Giving Infidelity a New Name: How Clinicians Can Best Support Their Clients

Even though the betrayal was deemed a destabilizing and an emotionally debilitating event, some of the participants used the label “traumatic event” or “trauma” to convey their experience, however, very few identified their experience as traumatic stress (Lonergan et al., 2021). When researchers presented psychoeducation from external sources about trauma and PTSD, the participants reported feeling validated and relieved. All in all, intimate partner betrayal is an emotionally devastating event and will take time to heal.

Intimate partner betrayal

Beltrán-Morillas, Valor-Segura, and Expósito (2019) argue that betrayed partners are more likely to form an anxious attachment to the adulter after the infidelity occurs. Furthermore, many individuals believe that infidelity is considered an unforgivable betrayal, given the high expectations for loyalty and commitment that people hold for their partners. However, Beltrán-Morillas et al. (2019) explained not all behaviors outside of the relationship were considered to be unforgivable. For example, participating in an emotional affair was more forgiving from the perspective of the betrayed partner compared to a sexual affair. As a result of intimate partner betrayal, the betrayed partner is often presented with a negative affect and anxious attachment to the adulter.

Of the many betrayals that can happen in a relationship, infidelity is considered the most severe and the most threatening to the stability of the relationship (Beltrán-Morillas et al., 2019). In other words, since many couples share property, expenses, time, and sometimes children, the act of infidelity is unbearable. What’s more, many people operationally define infidelity in four ways: behaviors of sexual nature (vaginal and or anal penetration or oral sex, technological [sending someone sexually explicit and or affectionate messages], emotional affairs, and masturbation (Beltrán-Morillas et al., 2019).

With the use and accessibility to technology, extradyadic behaviors are easy to deny and cover up, however, the emotional suffering of the betrayed partner remains either the same as traditional infidelity or even worse. Furthermore, people have the ability to remove applications from their smartphones, delete conversations, and erase all traces of an affair without difficulty. For some couples, the level of deceit can be more emotionally damaging compared to traditional infidelity.

According to Beltrán-Morillas et al. (2019), unforgiveness is manifested by the offender after the act of betrayal has destabilized the relationship. According to Berry et al. (2005), unforgiveness is experienced by the betrayed partner as a sign of revenge or avoidance of the person who violates the boundaries of the relationship. Furthermore, motivation to avoid has been used to change the narrative of the situation and help the betrayed partner regulate their emotions (Beltrán-Morillas et al., 2019). On the other hand, motivation for revenge is typically carried out when the betrayed partner wants to “get back” at the cheating partner. Additionally, the concepts of avoidance and revenge after intimate partner betrayal results in the betrayed partner no longer trusting the cheating partner and begins to form an anxious attachment.

Gunther (2017) suggests that the betrayed partner could experience symptoms of PTSD. Furthermore, the betrayed partner is emotionally distressed and tortured when the infidelity is made known, which causes symptoms of PTSD. More significantly, some of the symptoms that a betrayed partner could experience, regardless of sexual and gender orientation include: repeated intrusive thoughts, emotional dysregulation, out-of-body experiences, alternating feelings of numbness and retaliation, constantly searching for more data that might cause more distress, feelings of overwhelming powerlessness and brokenness, an urge to regain self-worth by assigning blame, and confusion and disorientation (Gunther, 2017). Also, Gunther (2017) mentions that the trauma of betrayal can trigger memories of unresolved emotional or spiritual damage from the past, which complicates the healing process. In conclusion, intimate partner betrayal is by far the most significant and threatening to a relationship. Once the betrayed partner is made aware of the infidelity, distressing feelings and PTSD symptoms could be expected.

Gunther (2017) explained that there 5 common re-emerging issues that couples experience after a betrayal. First, when people have a history of past trauma, they create defenses to help them survive those traumas. Furthemore, if the betrayed partner experienced a trauma in the past, the betrayed partner will have a stronger reaction to the current partner’s betrayal. Interestingly, the past trauma will mesh with the present trauma making healing much more challenging. Second, the betrayed partner could lose sight of their worth once the infidelity is discovered (Gunther, 2017). Oftentimes, the unfaithful partner may endorse that individual needs were not met in the relationship, which prompted the extradyadic behaviors. This statement often leaves the betrayed partner in more emotional distress. Third, is the strength of the relationship. For instance, if the relationship is wavering and there is a lack of communication between the partners, behaviors outside the relationship are more common (Gunther, 2017). Additionally, some relationships feel better to one partner than the other. In this case, the betrayed partner is more likely to experience intense emotions when the affair emerges and feelings of being blindsided are valid. Fourth, double betrayal intensifies the anguish and heartbreak when the third member of the triangle is a close and trusted family member or friend (Gunther, 2017). Finally, if the affair is new, then the healing process could be easier on the betrayed partner, but only if the couple agrees to work together and re-establish the relationship (Gunther, 2017). On the other hand, if the affair has been long standing or still active, the betrayed partner will have a more difficult time with healing.

