Post Infidelity Stress Disorder

How would you react if you found out that your spouse was cheating on you? No doubt it would be a severe shock and you would find yourself filled with anger, surprise, sorrow and all kinds of other emotions. In fact, research shows that the effect of discovering infidelity is so severe it can be likened to recovering from a life-threatening traumatic event.

Today we’re going to be looking at something many wives experience following the disclosure of infidelity which is basically PTSD with a twist. If you’re struggling with your marriage after infidelity then today’s sound, research-based advice, should bring you hope.

A guy called Dennis Ortman literally wrote the book on this in 2005. It’s not a well-researched subject area since it is relatively new. However, this is definitely something I have observed and it is very real[i].

So Ortman noticed that many of his clients who had experienced infidelity within their marriage showed similar patterns of stress in response to the betrayal. I don’t have a reference for this but I remember when I was studying for my masters in the late 2000’s I came across one article that pointed out that 60% of wives who were sexually betrayed shows all but one of the symptoms of PTSD. And Ortman noticed that these spouses he was working with also mirrored the criteria for Post Traumatic Stress Disorder

But: it’s worth noting that one of the diagnostic criteria for PTSD is that you have to have witnessed severe bodily harm or death. And of course that doesn’t apply here but he was seeing that all of the other criteria were being met.

So while traditionally understood PTSD would occur in response to witnessing something deeply traumatic and violent, in PISD there is no life-threatening event but the deep impact of the betrayal leads to similar symptoms, including:

1. Experience of intense fear, helplessness, or horror: Individuals who have experienced infidelity become overwhelmed by feelings of fear, helplessness, and horror when they remember the affair. They live with a constant feeling of helplessness and fear that it will happen again[ii].
2. Re-experiencing of the event: Victims of infidelity “relive the horror of the event and all the overwhelming feelings, sometimes years later.” Just as a war veteran may duck at the sound of gunfire or have flashbacks of traumatic moments that happened long ago during war, “victims of adultery relive the painful discovery of infidelity[iii]”.
3. Avoidance of reminders of the event: Victims of infidelity “cope by trying to forget the terrible things that have happened to them by avoiding thoughts, feelings, or conversations associated with the trauma[iv]”.
4. Emotional numbing: Victims of infidelity “become so overwhelmed by their feelings of anxiety, rage, and helplessness that they attempt to cope by withdrawing into an emotional cocoon…They detach from life and from themselves to survive the emotional storm[v]”.
5. Heightened anxiety: Victims of infidelity, “live on high alert for recurrence of the [infidelity].” They struggle to sleep and often have nightmares[vi].
6. Irritability and rage: “Individuals who have been traumatized become preoccupied with how they have been victimized, which causes them to become angry with the perpetrator, with life, and with themselves. At some level, they blame themselves for allowing the trauma to occur. Consequently, they are often irritable and experience temper outbursts[vii]”.

Why Can Discovery of an Affair Cause Such a Strong Reaction?

The main reason I see for this is that an affair or a betrayal of this magnitude is an incredible blow to the marriage bond. Discovering an affair or discovering porn or sex addiction is a betrayal of trust that shakes your belief in your most important relationship and leaves you feeling vulnerable.

Trust is a fundamental component required for a marriage in order to flourish. Think about it: if you had everything going great in your marriage except for trust, how great would your marriage be? Or even if you had someone you wanted to be friends with and you had everything in common and just got along perfectly but you couldn’t trust that person AT ALL, how far would your relationship develop before you decide it’s not worth it?

So you can see how important trust is. And infidelity destroys trust. Now I disagree somewhat with Orman here but he says “an affair is often experienced as a fatal psychic wound or a death blow to the relationship”. I guess I agree if he is saying that is often how it is experienced but I’d more frame it as a potentially lethal blow. And it’s mostly up to the betrayed spouse to decide if that blow is going to be fatal or not.

Of course, my bias is to save the marriage and help couples recover from that blow. We have written various materials on the subject including episodes on recovering from betrayal and rebuilding your marriage, as well as an intensive 30-day course, which we’ll look at later on. But let’s agree on the severity of the blow that infidelity causes.

In our marriages, we all make certain assumptions. Like: my spouse is trustworthy. My relationship is safe. I/we am in control of the course of our relationship. An affair is not just a big fight. It is a violation of the basic assumptions of marriage. Here’s a quote: “the violation of basic relational assumptions such as trust and predictability means that the injured person often experiences the shattering of core beliefs essential to emotional security in his or her relationship.”

This is why betrayal is traumatic: it strikes us at our core. The basic assumption that you can trust your spouse has been proven wrong and it leaves you reeling. This is why so many people who discover infidelity end up experiencing some or all of these PISD symptoms.

Before we look at helping yourself work through this issue should you believe this fits your experience, I just want to note a couple of things really quickly.

First, if you have been a person who was very dependent on your spouse you are more likely to develop PISD. If you’ve been more passive in your marriage and haven’t really taken control of the direction of your own life, you’re at greater risk. If you turn to others rather than yourself for nurturance and security then this makes the blow more severe. You’re not as resilient to the overwhelming shock and after-effects of discovering infidelity. So that becomes an extra point to work on as part of your recovery.

Also, if you have experienced past sexual abuse or patterns of abusive relationships with significant people then this betrayal can be particularly devastating. This is because it also reopens or at least revisits those old wounds[viii]. As part of your recovery, you may also need to go back to those traumatic events for healing as well as addressing the trauma of the betrayal.

