The Cost of Chronic Infidelity on Spouses and Partners: Understanding Betrayal Trauma


On a Sunday morning, the bright light of my husband’s cell phone woke me up. It was unusual for him to have his cell phone in bed. When he got up, I looked at the phone. Through viewing information on his two cell phones, I discovered that my husband was in the grips of an addiction to online pornography. I was in shock. I was traumatized, and my soul was crushed that day. I truly was paralyzed with fear and grief. I felt like my life as I knew it had been one big lie. And, I didn’t know what I didn’t know. Once my husband connected with a CSAT therapist, it was suggested that I needed to see a counselor as well. Embarrassed by his behavior and what it meant about me, I made an appointment with a therapist several towns away from where I lived so that I wouldn’t run into anyone that would know me. The first and only visit to this therapist actually added to my pain and shame. When [the male therapist] said, ‘What’s the problem? All men masturbate to porn,” I felt like I had just fallen further down the rabbit hole into a darker abyss. — Martha, wise partner

Most betrayed partners are too ashamed to tell anyone about their horrifying discovery—even a therapist. They feel stupid for not knowing that their beloved was cheating and lying right under their nose for years (Wilkie, 2020.) They blame themselves for their betrayer’s cheating. Infidelity confirms what many women believe—their worth is based on their weight, physical beauty, and desirability (Scott, 2021).

Martha took a brave step, only to be humiliated, shamed, and traumatized. The therapist’s lack of compassion is appalling and reflects a gender bias toward normalizing her betrayer’s deceptive behavior while implying that she was a sexually repressed and angry prude. Unfortunately, this experience is too common for betrayed partners regardless of the therapists’ gender.

As a young therapist, I remember a couple I will refer to as Scott and Suzanne. They sought help for communication issues which they believed were at the root of Scott’s habit of flirting with women when they went out together. Each outing invariably ended with Suzanne walking out in tears. Scott would have sex in the parking lot and come home racked with guilt. I assessed Scott for underlying issues, including childhood abuse, alcoholism, obsessive compulsive disorder (OCD), and attention deficit hyperactivity disorder (ADHD). I wondered if Suzanne had been raised in an abusive home where she had no voice, and now had trouble bringing up complex issues. Had Suzanne been sexually abused? Was Scott harboring resentment that he expressed passive-aggressively? Was Scott hoping for an open marriage or a menage-a-trois? I saw no evidence of pathology in Scott.

I presented the case to my supervision group. We unanimously agreed that the problem was with Suzanne. She reported that she was sexually abused by her grandfather as a young child. We believed she was triggered by sexual intimacy with her husband. We assumed an undercurrent of shame, avoidance, and rejection issues in the marital system. Armed with our collective insight, I presented my assessment to the couple, and we agreed that the likely culprit was Suzanne’s unresolved trauma. As a result, I discontinued couple therapy. Suzanne and I began to work on her trauma. Therapy ended prematurely because Suzanne felt blamed for Scott’s infidelity.

I began working in an outpatient sex addiction treatment practice several years later. The three years of extensive training and work with couples suffering from the horrific consequences of sex addiction were illuminating. The problem wasn’t Suzanne. The problem was that Scott was struggling with sex addiction. Scott was a charming and kind man who loved his wife and couldn’t understand why he cheated on her. In the light of day, he was embarrassed by his behavior. He couldn’t understand why he would behave so egregiously and shamelessly—let alone in front of his wife, whom he loved deeply. However, his realization did not stop him from cheating again and again.

I often think about this young couple I worked with 34 years ago and the long-term impact of what I, a marriage and family therapist, didn’t know to assess for back then and how that affected the coupleship. I wish I could say that Scott and Suzanne were the only couple who sought an MFT’s “expert” help to heal infidelity, only to have the therapist inadvertently victimize the victim, vindicating the perpetrator.