Clinical implications

Gulotta (2022) reinforces the idea that intimate partner betrayal is an interpersonal trauma, and is accompanied with several symptoms of PTSD. Although it is not a clear diagnosis in the Diagnostic and Statistical Manual for Mental Disorders (DSM-5; American Psychiatric Association, 2013). Gulotta (2022) also described the lasting effects of infidelity as Post-Infidelity Stress Disorder (PISD). Furthermore, the residual effects of PISD often include self-doubt, trouble trusting others, resistance to form new intimate relationships, nightmares, and social withdrawal. Finally, Gulotta (2022) mentions that anxiety related to PISD is chronic and persistent. The prolonged and chronic anxiety after cheating causes the betrayed partner’s psychological defenses to become overwhelming, causing them the inability to function in a healthy manner.

Clinicians need to consider some of the clinical implications that could arise when working with clients who have been betrayed by their intimate partners. First, it is important for clinicians to validate the emotional experience of their clients, and remember that their clients may be experiencing symptoms of PTSD. Second, as mentioned by Lonergan et al. (2021), providing the client with psychoeducation about trauma symptoms experienced after infidelity helped the client feel validated. Finally, it is important for clinicians to routinely educate their clients about their experiences from a clinical perspective, along with how to better manage their symptoms, so that their clients can live a more healthy life.

Infidelity is also considered complex grief. When a person is grieving, they typically go through five different stages: denial, anger, bargaining, depression, and acceptance (Moore, 2012). It is not uncommon for betrayed partners to vacillate between the different stages during the healing process. For example, someone might bounce from denial to depression to anger and so on. According to Moore (2012), betrayed partners often experience feelings of worthlessness and lowered self-confidence, which are experienced more than someone who is grieving a loss. Of important note, Moore (2012) expresses that death is socially expected whereas infidelity is socially shunned, causing the experience to have a more profound effect on the betrayed partner. There are several treatment approaches that Moore (2012) highlighted to help the betrayed partner cope with the loss of trust in the relationship: client-centered talk therapy, hypnotherapy, eye movement desensitization and reprocessing (EMDR), and 12-step programs were all useful.

In terms of client-centered talk therapy, it is important for the therapist to create a nonjudgmental and safe space for the client to become vulnerable and comfortable discussing the trauma. Some counseling skills that a clinician can utilize include empathetic listening, nonjudgmental stance, mindfulness of facial expressions and body language, and reflection.

The process of hypnotherapy in the healing of intimate partner betrayal helps the betrayed partner reconnect with oneself (Moore, 2012). Furthermore, hypnotherapy can help the client meet parts of oneself that were hurting prior to the infidelity, and heal the parts that are occurring now (Moore, 2012). Lastly, Moore (2012) explains that taking a client into a deep and relaxed state, in which the client can bring in peaceful parts of oneself can have a prolonged effect on the parts that are hurting, and helps the client rebuild strength and self-esteem.

Eye Movement and Desensitization and Reprocessing (EMDR) is used to help a client digest and process the intense emotions that the betrayed partner experiences following a betrayal (Moore, 2012). Moreover, the everyday challenge of just getting through the day can be difficult for the betrayed partner because of the distressing emotions and intrusive thoughts that occur. Finally, Moore (2012) suggests that EMDR may help speed up the healing process.

Moore (2012) encourages clients to join a 12-step meeting, such as S Anon, in order to join a community of people who are experiencing similarities of intimate partner betrayal. Furthermore, informing clients that S Anon is an alternative option in conjunction with individual therapy can be useful in the healing process.

Although there is not a specific modality that treats intimate partner betrayal, parts of trauma-focused cognitive behavior therapy (TF-CBT; Medical University of South Carolina, 2017) may assist the client in the healing process: psychoeducation, relaxation skills, writing a trauma narrative, and processing the event.

The first aspect of TF-CBT is psychoeducation. Therapists may want to provide psychoeducation to their client in order to help normalize their thoughts and emotions about the traumatic experience. In fact, talking about the traumatic event can help lessen the client’s anxiety, especially when the therapist is affirming and validating. It is valid for the betrayed partner to want to suppress their feelings about the situation, however, it is effective to name and discuss the client’s feelings, thoughts, and experiences. Finally, these are the beginning steps of trauma-focused cognitive behavioral therapy.

