We're on the Air: A Psychosocial Podcast

MEDIA ON THE MIND

Dr LaGrotta is an addiction psychiatry fellow at Mount Sinai St. Luke’s-West in New York City. Dr Aftab is a geriatric psychiatry fellow at University of California San Diego in La Jolla, CA. He is also a member of the Psychiatric Times Advisory Board.

“How important is sexuality in a relationship? If sex is good, it actually accounts for a rather small part of the couple’s satisfaction, but if sex is a problem it accounts for a huge part of the couple’s dissatisfaction.” The Belgian celebrity therapist and author Esther Perel, MA, LMFT, opens the eighth episode of her podcast Where Should We Begin?¹ by trying to answer this question.

In her two bestselling books, Mating in Captivity: Unlocking Erotic Intelligence² and The State of Affairs: Rethinking Infidelity,³ Ms Perel has respectively explored the interplay between intimacy and sexual desire and the complex psychology behind infidelity, establishing her expertise in these areas as well as her widespread popularity. Her 2015 TED Talk, Rethinking Infidelity, has been viewed more than 11 million times.⁴

In Where Should We Begin?,¹ now in its third season, Ms Perel demonstrates her immense psychological wisdom in therapeutic conversations with real-world couples.

Each episode is a one-time, unscripted, real therapy session with an anonymous couple who has agreed to be a part of the podcast. The actual sessions are three hours long which have been reduced to about 45 minutes for each individual episode. The couples in podcast confront a wide array of relationship difficulties: infidelity, sexual addiction, impotence, diminishing romanticism between best friends, sexlessness, traumatic pasts, and infertility. In almost all instances, the couples are struggling to communicate, to grasp the pain of their partners, and to convey their own hurt.

The conversations in the podcast are intimate and raw, and the window offered by Perel into the private life of couples can feel almost voyeuristic. Each episode forces the listener to immerse herself into the torments and emotional agonies of strangers but ultimately these are universal human maladies-experienced by almost everyone at one point or another, but rarely spoken of candidly outside the confines of private life or fiction.

Our relationships are burdened by many myths: Society tells us that if a relationship is good, then good sex will come naturally. We don’t need to work at it. If one is working too hard in a relationship, the relationship isn't the right fit. It is shameful to stay in a relationship with a partner who has cheated. Perel spends episode after episode, session after session, destroying such notions. She has little patience for moral exhortations or talk of good and evil. People are often both right and wrong; a victim in one aspect can be an aggressor from another. Her sheer honestly, therapeutic bluntness, and ability to connect with her clients shines through in every interaction that she has with them.

The podcast serves to showcase Perel's skill as a therapist-and a venue for the public to understand the value of therapy. Right from the beginning, Perel makes interpretations that are so accurate, the couple is often left stunned. Her questions are often so emotionally illuminating that they are met with immediate tearfulness, as “patients” realize something about their predicament that has eluded them their whole lives.

Her ability to translate for couples is spectacular: either quite literally translating languages (in one episode, she encourages a bilingual husband to speak in French as she translates for the English-speaking wife, offering the couple a new perspective on their relationship), or more commonly translating amongst couples’ opposing love languages.

It is remarkable to hear her take an individual's story and present it in a way that is valuable for the couple, not just the individual. For example, when discussing the shame that one of her clients held in regard to his own past, she informs the listeners, “I could have an entire individual session with him . . .  but I also know that they came as a couple and part of what needs to happen . . . is for him to step out of himself and to be able to reach out to her.”

Each story is important, but the way in which the individual stories interrelate is the focus of Perel's work. She focuses on the narrative that the couples have gotten stuck in, and she tries to nudge them towards a different way of looking at their relationship. “People come in with a story. I want them to leave with a different story, because a different story is what breeds hope. It’s what gives them a sense of possibility.”

Occasionally throughout the back-and-forth dialogue, the podcast will step away from the session and let the listener inside Perel's head. She shares her thoughts and elaborates on her techniques used in the session at hand. In the ninth episode of the first season titled “Trauma Doesn't Like to be Touched,” a man is describing a previous trauma and the lasting effects it has on his current romantic relationship. Perel steps away from the session and lets us in on her thoughts, informing the listener: “One of the many ways to begin to understand trauma is that it is an overwhelming experience that often induces terror and helplessness . . . When it comes to trauma, the body keeps the score. While he thinks it’s his mind, when he recoils it’s the body that recoils . . . and it freezes and closes off in order to protect.”

It would be a glaring omission not to point out the tremendous educational value of this podcast for psychiatry and psychology trainees. Exposure to couples therapy is a component of psychiatry residency training, and adept educators can utilize this podcast in creative ways to illustrate the practice of couples therapy.

Whether you are a mental health professional, an individual struggling in romantic relationship, or just a curious listener, this podcast will surely not disappoint.

Disclosures:

The authors report no conflicts of interest concerning the subject matter of this article.

References:

1. Perel E. Where Should We Begin. https://www.estherperel.com/podcast. Accessed November 1, 2018.

2. Perel E. Mating in Captivity: Unlocking Erotic Intelligence. New York: Harper Collins; 2016. https://www.harpercollins.com/9780060753641/mating-in-captivity. Accessed November 1, 2018.

3. Perel E. The State of Affairs: Rethinking Infidelity. New York: Harper Collins; 2017. https://www.harpercollins.com/9780062322586/the-state-of-affairs. Accessed November 1, 2018.

4. Perel E. Rethinking infidelity . . . a talk for anyone who has ever loved. Ted2015. March 2015. https://www.ted.com/talks/esther_perel_rethinking_infidelity_a_talk_for_anyone_who_has_ever_loved?language=en. Accessed November 1, 2018.