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Dr. Orna Guralnik is the therapist, as seen in Season 4 of "Couples Therapy." (Paramount+ with Showtime)
Dr. Orna Guralnik is the therapist, as seen in Season 4 of “Couples Therapy.” (Paramount+ with Showtime)

The least cynical reality show on television, Showtime’s “Couples Therapy” is absorbing as ever in Season 4 thanks to the probing questions and insights from the show’s resident therapist, Dr. Orna Guralnik.

Participants this time out may be upending relationship norms on the surface — there’s a throuple! — but even so, they are working through universal struggles, conflicts and vulnerabilities.

Everything feels so charged. And yet the show has such a soothing effect because it’s predicated on the idea that conflict can happen in a safe and managed environment. That human behavior (and misery) isn’t mysterious or unchangeable. There’s something so optimistic in that outlook. “We’re all in the grip of some kind of prism through which we see reality,” Guralnik says in voiceover as we see glimpses of her clients go about their daily lives. “Often couples, when they’re busy fighting with each other, are reenacting things that happened to them in the past. Their trauma is holding them hostage to a very particular way of interpreting reality.”

But there are other ways to see the world — or the dynamic one has with a partner — she says. And once people embrace that, they can break free of those old patterns “and suddenly the world kind of opens.”

Whether or not you relate to the people featured on “Couples Therapy” — or even like them as individuals — doesn’t matter as much as Guralnik’s reassuring presence. She’s kind and quietly attentive, but fully in control of these sessions. She has a soft timbre to her voice, but she will firmly push back when the moment warrants it.

From left: Elíana and Mitch are featured in Season 4 of "Couples Therapy." (Paramount+ with Showtime)
From left: Elíana and Mitch are featured in Season 4 of “Couples Therapy.” (Paramount+ with Showtime)

The season follows the travails of three couples and one throuple. One couple are the children of immigrants and their troubles involve her hateful mother and a nonexistent sex life. Another couple is, years later, still reeling from childhood traumas that creep into their relationship. Another couple is trying to navigate a tension borne from mutual frustration that plays out in conflicts about domestic chores. In the throuple, two women are in a relationship with the same man, but not in a relationship with one another — and in fact, the women see other people as well. They are polyamorous, but this particular threesome has been causing them enough angst (about whose needs and feelings are prioritized) to bring them here.

The various participants are deeply human but also cringe-worthy. You think: I would not want to be in a relationship with any of these people! But Guralnik isn’t there to judge.

Sometimes she helps people figure out what they’re really feeling. Psychoanalysis, she says, “is the idea that we are motivated by unconscious forces. We know that what people are saying is only part of what is going on. Analysts listen for unconscious material and how the past might be hijacking their experience right now.”

In one session, a client feels it’s important to talk about who started a fight.

Guralnik: “I think that’s one way to possibly go. From my experience, it doesn’t really work — and it doesn’t matter who started it.”

Client: “Hmm. I just feel like it does matter who started it.”

Guralnik: “It matters if you’re in court. It doesn’t matter if you just want to make things better.” Orna!

Sometimes she asks about their childhood because “what happens to us early in life establishes a certain kind of blueprint as to how the rest of life is going to get experienced,” she says. “We’re born in a state of complete vulnerability and dependence and we take in for the first time social order, hierarchies, what is forbidden, what is allowed. All of that, really, starts in the family.”

From left: Josh, Lorena and Aryn are featured in Season 4 of "Couples Therapy." (Paramount+ with Showtime)
From left: Josh, Lorena and Aryn are featured in Season 4 of “Couples Therapy.” (Paramount+ with Showtime)

One client this season is dealing with repression. Another with dissociation. These create additional complications in their relationships. Emotionally or physically abusive childhoods can have long-term effects on adult intimacy, but Guralnik tries to help her clients embrace the idea that those old coping mechanisms can be abandoned if they don’t work for them anymore.

Each session takes place on a set carefully designed to look like a lived-in office space, with stylish but unobtrusive mid-century furniture and grasscloth wallpaper. Her dog Nico is curled up quietly in the corner. The couch is blue-gray with terracotta-colored throw pillows, and behind it is a credenza stained a golden oak. The coffee table has books and knicknacks. The lighting is soft and seems natural, as if an unseen window is providing illumination.

The overall effect is cozy and the dreamy soundtrack only accentuates that feeling. The doctor is in.

“Couples Therapy” — 4 stars (out of 4)

Where to watch: Two episodes air back-to-back 9 p.m. Sundays on Showtime (streaming on Paramount+)

Nina Metz is a Tribune critic.