Treatment Options for PISD

One thing that is good is that since PISD is so similar to PTSD we therapists can take lessons learned from trauma treatment on PTSD and bring those over. Gordon et al (2008)[ix] see healing from infidelity “as analogous to recovery from interpersonal trauma” and because of this, they focus in on how the trauma of infidelity violated assumptions that the wounded partner had about the world.

Assess Assumptions and Perceptions of Self and the World

I’m going to tell you what therapy would look like but this podcast is only a self-help tool and is not meant to replace individual counseling. I can help with this if you reach out to me but also I need to make the disclaimer that this is not an attempt to solicit clients from jurisdictions where I do not have the legal ability to practice.

The counselor can help individuals “revisit the traumatic event” and examine how the experience of infidelity “changed their perceptions of themselves, other people, and the world in general[x]”.

What happens here is because of these traumatic events you may conclude that the world is not a safe place and you will never trust again. I can see why you would make that conclusion. But: this is going to leave you incredibly isolated because by default this means you will never have a meaningful relationship with anyone ever again. That’s an incredibly lonely place to put yourself, right?

Through this process, those who have been hurt by infidelity can examine their beliefs to determine if they need to be changed or restructured, thus coming out of counseling with a more accurate view of the world[xi]. Going back to the example I just gave, this might mean you would acknowledge that you have experienced an incredible betrayal but you also choose to believe that you will not see ALL relationships this way. And you choose to believe that you can develop the skills so that a wiser version of yourself can accurately assess the trustworthiness of your most important relationships.

That takes some work but it is possible.

Overcoming PISD

Orman also identified three ways to move forward and I like these so let’s go over them.

First, establish a sense of safety. If you’ve experienced trauma or betrayal you probably feel unsafe internally and externally. Internally: you feel these difficult emotions. You can’t prevent your heart from being ripped out again. Externally, you can’t control or predict anything that will happen to you. That all feels very unsafe.

In this process then, Orman points out that “The initial shock and emotional upheaval need to be calmed by courageously facing the pain and reflecting with the support of loved ones”

This is a very trying stage of recovery. So at this time, you’ll also want to avoid making important decisions until you’ve re-established that sense of safety. You’ll also want to take time to grieve for as long as is necessary. And you’ll want to be sure to seek out as much support as possible from your support network.

Second, you’ll need to make a decision about the relationship. Now don’t freak out on me. Even if you’re committed I think you still need to make this choice. A choice for the relationship. And you can’t honestly make a choice for the relationship unless you believe that leaving is an option. Again: our values are to help as many marriages as possible. But you have to give this dilemma an honest consideration and you should take as much time as you need to do so.

I think as you consider this that “It is important to determine whether the infidelity was an isolated incident or a well-established behavior pattern and whether the unfaithful partner is willing to seek help and change.[xii]” Keep in mind there are two parts there: do we have a pattern? Is your spouse willing to seek help and change?
If you don’t have either of those things it’s a very challenging place to be in. I would say don’t forget to allow God to lead in your decision and just be mindful as you pray about it that He is a good God and He is fully trustworthy, even when people aren’t. He works redemptively and He works for your good. So trust him and cry out to him. I am reminded of the words of 1 Cor 10:13 “God is faithful, and he will not let you be tempted beyond your ability, but with the temptation, he will also provide the way of escape, that you may be able to endure it.” ESV

So really ask God to lead you through that decision, to do His will. And then regardless of whether you choose to stay or leave there is the third step of healing through forgiveness[xiii].

This is probably the lengthiest phase, both in my observation and according to what Orman says on this. This involves taking the difficult, painful memories of the trauma and finding healing so that the hard emotions are replaced with softer emotions. So instead of rage and bitterness and hatred, you are able to stay with the sadness, loss, and grief. Peace and joy come in instead of revenge. This releases you from the need to require justice and allows you to move forward with life in a way that is constructive and positive and looks to the future rather than ruminating on the past.

I often see anger immediately following the betrayal. I would respectfully suggest that most of that anger is self-righteous but I would also state clearly that you have the right to be angry. Who wouldn’t be? You’ve been utterly betrayed and that is unacceptable. But if you stay in that angry place it’s going to keep you from growing and developing into a wiser, stronger, more resilient version of yourself.

So those are three steps you can take to help you move forward. If possible, you would probably find it helpful to proceed through these with a marriage counselor. First, you need to establish a sense of safety, then make a decision to stay in the relationship and then find healing through forgiveness. This is by no means an easy journey— it involves meeting your pain, your confusion, your anger and your doubts about your worldview head-on. But only by facing these tough emotions and painstakingly working through them will you be able to come out the other side, re-learn to trust and accept people into your life again.

Recovering from betrayal can be just as painful as overcoming PTSD. This week we look at why betrayal hits so hard and how you can recover.

References

[i] Dennis C. Ortman, ‘Post-Infidelity Stress Disorder’, Journal of Psychosocial Nursing & Mental Health Services, 43.10 (2005), 46–54.
[ii] Ortman.
[iii] Ortman.
[iv] Ortman.
[v] Ortman.
[vi] Ortman.
[vii] Ortman.
[viii] Ortman.
[ix] Kristina Coop Gordon, Donald H. Baucom, and Douglas K. Snyder, ‘Optimal Strategies in Couple Therapy: Treating Couples Dealing with the Trauma of Infidelity’, Journal of Contemporary Psychotherapy, 38.3 (2008), 151–60 <https://doi.org/http://dx.doi.org/10.1007/s10879-008-9085-1>.
[x] Gordon, Baucom, and Snyder.
[xi] Gordon, Baucom, and Snyder.
[xii] Ortman.
[xiii] Ortman.

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