Another aspect of TF-CBT is teaching the client some relaxation skills. After experiencing intimate partner betrayal, the betrayed partner may experience symptoms of PTSD, as research has shown, leaving the betrayed partner constantly feeling overwhelmed and anxious. Relaxation skills are attainable and effective for regulating the client’s physiological responses. For instance, approaches such as deep breathing and progressive muscle relaxation are helpful tools to help ease tension that the client may experience in their body (Medical University of South Carolina, 2017). Furthermore, the clinician will demonstrate the skill and monitor the client to make sure that the skill is used correctly. Once the client has demonstrated mastery over the skill, they can effectively use it during moments of distress. Other skills that could be helpful for the betrayed partner, include listening to music, meditation, and the use of imagery (Medical University of South Carolina, 2017). Lastly, a clinician may assign the client homework to practice relaxation skills until the next session.

The other aspect of TF-CBT to help the betrayed partner heal from infidelity is writing a trauma narrative (Medical University of South Carolina, 2017). A trauma narrative can look differently based on the client’s preference: a book, a song, a picture, etc . The objective of creating a trauma narrative is to facilitate the client’s description of the trauma and also incorporate his or her thoughts and feelings (Medical University of South Carolina, 2017). Second, the client will be instructed to complete a table of contents at the beginning of the narrative. Creating a table of contents helps organize the information that will be presented: a section about the client, a section about the client’s intimate relationship, a section that describes the trauma, and the client’s reactions, and the final chapter will be future-oriented. Importantly, the client can complete the chapters out-of-order, if desired. Furthermore, the clinician can guide the client through the narrative content by asking open-ended questions to help the client write content. From the perspective of the therapist, it is important to listen to the client’s content and make sure that there are not any gaps in the narrative and listen to blame statements. Additionally, creating a trauma narrative and encouraging the client to read the content out loud allows for gradual exposure. Also, the therapist will need to look out for signs of distress when the client is sharing their narrative. Moreover, the client is encouraged to discuss the worst part of the trauma in as much detail as possible. The end of the narrative should be future-oriented and help the client focus on moving on from the trauma. Finally, the therapist will praise the client for creating the narrative and validate any distressing moments.

The final approach is processing the trauma. During this phase, the therapist and client will have a collaborative discussion about the trauma and symptoms that the client is experiencing (Medical University of South Carolina, 2017). Furthermore, during the process phase, the client will be able to talk about the trauma in a healthier way with coping skills to help reduce anxiety. Finally, the client may recognize cognitive distortions that are spoken and reframe them in a nonjudgmental way.

Overall, trauma-focused cognitive behavioral therapy is a multi-step clinical approach to help clients be able to manage distressing emotions around their trauma and be able to effectively heal. The role of the therapist is to be affirming, validating, warm, and use the therapeutic relationship to help the client feel safe in communicating distress. Also, creating and processing the trauma narrative is the bulk of the therapy. Although there is no standard modality for treating betrayed partners after infidelity, aspects of TF-CBT can be effective for the healing process.

Cultural considerations

Of important note, Beltrán-Morillas et al., (2019) suggest that clinicians consider cultural norms when counseling clients who have experienced extradyadic behaviors in their relationship. For instance, in Western cultures the concept of infidelity is unacceptable,  whereas in Eastern cultures, specifically in Thailand, sex has been commericalized and acceptance of extradydaic sex has increased (Beltrán-Morillas et al., 2019).

Scelza (2022) conducted a cross-cultural study on the perception of infidelity among different cultures and surveyed 1,048 men and women from 11 societies across five continents. Interestingly, the study showed that men were particularly more upset than women by sexual infidelity. Additionally, Scelza (2022) indicated that cultural factors dictate the way that extradyadic behaviors are viewed. Moreover, Scelza (2022) conceptualized the idea of jealousy in intimate relationships across cultures. The study revealed that cultures that are accepting of “concurrent” sexual relationships provided more muted responses to questions regarding jealousy. More importantly, the data collected were from both small-scaled societies and major metropolitan areas, such as Los Angeles and Okinawa. Moreover, the study also showed that the majority of the populations studied believed that sexual infidelity was more upsetting than emotional infidelity. On the other hand, the data collected from Western cultures (such as the population sample coming from Los Angeles and Okinawa) indicated that participants believed that an emotional affair was more hurtful compared to a sexual affair (Scelza, 2022). Lastly, Scelza (2022) studied the cross-cultural attitudes between infidelity and jealousy across cultural contexts to provide more inclusion of information rather than solely focusing on Western culture.

In conclusion, intimate partner betrayal by sexual infidelity causes the most strain and threat in a relationship. Most importantly, the betrayed partner may begin experiencing signs and symptoms of PTSD once the infidelity has been exposed. Across cultures, various groups have different perceptions in terms of extradyadic behaviors. For instance, in Western culture, infidelity is shunned, whereas in Eastern culture there is more acceptance. Although there is no specific treatment modality to help the betrayed partner, aspects of TF-CBT along with hypnotherapy, EMDR, and 12-step groups have been useful in treating the residual effects of trauma.

Clinicians need to consider some of the clinical implications that could arise when working with clients who have been betrayed by their intimate partners.