Therapy Voyeurism Really Might Be Doing Some Good

Shows such as Couples Therapy are primarily entertainment, but they also can get you to start thinking like a psychologist.

An image of Orna Guralnik, the therapist who is featured in Showtime's 'Couples Therapy.'
Showtime's 'Couples Therapy' features Orna Guralnik, a real-life therapist in New York. (Showtime)

I watched the entirety of Couples Therapy from my childhood bedroom while visiting my parents in July. It was as apt a time and place as any for entertaining some heavy psychoanalytic ideas that would, no doubt, cause me to reflect on my life. The Showtime docuseries follows Orna Guralnik, a real-life psychologist in New York, as she works with couples over the course of several months. Deep into the second season, Guralnik challenges one woman to consider that the bursts of anger she feels toward her husband aren’t actually about him, but are instead motivated by anxiety inherited from a demanding mother who considered herself a failure. “Anxiety tells you something about your parents’ unhappiness, and your being recruited to do something about it,” Guralnik tells the woman.

At this point, I had to close my laptop and stare at the wall for a few minutes. Had I been running emotional errands for the two people down the hall without realizing? I wasn’t sure whether it was wise, or fair to my parents, to apply what Guralnik had said to my own life, but I had some ideas about how I might do so.

Couples Therapy makes for good TV: The couples come off as vivid and earnest, but there’s still lots of drama, if not quite the over-the-top kind you can find on reality shows like The Bachelor and Real Housewives. They point fingers, reach stalemates, and struggle to see how past trauma has shaped the way they treat their partners. With time, some of them do make progress, coming to understand their role in negative relationship dynamics and learning to take a more empathetic view of their partner. The show belongs to a budding genre—let’s call it “therapy voyeurism”—in which real counseling sessions are recorded and packaged for mass consumption: In addition to Couples Therapy, there’s Viceland’s The Therapist and Esther Perel’s couples-therapy podcast, Where Should We Begin?, both of which debuted in 2017. (The former lasted one season, while the fourth season of Perel’s podcast came out last year.)

My own experience watching Couples Therapy led me to wonder whether therapy voyeurism can be more than just entertainment. Right now, people would have good reason to turn to these shows as a stand-in for or supplement to actual therapy. The pandemic has ushered in a profound mental-health crisis, and although many people were kept out of therapy in normal times because of a lack of time and money, even those who are actively pursuing treatment now have been stymied by a shortage of therapists with openings in their schedules. Coincidentally or not, a Showtime spokesperson said that streaming viewership of Couples Therapy had doubled from its debut season, in 2019, to its second season, which came out in April. I reached out to some psychologists to get their take on the phenomenon, and they were very clear: Therapy voyeurism is not real therapy—but that doesn’t mean it’s totally pointless either.

In all likelihood, viewers won’t walk away from an episode (or even a season) of Couples Therapy with a how-to guide for managing their anxiety, lifting their depression, and solving their relationship problems. But in the most basic sense, watching Guralnik guide couples toward the root of their conflict through a combination of questions and observations can give you a better understanding of how to work through your feelings. This, says Steven Tuber, a professor of clinical psychology at the City College of New York, isn’t so different from the outcome of actual therapy, in which psychologists are generally less keen on telling their patients exactly how to handle a situation than giving them a new way to think about their problems. “If you give a person a fancy interpretation, they’ll feel a lot better that day,” he told me. “But if you teach them to think psychologically, they can do that for a lifetime.”

Guralnik certainly got in my head. After watching the show, I found myself considering my own role in perpetuating certain dynamics in my relationship, rather than assuming that they begin and end with my boyfriend. I became more open to the possibility that my negative reaction to something he does might have more to do with my existing anxieties than his inherent wrongness. (Though, sometimes, yes, he’s dead wrong.) Reckoning with these ideas didn’t make me feel like I was uniquely bad at relationships—after all, I’d just watched several other people do the same.