By the time couples come into the MFT’s office, they have been in crisis since the discovery of infidelity. Steeped in shame, the betrayer emotionally shuts down. The betrayed partner is in a state of hyperarousal, distressed, embarrassed, confused by their discovery, and terrified about what they don’t yet know. Their partner is suddenly a stranger who is capable of anything. Uneducated about sex addiction, clinicians often focus on treating the betrayed partner’s acute symptoms as the primary concern without understanding the unique injury of betrayal trauma. As a result, betrayed partners are often diagnosed with borderline personality disorder, while the betrayer is a victim seeking refuge in an affair. In an attempt to avoid accountability, betrayers gaslight their spouse and the therapist, presenting as rational and pointing the finger at their angry partner, claiming they are the problem. As a result, the unseasoned therapist doesn’t know the right questions to assess for chronic and compulsive sexual acting out, and betrayers don’t admit to any behavior that hasn’t been discovered.The following discussion challenges our biases and assumptions as systemic therapists therapists regarding sexuality in committed relationships and how chronic and compulsive sexual behavior affects the betrayed partner.

Sex addiction or bad behavior?

In 2018, The World Health Organization classified compulsive sexual behavior disorder in the ICD-11 as a mental health disorder defined by a persistent pattern of failure to control intense, repetitive sexual impulses or urges resulting in repetitive sexual behavior (Kraus et al., 2018). Commonly referred to as sex addiction, it is a complex, attachment-based disorder rooted in early childhood trauma (McMahon, 2018). It often begins with using masturbation to self-soothe, which can become the solution to all problems, eventually compulsive, and interferes with healthy emotional, social, and sexual development (Weiss, 2012). 

Betrayal trauma

Unlike other addictions, sex addiction is essentially undetectable. In long-term relationships, it masquerades as overworking to climb the corporate ladder, needing time alone to de-stress, a habit of withdrawal, and, often, erectile dysfunction. The unsuspecting partner forgoes their own intimacy needs, offering empathy to their stressed-out spouse. Partners are used to raising the kids, taking care of the home, working, turning to friends for emotional support, and lowering their expectations for intimacy and affection, telling themselves that their husband is a good father who loves his kids, works hard, and that everything else is good in their lives. They think, so what if they haven’t kissed, had sex, or foreplay for a few years. Long-term infidelity fractures the foundation of relational attachment.

Betrayal trauma and PTSD

Long-standing deception and infidelity over the course of a relationship involve a pattern of covert harm that undermines self-esteem, trust, and security. Gaslighting compromises the victim’s sense of reality over time. Sex addiction-induced trauma results in complex post-traumatic stress disorder.

Treating betrayed partners

MFTs trained to treat the myriad of issues specific to long-term, habitual infidelity and complex PTSD are best able to guide partners through the first three months following discovery—a period of unending crisis. After that, lies are confronted, and the full extent of deception is realized. Their shock remains acute. The next step is full therapeutic disclosure. To mitigate therapist-induced trauma, it is best facilitated by certified sex addiction therapists and certified partner specialists. Full disclosure is recommended within six months of beginning treatment (Adams, 2016). After formal disclosure, partners feel like their marriage was dismembered, murdered, and left to bleed out as they were expected to support their betrayer’s recovery, along with making dinner and helping the kids with their homework.

Profound shock

Victims struggle to make sense of their lived reality; what was real? If they seamlessly hid decades-long secret behavior, what else is their partner capable of

Information-seeking obsession

Whereas repression of the traumatizing incident is common in trauma victims, betrayal trauma victims can’t stop thinking about their trauma. The discovery of the infidelity unleashes a tidal wave of fear, driving an insatiable need to know everything—what they did, whom they did it with, what they said, what they were thinking, where they acted out, when they did it, and how they got away with it. It becomes a black hole of obsession that increases mistrust and unsafety with an overlay of impending doom. It doesn’t help that betrayers are often dishonest, minimize the extent of their behavior, and shut down when confronted with questions.

Life review

The sudden discovery and trauma-based obsession force the hurt partner to review memories of the betrayer, seeking evidence and questioning the authenticity of meaningful moments. Their past is contaminated, and their future destroyed, leaving them in an untethered state of nothingness; nowhere.

