Understanding Psychodynamic Therapy: My Approach Through the Lens of ‘Couples Therapy’ Star Dr. Orna Guralnik

This article is based on psychodynamic principles, with key insights drawn from Dr. Orna Guralnik’s explanation of these concepts[1].

Like many of you, I’ve been captivated by Showtime’s groundbreaking series Couples Therapy, where Dr. Orna Guralnik masterfully demonstrates the profound impact of psychodynamic therapy. As a fellow psychodynamic therapist, I see my own therapeutic approach reflected in her skilled and sensitive work, and I find myself deeply appreciating how the show illuminates this transformative method of therapy.

In my practice, like Dr. Guralnik’s, I work with the understanding that our behaviors and emotional states are shaped by unconscious thoughts and feelings. When I watch her help couples unravel their complex relationships on screen, I see the same process I facilitate in my own therapy room – examining how past experiences influence present interactions. What resonates deeply with me in Dr. Guralnik’s work, and what I strive for in my own practice, is the emphasis on the relational aspects of therapy. As psychodynamic practitioners, we understand that our earliest relationships create patterns that echo throughout our lives.

The psychodynamic approach recognizes several fundamental principles: each person’s psychological makeup is entirely unique, unconscious thoughts and feelings significantly influence our current behavior, our past shapes our present in ways we might not recognize, and human development is a continuous, lifelong process. In my practice, I’ve observed how we’re often unaware of the factors driving our emotions and behaviors. While there are many valuable resources available, including insightful self-help books and caring advice from friends, the unique depth of psychodynamic therapy can help address underlying patterns that may not be accessible through other means[1].

This approach proves particularly effective for those experiencing persistent relationship patterns that leave them feeling stuck, chronic feelings of depression or anxiety, questions about identity and self-understanding, or difficulties stemming from family-of-origin issues. It can also be especially helpful for those dealing with long-standing problems that never quite reach resolution, a sense that they can’t “be themselves” or act spontaneously, or recurring challenges in forming and maintaining satisfying relationships.

Like Dr. Guralnik, I use the therapeutic relationship itself as a tool for understanding and growth. In my practice, our therapeutic relationship becomes a safe space where patterns can be explored and new ways of relating can be discovered. This process often involves what we call “transference” – where feelings about important people in your life surface in our therapeutic relationship[1]. These can include both positive and negative feelings, which provide valuable opportunities to understand your emotional patterns and how they influence your relationships.

While not everyone needs the intensity of multiple sessions per week that traditional psychoanalysis requires, I believe, as demonstrated in Dr. Guralnik’s work, in the value of taking time to develop a comprehensive understanding of oneself and one’s relationships. Through our work together, you might experience what we call “regression” – getting in touch with feelings from early childhood. These experiences are handled carefully and safely, becoming opportunities for growth and new understanding[1].

Like Dr. Guralnik, I bring these traditional psychodynamic concepts into the modern era. In my practice, these time-tested principles apply to contemporary relationships and current social challenges[1]. While these theories may have originated over a century ago, their application remains deeply relevant to today’s relationship struggles.

Whether you’re familiar with Dr. Guralnik’s work on Couples Therapy or are just beginning to explore therapeutic options, psychodynamic therapy offers a path to deeper self-understanding and lasting change. The therapeutic journey, while challenging, can lead to profound and lasting transformation. Together, we can begin to understand not just what you do in relationships, but why you do it – and most importantly, how you can create healthier patterns for the future.

If you’re interested in learning more about psychodynamic therapy and how it might support your journey, I welcome you to reach out for a consultation.

References:

[1] Learn more about psychodynamic therapy from Dr. Orna Guralnik’s explanation of therapy on her official website: https://www.ornaguralnik.com/psychotherapy-psychoanalysis.


Blake Overstreet, LPC, is a licensed professional therapist at Vervewell Counseling in Fort Worth, TX, specializing in therapy for teenagers (13+), young adults, adults, and couples. Blake empowers clients to deepen emotional resilience, cultivate meaningful relationships, foster personal growth, uncover purpose and meaning, and overcome self-imposed barriers. While operating primarily from a psychodynamic perspective, Blake also offers EMDR (Eye Movement Desensitization and Reprocessing) for individuals dealing with post-traumatic stress. He sees clients in person and via telehealth across Texas.

You Might Also Like....

Anxiety and Panic Management (all therapists)

Vervewell therapists work with clients who may be experiencing regular bouts of anxiety. Sometimes anxiety shows up as panic. Learning simpler ideas like deep breathing and visualization are often utilized, as well as more complex modalities like reactive vs responsive, thought driven action, and curated headspace day after day. 

Anxiety represents the psyche’s alarm system responding to perceived threats, both real and Imagined. Rather than simply suppressing symptoms, we’ll explore anxiety as a meaningful communication from parts of yourself demanding attention. You’ll develop sophisticated strategies for self-regulation while investigating the underlying conflicts your anxiety may be expressing. This involves learning to differentiate between realistic concerns requiring action and neurotic anxiety serving defensive purposes. By developing a more nuanced relationship with your anxiety, you transform it from tyrant to teacher, using its energy for growth rather than paralysis.