Marie Nussbaum

Couple Therapy: Between Love, Attachment, and Repair

Exploring wounds, expectations, and silences

Couple therapy is not about “saving” a relationship at all costs, but about offering a space where partners can explore what is unfolding between them: wounds, expectations, repetitions, silences. It allows for the articulation of what often operates beneath the surface—unspoken loyalties, fears of abandonment, value conflicts, or diverging desires.

International figures and clinical approaches

In New York, psychoanalyst Orna Guralnik, known for her role in the documentary series Couples Therapy on Showtime, embodies an approach that is both rigorous and deeply human. In her sessions, she invites couples to slow down, to listen, to confront their own contradictions. She shows that conflict is not failure, but an entry point into deeper understanding of self and other. Her work highlights how the past shapes the present in love: trauma, family legacies, cultural identities. She emphasizes the need for a secure frame where vulnerability can be risked without being overwhelmed.

Esther Perel, another internationally renowned figure, explores the paradoxes of desire and intimacy in couples. In Mating in Captivity, she shows how couples often struggle between safety and freedom, fusion and autonomy. She insists that “the couple is not a fixed entity, but a living space, crossed by opposing forces.” For her, therapy is a place to reinvent connection, breathe new life into the relationship, or simply understand what is unfolding.

French perspectives: love and attachment

In France, Boris Cyrulnik offers a different lens on affective dynamics. In When We Fall in Love, We Rise Attached, he clearly distinguishes love—often sudden and linked to infatuation—from attachment, which is woven over time. “Love activates the reward system: dopamine, serotonin, endorphins. Attachment relies on the limbic system, the one of memory and safety.” Cyrulnik reminds us that attachment should not become numbing—it should allow for exploration, separation without fear, and confident return.

Serge Tisseron, psychiatrist and PhD in psychology, adds a crucial dimension: that of symbolization and mental imagery. He has worked extensively on family secrets, the effects of unspoken truths, and our relationship to technology. In his writings on intimacy and extimacy, he shows how couples can become trapped in fixed representations of each other or in unexamined projections. For Tisseron, couple therapy is a space to deconstruct implicit scripts, update unrealistic expectations, and reinvent the bond.

Clinical situations and transformations

In clinical practice, situations are often complex, nuanced, and deeply human. Eddi and Jade, for example, come to therapy after ten years together. They say they no longer know how to communicate, feel exhausted, and have not connected since the birth of their baby. Beneath the reproaches and silences lie issues of recognition, role distribution, and loneliness in parenthood. Therapy here allows for naming feelings, restoring listening, and sometimes giving the couple space beyond parenting.

Fanny and Jérôme arrive with a quiet tension: they don’t fight, but they no longer really talk. They live side by side in a form of emotional politeness. Therapy allows them to explore what has become frozen: unspoken expectations, old wounds, silent renunciations. It opens a space where each can say what they never dared express—not to accuse, but to understand.

Jean and Marie come to sessions after a violent crisis. They say they no longer recognize each other, can no longer stand each other. But behind the shouting lies fear of losing the other, separation anxiety, confusion between love and control. Therapy offers them a place to differentiate emotions, to think through issues of power, dependency, and desire.

Ania and Igor, recently married, cannot agree on buying an apartment or having a child. This initial complaint reveals deeper divergences: relationship to money, career, parental models, projections about the future. Therapy here helps decode underlying issues, create dialogue between representations, and learn to know the other—and oneself—within the marital bond.

Space of transformation and truth

Couple therapy promises neither reconciliation nor separation. It is not the therapist’s role to decide the outcome. But it offers a space of truth, kindness, listening, transformation, and sometimes repair. It allows movement from “I love you” to “I see you,” from “you don’t understand me” to “here’s what I feel.” It invites thinking together, dreaming together, or separating with dignity. It weaves connection, meaning, and sometimes a new way of being together—or of no longer suffering as a pair.

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