Crisis tools

Interventions that help ground betrayed partners in the office include:

  • Putting their palms together and rubbing briskly or rubbing palms briskly on thighs
  • Ask them to start naming circles they see around them
  • Vagal breaths
  • Validate their reality
  • Educate about trauma symptoms and what to expect
  • Recommend books specific to betrayal trauma
  • Discourage seeking information on the internet as it may increase hopelessness

The marital system

As systems thinkers, MFTs are uniquely qualified to treat infidelity. MFTs understand the multi-dimensional impact of secrets on the family, including loyalty binds, parentification, enmeshment, and emotional abandonment. Further, MFTs are equipped to help couples restore trust and return to healthy emotional and sexual intimacy. Marital healing requires the clinician to maintain a multi-partial stance even when the “playing field” is not level.

Assessing for compulsive sexual behavior

When working with a couple seeking help for affair recovery, assess for chronic infidelity by asking about the habitual use of:

  • pornography and masturbation; including frequency, time spent, and job or relationship consequences
  • strip clubs, including lap dances
  • sex workers and escorts
  • hookups
  • profiles on dating websites
  • emotional affairs
  • sexting, webcams, chat rooms

As betrayed partners move through the crisis, they must face their reality and begin to make meaning out of their suffering. Trained to work with individuals in the context of their relational system, MFTs understand that individual trauma healing precedes couple therapy. Healing the trauma of betrayal involves beginning a courageous journey inward. They come to realize that deep love, hurt, mistrust, and anger can all exist together. Their work includes reclaiming memories, forgiving themselves for what they didn’t or couldn’t face, and working through the abuse perpetrated by their beloved. Telling their story with dignity and self-respect invites space for the possibility of building a relationship on a solid foundation—if they so choose.


Compulsive sexual behavior is prevalent and is a threat to healthy relationships. The statistics are staggering; every second, 28,258 users view pornography on the internet, $3,075.64 is being spent, and 372 people are typing the word “adult” into a search engine (Pierce, 2011). It is estimated that up to 30 million Americans struggle with compulsive sexual behavior, the majority of them married (Dryden-Edwards, 2020).

A call to action

On average, children are exposed to pornography by nine years of age (Bentley, 2016). Young adults are increasingly at risk. Sex addiction is changing the landscape of American families. Graduate programs must include compulsive sexual behavior in their courses of study. MFTs require training to identify the subtle signs of sexual compulsion in their practice and provide appropriate treatment.

I wish I could say that Scott and Suzanne were the only couple who sought an MFT’s “expert” help to heal infidelity, only to have the therapist inadvertently victimize the victim, vindicating the perpetrator.

Michele F. Saffier, MA, is an AAMFT Professional Member holding the Clinical Fellow designation and is co-author of Betrayal Trauma: The Survival Guide for Betrayed Partners on their Heroes’ Journey to Healthy Intimacy. She is a Certified Sex Addiction Therapist, Betrayal Trauma Specialist and co-founder of The Center for Healing Self and Relationships, an outpatient treatment program that specializes in the treatment of compulsive sexual behavior and betrayal trauma. Saffier maintains a private practice in Blue Bell, PA.


Bentley, L. (2016). Gender and childhood pornography exposure: New research reveals surprises. Defend Young Minds.

Dryden-Edwards, R. (2020). Sexual addiction. Retrieved from

Hilton, D. J, & Carnes, S., & Love, T. (2016). Neurobiology of behavioral addictions, Oxford Press, 176-190.

Kraus, S. W., Krueger, R. B., Briken, P., First, M. B., Stein, D. J., Kaplan, M. S., Voon, V., Abdo, C., Grant, J. E., Atalla, E., & Reed, G. M. (2018). Compulsive sexual behaviour disorder in the ICD-11. World Psychiatry: Official Journal of the World Psychiatric Association (WPA), 17(1), 109-110.

Kühn, S., & Gallinat, J. (2016). Neurobiological basis of hypersexuality. International Review of Neurobiology, 129, 67-83.

McMahon, D. (2018). When trauma slips into addiction. The Imprint Youth & Family News.

Pierce, N. S. (2011). As you desire: Erotica or porn: Can you tell the difference? Retrieved from

Scott, E. (2021). Feeling embarrassed about being cheated on? Here’s why – and how to deal with it. Metro.

Weiss, R. (2012). Compulsive masturbation: The secret sexual disorder. PsychCentral.

Wilkie, N. (2020). Reset: The relationship paradigm – Finding a new course after drifting apart. Academy for Relationships.

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