Does Sexual Betrayal Cause PTSD?

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Renee (a composite portrait) came to see me, because her relationship with her husband, Tim, had grown distant, and they rarely had sex anymore. She was paying for Tim to go to graduate school a few hours from where she worked in New York City. He lived in a dorm and claimed he was too busy to come home on weekends. Renee didn’t like visiting him and having to sleep in his dorm room. She also didn’t like that Tim’s female classmates were flirtatious and seemed to flatter Tim’s ego. I asked Renee if she ever worried that Tim might be having an affair. She looked at me like I was crazy. The next session I discovered that Renee confronted Tim, and he confessed to an ongoing affair. Tim was contrite, said he would end the affair, and wanted to reconcile.

Renee was shattered and didn’t know what to do. In the ensuing weeks, she had many sleepless nights and lost her appetite. She couldn’t get the image out of her head of Tim having sex with the flirtatious classmate she had met. It was all too humiliating and enraging that she had been played for a fool. It was impossible to have a discussion with Tim about how to move forward without screaming at him. Then she’d have to have a drink to calm down. Renee obsessed over and over again whether she could believe a single word Tim said, and whether it was worth even trying to recover from infidelity. Renee also started demanding to police all of Tim’s emails, text messages, and phone calls to keep him under 24-hour surveillance, because she didn’t believe that he had ended the affair as he claimed. Renee didn’t know whether she was crazy to trust Tim and give him a second chance or crazy to divorce him over a brief fling that he regretted in retrospect.

Sexual betrayal is traumatic, because infidelity is an “attachment injury.” Our life partner is our secure home base, our haven in a heartless world. We lose faith in our secure home base when our life partner betrays our trust. The person we turn to for emotional support is the very same person who has deeply hurt and humiliated us through sexual betrayal. We realize we have been living in a fool’s paradise and can no longer trust our own judgment. We don’t know what to believe, as our world seems permanently shattered.

Regardless of whether the relationship can recover from infidelity, the betrayed partner has to recover from the PTSD-like symptoms that infidelity might cause. The trauma of sexual betrayal is exacerbated when the unfaithful partner blames the victim of sexual betrayal for causing the infidelity, or when the unfaithful partner runs off to live happily ever after in a second marriage to the affair partner. The betrayed partner requires a program of recovery and healing from the emotional damage that infidelity may cause.

Recovery from infidelity requires these essential steps:

1. Don’t blame yourself. Yes, you contributed your share to the relationship problems, but you were honest and honored your commitment to sexual exclusivity. You didn’t deserve to be lied to by someone who didn’t honor his or her commitment to sexual exclusivity.

2. Take care of yourself. You’re understandably upset, so don’t start self-medicating in unhealthy ways by eating, drinking, or smoking too much. Turn to trusted family members and friends for social support. Stay away from “judgy” people who make you doubt yourself or feel badly about yourself.

3. Contain your "dark side." Sexual betrayal brings out the worst in people: a homicidal and paranoid side. Don’t give in to the dark side. You’re entitled to your hurt and anger, but don’t scream and yell or engage in retaliatory infidelity. Revenge feels good in the moment, but in the long term, it doesn’t take away the underlying hurt. Express your hurt and anger like a mature person. You’ll have more self-respect. You’re entitled to be a bit paranoid. Why believe a single thing your cheating partner says? But it won’t get you anywhere to keep your unfaithful partner on around-the-clock surveillance. There is nothing you can do about it if your partner is going to keep cheating and be smarter about evading detection.

4. Be patient. Recovery takes time. An unfaithful partner willing to recommit to monogamy must pass the test of time in order to regain the trust of a betrayed partner. Your unfaithful partner should be willing to spend a long time in the doghouse and jump through a few hoops to regain your trust. The unfaithful partner is not entitled to quick forgiveness. To trust a new romantic partner who “seems” trustworthy also takes time; that person must also prove trustworthy in the long term. Trust is something that must be earned in any lasting relationship.

5. Get professional help if you need it. There is no one right way to deal with sexual betrayal. Find a therapist who will respect your choices about whether to stick with a cheating partner or dump that person. The therapist needs to be patient with your tendency to be uncertain, self-doubting, and indecisive in how to best move forward in your life.