Another potential benefit of therapy voyeurism, Tuber said, is that these shows could encourage people to seek out a therapist by showing them what treatment actually looks like. (Assuming, of course, that they can get an appointment in the pandemic rush for mental-health support.) While the stigma around therapy has diminished over time, it remains a significant barrier for many people who could benefit from getting help. “If [the psychologist] comes off as thoughtful and multidimensional, it will make it easier for people on the fence to say, ‘This isn’t so scary, I’m going to look into this,’” he said. People who are already in therapy stand to gain something too: They can see how they respond to different approaches, making them more informed consumers and potentially compelling them to find a therapist who better fits what they’re looking for.

Last month, I reached Guralnik over Zoom, and she confirmed that I’m not alone in using Couples Therapy as a lens through which to look at my own life. (Her dog, Nico, an Alaskan Klee Kai and a delightful presence on the show, was asleep on the couch behind her.) “People typically watch the show with other people,” she said. Parents and children, romantic partners, and friends tune in together, and they’ll hit pause throughout to discuss their own relationships. “They’ll say, ‘Oh, he reminds me of you,’ or ‘He reminds me of me,’” Guralnik said. “We didn’t know that was going to happen.”

Guralnik doesn’t see Couples Therapy as a replacement for, well, couples therapy. “Hopefully people are not going to use the show to do that,” she said. But in her view, it can be helpful for the same reason it’s not an adequate substitute: It’s not about you. Just as children’s make-believe games allow them to engage with scenarios that they may encounter later in life, Guralnik sees her show as a space where adults can imagine their own issues played out from a safe remove. This distance frees us up to think more creatively, come up with different solutions, and hold greater compassion for ourselves and others.

But what that means is that therapy voyeurism is just one of many activities that provide us with this kind of productive distance from ourselves. In fact, they’re all around us: Books, movies, games, and even sports can all serve a similar function. In a couples-therapy program she teaches, the Chicago psychotherapist Karen Bloomberg assigns Alain de Botton’s The Course of Love, a novel that tells the story of a long-term romantic relationship and ends each chapter with an analysis of the couple’s dynamic. “It sounds kind of hokey, but it’s very well done,” she told me. She and her husband ended up discussing their own relationship after they’d both read it, and she recommended it to their adult children. As with therapy shows, it provides a new way of seeing your problems: “It’s not you, but it could be you, and it could hold the space until you’re ready to look at yourself in that way,” she said.

None of the psychologists I talked with mentioned any major downsides of consuming therapy shows and podcasts, though it seems possible that some viewers might overextrapolate from them in the same way that WebMD can spur people into thinking their minor problems are actually cancer. But the irony of therapy voyeurism is that its potential benefits may be limited by the genre’s reach. Tuber said he was skeptical that therapy shows would penetrate beyond the relatively narrow slice of the population that is already open to the therapeutic process: In 2019, less than 20 percent of adults had received mental-health treatment in the past year, according to the CDC, and those who did were far more likely to be white and female. “Overwhelmingly, when people are struggling with issues, they talk to a family member, religious figure, or their general practitioner way before they go see a therapist,” Tuber said. (Guralnik said she has heard from viewers all over the world, though Showtime would not provide details on the demographics of the show’s viewership.)

I’d bought into the idea of therapy well before I heard about Couples Therapy, and the show appealed precisely because I already wanted to go deeper into that world. Watching it made me feel good about myself: smarter, because I could clearly see when someone was assigning too much blame to their partner; more benevolent, and maybe a bit saintly, because I learned to empathize with those on the show who struck me as absolute villains at the outset. These lessons, if not the self-aggrandizement, were a good thing, and they were largely possible because of the neutrality and emotional buffer I was afforded as an outside observer. But while that buffer can be useful, it has to come down if you want to truly dig into your own psyche.

Unfortunately, bingeing a show has not fixed all the problems in my life. “We talk a lot about ‘bringing something into the room.’ What that means is really experiencing the vulnerability right there, in the moment, with the therapist,” Bloomberg said. “That’s what doesn’t happen when you’re watching.”