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Welcome back to Worth the Chat!

Over the weekend, one of my favorite shows returned for a fifth season: Couples Therapy. It’s one of my rare 5-star picks, as I’m pretty stingy with them. Five-star territory for me is anything I can't shake or would boldly recommend to anyone. This is one of them.

When you think about televised therapy, your mind probably goes to one of the delicious trainwrecks of the early to mid-aughts, like Marriage Boot Camp, where ex-reality stars were humiliated for a check; or when Dr. Drew would be more messy boots than moderator on the 16 & Pregnant reunions; and, of course, the sick day marathons of Jerry Springer and Maury that raised a generation of millennials now obsessed with reality TV. 

Couples Therapy—now in its fifth season on Paramount+ with Showtime—is what happens when someone takes the premise of televised therapy seriously. Like, genuinely, uncomfortably, beautifully seriously. And in a landscape where every reality show is designed for entertainment at any cost, and cast members use their episodes as thinly veiled influencer auditions, this show feels like a high-brow art form.

Credit: Showtime

The whole series hinges on Dr. Orna Guralnik, a clinical psychologist and psychoanalyst practicing in New York City. She's on the faculty at NYU's Postdoctoral Program in Psychoanalysis and sits on the editorial boards of two academic journals. Plus, she’s cool as hell. Charli xcx has called her “the sexiest woman alive”; she won the Style Icon award at the 2025 Las Culturistas Culture Awards (the only awards show worth watching IYKYK); and she’s been a returning guest on Call Her Daddy.

Why it works:

The show was created by documentary filmmakers Josh Kriegman, Elyse Steinberg, and Eli B. Despres, who were inspired by the surprising twist their previous project took. While filming their fly-on-the-wall documentary following Anthony Weiner's 2013 mayoral run, they watched (and filmed) Weiner’s marriage implode after multiple infidelity scandals broke. Seeing that kind of unguarded vulnerability on camera sparked the idea for something bigger, and Couples Therapy was born.

In case you haven’t seen the show, every season follows three to four diverse couples over twenty weeks of real sessions, edited down into nine episodes. The couples are wonderfully diverse, representing different relationship structures, cultural backgrounds, sexual orientations, and experiencing different types of crises. These are not people auditioning for a brand deal—they are actual people in actual relationships, each hoping to help themselves and those watching.

So how does something so vulnerable and revealing not end up as exploitative trash TV? First, the couples don't interact with production, and cameras are concealed behind a one-way mirror. Within a few minutes of sitting across from Dr. Orna, most forget they're being filmed at all. Second, the couples undergo an extensive screening process to weed out anyone who could be harmed by the pressure and anxiety of the show. Third, Dr. Orna seeks counsel from her peers and mentors to help her navigate particularly complex dynamics and blind spots—a core part of the show seen throughout each season.

The couples:

Couples seemingly leave the show with a stronger sense of clarity than they entered with, whether that be a separation, a new beginning, or simply a better understanding of themselves and their partner. The presenting problem is almost never the actual problem, and the thing a couple walks in fighting about—the dishes, the distance, the affairs, the resentment that has quietly calcified over years—is almost always a surface symptom of something that started long before they ever met each other: childhood wounds and patterns reinforced over a lifetime.

But make no mistake, the tea is piping hot, and if you're the kind of person who eavesdrops on first dates at restaurants or considers a shared glass of wine and a good gossip sesh a form of self-care, you will love this show.

Credit: Showtime

Season 1's Annie and Mau are glamorous, turbulent, and maddeningly polarizing. Watching Dr. Orna put a narcissist in his place was one of the most satisfying things I've ever seen on TV. Season 3 gave us India and Dale, whose new-baby stress opened into a much bigger conversation about how racism and the weight of navigating a world that is working against you can seep into a marriage. That season also gave us Molly and Josh, whose story involving infidelity, abortion, and drug abuse had my jaw on the floor. Season 4 featured the show's first polyamorous throuple working through jealousy in a relationship structure most couples counseling isn’t equipped for.

The latest season is as timely as the show has ever been. Marjorie and Jason have been married for over a decade, but the political climate and their polarizing views have turned their living room into a war zone. There's another couple whose situation I'll let you discover on your own; just know it involves a professional cuddler.

Worth chatting about:

Fair warning: Bingeing in one sitting will feel like you just emerged from your own therapy retreat. Dr. Orna will dismantle someone with the most compassionate, blink-and-you'll-miss-it precision you've ever witnessed—with her dog Nico by her side—and it’ll change your life.

This is one to share with the friend who comes to you seeking relationship advice above your pay grade or to be sent as a not-so-subtle recommendation to your own partner. And for anyone too intimidated to start therapy themselves, you may just start your own self-improvement journey after watching; don’t say I didn’t warn you.

Season 5 is the perfect entry point, and all nine episodes are available now. But if you want the full picture, start with Season 1. Annie and Mau alone are worth the discourse.

Is there a hidden gem you’re obsessed with that I should be watching?
Reply and let me know!

Meredith is the Managing Editor at Pix Media and has been covering TV, movies, podcasts, and books for 8 years. Raised on VH1's I Love the... series, E! True Hollywood Stories, and The Real Housewives, Meredith has been fluent in pop culture since infancy. She religiously watches every Bravo show, lives for HBO Sunday nights, goes deep on reality-scandal discourse, and has a TBR that is physically taking over her apartment.

Currently watching: Summer House and Off Campus