. Their asses are riding them. Because love is really about being interested in your loved one’s growth and well-being. To whom exactly are each of them committed to? To whom or what is Orna most devoted to, in secret? Who hurt you, Orna? Who hurt you?

Does this count as toadying or kissing the toad?

Orna’s work with Annie and Mau is thus also an enactment of racialized trauma, then, in Dr. Vaughan’s parlance. By studiously avoiding potential conflict, by not “broaching” issues of identity and power dynamics, by not being “in the room,” Orna has underscored the trauma.

After she et the conflict, I wonder what became of it?

It appears that Dr. Orna did not have any dark-skinned couples in season 2 (though there appears to be one lighter-skinned Black woman). Season 3 appears to have added an Asian American woman, and perhaps some other people of color. Interesting. If my perceptions are accurate, I might guess Orna became a more selective savior in season 2, and may be venturing out into more amply colored waters in season 3. I wonder if she’s grown in her models for herself, other humans, or the therapeutic endeavor.

I’m not that invested in the answer to that question. I’ll eat and serve what I’m cooking, thank you very much.

Problem #4

What are the ethics of broadcast therapy? Does therapy with a lens still smell as sweet? Plenty of therapists have recorded sessions with the consent of their patients for teaching or research purposes. But Couples Therapy is not strictly for teaching or research, but rather a kind of entertainment, infotainment, and profit. Was there a human subjects committee for this “experiment” or stunt? Are the patients sharing in the profits? As more therapists take on a public role, it’s time to pay more attention, not less, to the ethics, underpinnings, and effects of this kind of influence.

We cannot separate the therapy portrayed, I think, from the urge for dramatic effect and titillation of viewers. Maybe Orna’s methods predispose to drama, in the triggering and recounting of personal history, aimed to get patients to catharsis or grief and melancholia, which are, in general, Orna’s Chef’s Special sweet spot. I don’t know if the cameras or the intention to broadcast and sell the show affected any of the parties in the room. I have read that some participants claimed it did not. As many documentary subjects have said, “we soon forgot about the cameras.”

I’m glad that these folks were able to stay present and tuned into what was happening within the magical one-way-glass enclosure. I guess we are all potentially on the other side of the glass now, looking back in, on moments encased in the amber of 4K video (or $K, same key, but shifted).

The Heisenberg Uncertainty Principle states that the act of observation changes the observed event.

Well, here we are, observing. What will change?

I’m not sure what change the experience of observing and being observed will bring to Showtime, Orna Guralnik, or her patients. I’m not sure what change this experience will have on the basic fault or White Supremacy. They barely tried, on the latter score, from what I could see. I’m not sure if any of these are capable of change, but I’d like to hope.

As for me, I’m building out bedrock. And I know I’m not alone.

 

 

Note: Two other couples are seen in season one. Lauren and Sarah, and Evelyn and Alan. I regret I was not able to include details of their work with Orna in the show, but this review was meant to be illustrative, not comprehensive. In that sense, I may have also elided elements which were more positive and meaningful to participants and viewers. The show itself elided many issues, including class. Please add your comments below, and hopefully this might add to the discussion around the issues raised. There are many noted models for couples work, including the Gottman’s (highlighted in reference 1), Emotion Focused Therapy pioneered by Sue Johnson, Family Systems, Internal Family Systems, Imago therapy pioneered by Harville Hendrix, and psychoanalytic, psychoeducational, and psychodynamic approaches galore, not to leave out, heaven help us, methods of Jungian analysis. I reference my own mentor Seymour Boorstein’s work, in reference 2, along with his book, in reference 3.

For further reading on couples therapy, and broaching; the recent Frontline documentary regarding “the Big Lie”; my psychological takes on some recent films; some past writing referenced above, and other resources; you can take a look at these:

  1. Chandra R. Hot Tips for Relationship Success. Psychology Today, March 2, 2011

  2. Chandra R. Hot Tips for Relationship Success, Part 2. Psychology Today, February 9, 2012

  3. Boorstein S. Who’s Talking Now? The Owl or the Crocodile? AuthorHouse, 2011.

  4. Plot to Overturn the Election. Frontline, March 22, 2022.

  5. Day-Vines NL, Wood SM Grothaus T, Craigen L, Holman A, Dotson-Blake K, Douglass MJ. Strategies for Broaching the Subjects of Race, Ethnicity, and Culture. Journal of Counseling & Development, v85 n4 p401-409 Fall 2007

  6. Chandra R. MOSF 16.3: Minor Feelings and Sister Outsider: A Brown Psychiatrist Thingsabouddit, East Wind eZine, August 7, 2021

  7. Chandra R. MOSF 16.4: Film as Metaphor, Myth, Virtual Reality and Stepping Stone from Dismemberment to Belonging, East Wind eZine, August 27, 2021

  8. Chandra R. Hamaguchi’s “Drive My Car” and the Myth of Self-Regulation, Psychology Today, February 7, 2022

  9. Chandra R. “Everything Everywhere”: Multiverses, Metaverses and You, Psychology Today, March 29, 2022

  10. Chandra R. “A Dangerous Method”: Relationships, Sexuality, Ideas and Ego, Psychology Today, December 27, 2011

  11. Guggenbühl-Craig A. Power in the Helping Professions. Spring Publications, 1971. (Formative and essential reading on these central issues.)

Photo by Bob Hsiang

Ravi Chandra is a psychiatrist, writer and compassion educator in San Francisco, and a Distinguished Fellow of the American Psychiatric Association. For fourteen years, he was lucky to have his MOSF posts published by the Center for Asian American Media, and now looks forward to broadening and building a diverse creative community and coalition through reflecting on culture and psychology for East Wind eZine. Sign up for updates here, and see all the posts here. He writes from the metaphorical intersection of The Fillmore and Japantown in San Francisco, where Black and Asian communities have mingled since the end of the incarceration of Japanese Americans during World War II. He literally works there, between two Indian restaurants, go figure, though one has permanently shuttered during COVID. His debut documentary was named Best Film (Festival Director’s Award) at the 2021 Cannes Independent Film Festival. The Bandaged Place: From AIDS to COVID and Racial Justice is available on-demand (use code “Awake” at checkout for a 20% discount on rentals or purchases through May 31, while supplies last). His nonfiction debut, Facebuddha: Transcendence in the Age of Social Networks, won the 2017 Nautilus Silver Award for Religion/Spirituality of Eastern Thought. You can find him on Psychology TodayTwitterFacebookInstagramYouTube, SoundCloud, or better yet, in the IRL.

5 Comments

  1. Cara Gereau on May 4, 2022 at 8:21 am

    I cannot recall an essay where I have had more hoots, whoops, laughs and head nodding. What a break down. My heart and mind appreciate the depth of your work and insight. This not only leaves my brain stirring but also makes me want to rewatch, or watch the next season closely. On a larger scale, these are issues that are discussed on the edge of our field but certainly are not central to couples therapy or otherwise. Thank you for this labor – much to sit with.



  2. Ravi Chandra on May 4, 2022 at 9:08 am

    Wow, Cara, I cannot tell you how much this means to me. You are a fast reader! I didn’t expect any comments for some time. I’m glad my writing resonated – I think we all do so many things quite naturally from the core of who we are (and of course after getting educational experiences galore), but at some point, there’s a conflict between the dogma of “doing it right” and the feel of the work. I just sense there’s a lot of avoidance, inhibition, ambivalence, distance, alienation, and just basic lack of communication on these very central issues because of …. I’m not sure what. Maybe there’s fear that someone else will make a comment about work that’s held very closely, and it’s all so sensitive. I know how that feels. And there is in some quarters a habit of calling out therapists for “errors”. I once heard a psychoanalyst derisively snort and angrily denounce a trainee for reporting that she went on a vacation, and apparently the patient had some issue with the absence because she didn’t tell the patient “the right way” or some nonsense. It was a cruel thing to behold. It was my first experience at such a meeting, and I’ve regretted ever since not standing up and telling that dude off. I talked about it with supervisors I knew, but they kind of shrugged it off. If a supervisor can’t relate to their charges as human beings, how do you think their methods are going to make the patients feel. No, we are in need of some serious resets in our field. I hope this work is more advanced in the younger generations. Thanks again for your wonderful comment 🙂 — Ravi



  3. Ravi Chandra on May 4, 2022 at 9:54 am

    Related to power vs relationship:

    And the reason things have gone bad is because society has lost the quality of good relationships, if it ever had it. Granted, forming relationships with people you are unfamiliar with might trigger anxiety and worse for some. And the people who don’t know how to control their anxiety and distress and fears of losing status (because society is all about effing status, right) they “try to control others when they can’t control their own distress.”

    And so how can you make a relationship with a system that cares only about status, power and judgment, and not about relationships with the vulnerable or relating to difficult situations of vulnerability, situations that by their definition have never arisen before and thus have no rules meant for them? It’s absurd and cruel. People are so quick to adhere to rules (such as “originalism” because it makes their lives in the system better or easier. They don’t have to think or learn about things like cultural competence. Thus racism, sexism, etc. persist.



  4. Cara Gereau on May 4, 2022 at 12:33 pm

    Deeply agree on the conflict between the “dogma of ‘doing it right’ and the feel of the work” – so much of the dogma steeped in racism, patriarchy, and misogyny. It is all so sensitive and I also can relate to that. Perhaps the power play of calling out “errors”, again, as if there is a RIGHT instead of a curiosity (as isn’t the response even if a mis-step telling of process and what is happening between therapist and client?!) is it’s own mirror of patriarchal culture. I’ve been through two levels of Relational Life Therapy (Terry Reals work) and have deeply appreciated that unbalancing patriarchy is explicitly named as part of the work – accordingly the therapist is not neutral and there is not joining with grandiosity at expense of the person in the one down position. A small step, hopefully, toward working on the system within the system honestly. Wishing you much amplification of this dialogue within the field. Warmly, Cara



  5. Ravi Chandra on May 7, 2022 at 6:16 pm

    Well said! “The therapist is not neutral” indeed. And the goal is not neutrality, but the capacity to understand the patient and oneself, and be part of the provision of care that brings both patient and therapist closer to belonging.

    I hope in my work I tend to be deeply on the side of the patient. We live in a broken world, and the therapist is always tasked to being a part of healing the ruptures. If one is too distant, then one becomes complicit in the rupture, and not part of the repair. This has happened to me, as I pointed out, and many others. There are some patients I personally had great difficulty working with, because what they asked of me was far more than I could provide, though I went as far as I could in those moments. I hope I gave them something, at least a few moments of connection, in the midst of the great ruptures that all too often rule our lives. But no therapist is a savior. The world has its work to do too, and there is always a hanging question about who is capable of doing the work, or even whether the world has it in her, so to speak.



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