Thursday, November 17, 2016

Infidelity in Relationships

The revelation of a partner’s affair is a serious crisis in a relationship.  It undermines trust, causes great pain to the hurt partner, and often brings the relationship as a whole into question.  While it is difficult to know precisely how many relationships experience infidelity, studies as a whole suggest that between 18-20% of married couples, and 30-40% of unmarried couples have experienced infidelity.  There are societal factors that make it increasingly challenging for couples to maintain fidelity in a committed relationship.  Among these are: more permissive sexual attitudes, population shifts to larger communities with greater anonymity, the increased availability of internet pornography and cybersex, changes in the status and roles of women towards increasing financial independence and higher positions of power, and the fact that the traditional in-tact family is less and less the norm.  While these risk factors do exist and while infidelity can occur even in a good relationship, there are ways that personal recovery and healing of the relationship can occur.  In this article I will share the key factors to recovery that I’ve learned in working with couples struggling with infidelity.


Infidelity in a relationship can happen for different reasons; there is not just one kind of affair.  The range of affairs include:

·        one night stands

·        emotional affair

·        sexual addiction - a series of affairs

·        a single long-term affair

·        as a reflection of the unfaithful partner’s insecurities, unmet needs, internal conflicts

·        as a means of exiting the relationship

·        as a response to difficulties in the relationship


These different scenarios will have different implications for each partner and for the couple.  A therapist can help the couple make sense of this crisis in the relationship - an important first step.


Affairs are traumatic/painful for the hurt partner and can affect each person differently.


·        Some will view the discovery of a partner’s affair as a negative reflection on their worthiness, acceptability.

·        Some will begin to question the validity of their judgement, feelings, intuition, and begin doubting themselves more.

·        Some, in response to feelings of shame/humiliation, will withdraw from supports, and will isolate themselves.

·        Others may experience the understandable urge to retaliate, seek revenge as a way of releasing intense anger or to protect from further hurt.

·        Others may try to escape these painful emotions by burying their feelings, moving quickly to forgiveness, putting the experience behind them or ending the relationship.

·        Most will experience increased doubts - questions about their partner and about the future of the relationship itself.


A therapist can create a safe environment that allows hurt partners to face the shock and pain of the betrayal, to resist the urge to make quick decisions about the relationship or to retaliate destructively at the unfaithful partner.  The therapists non-judgmental, non-pressuring presence can assist hurt partners to not bury or hide from their feelings, to learn to trust their intuition that warns them that ‘something isn’t right’, and to carefully understand their own feelings and needs.


If unfaithful partners have any intentions of saving their relationships, it is their responsibility to acknowledge the pain they have caused, to resolve any doubts or misgivings about commitment to their partner, to stop the affair in order to create any hope of rebuilding the relationship, and to do the hard work of regaining the hurt partner’s trust.


A therapist needs to be aware that often the individuals in a couple do not have the same agenda for the relationship.  Although one partner may want to continue the relationship, the other partner may have real reservations.  A therapist needs to be sensitive to this possibility and be available to meet individually with each partner to assess each partner’s interest in continuing the relationship.  The therapist’s ability to understand each partner’s state of mind and to help the partners confront doubts, conflicted feelings about committing to the relationship will help the couple be clear where they stand with each other.


An important complicating factor occurs when unfaithful partners have difficulty letting go of the affair and committing to the relationship. It can happen that unfaithful partners may have difficulty letting go of someone with whom they experienced something needed at a certain time in their lives. In addition, the unfaithful partner may experience guilt over ending the affair, abandoning or deserting someone who provided something positive to them. Since it is probably expecting too much for the hurt partner to be patient and understanding of these conflicts, this is where a therapist may be helpful.  A therapist’s non-judgmental presence can provide the space for unfaithful partners to resolve their reluctance or guilt about ending the affair, or to mourn the loss of the positive aspects of the affair in ways that don’t create more distrust and damage to the relationship.


Finally, once trust had been broken, it can only be regained through concrete action, behavioral changes that reassure the other “you’re safe with me, I’m committed to you”. Verbal reassurance alone won’t accomplish this. The hard work for the unfaithful partners involves pushing themselves beyond their normal comfort zone, taking initiative, making sacrifices that communicate to their partners “I’m not trying to sweep this under the carpet”, i.e., that they are diligently working to understand the reasons for the affair(s). A therapist can help the unfaithful partners manage feelings of guilt, shame, or a desire to spare the hurt partners further pain. This can lead to defensiveness, or impatience with or avoidance of the hurt partners’ questions about the affair, or to pressuring the partner to prematurely trust or forgive, or to put the affair in the past. This will only leave hurt partners with lingering uncertainty about “when the axe will fall again”.


Once the hurt partner has been convinced that the affair has ended, that partner faces the difficult decision of giving the relationship another chance.


The hard work for hurt partners involves their willingness to give the other the opportunity to regain trust, and to work with that partner to build a better relationship. This isn’t easy when one has been deeply hurt, and involves the risk of further disappointment and pain if things don’t work out. There is the factor of the couple’s lifestyle and social relationships, which will be severely impacted by a separation or divorce.  It becomes even more difficult when children are involved.  Hurt partners need to consider all these factors in deciding what is right for themselves and their families, what they can live with, their personal limits.  A relationship with a therapist can provide the space for hurt partners to consider all these factors without external pressure or advice (which can come from well-meaning family and friends) to make a premature decision about the relationship. Hurt partners may need the aid of a therapist to overcome fears of rejection or of disappointing others in order to voice their doubts, needs at the time, to assert what is required from the unfaithful partner to feel safer and emotionally secure, and to hold their partners accountable when they are not doing enough.


If the affair has ended, and the couple chooses to give the relationship another chance, therapy can provide an opportunity to identify and understand pre-existing problems in the relationship and help the couple make careful decisions about their future.


Affairs are often symptomatic of longer-standing problems in the relationship that have been difficult for the couple to confront in their own. This can be due to the lingering effects that important, but difficult, relationships earlier in life (parents, siblings, and extended family) have on each partner’s sense of self and what they can expect from or are entitled to from others in relationships. These lingering effects - on self-worth, sense of entitlement, willingness to be close, fears off trust - can inadvertently undermine a couple’s efforts to build a foundation of understanding, trust and love. Although discovery of an affair is an extremely painful and damaging crisis in a relationship, it provides an opportunity for the couple to understand problematic patterns of relating to each other, and deeper personal insecurities or conflicts that interfere with developing closeness, trust, and confidence in their ability to manage normal conflicts and the ups and downs of a relationship. A therapist can provide a safe environment where strong emotions are acknowledged and dealt with in ways that help the couple engage in constructive dialogue about the affair, what it means to their relationship and work together to make careful decisions about their future.

Wednesday, April 27, 2016

Living With Chronic Pain - How a Therapist Can Help

Chronic Pain is one of the most difficult and troubling health problems confronting our society. It has been conservatively estimated that one in 10 people in the U.S. suffers from some form of chronic pain - defined here as pain that persists for 6 months or longer. If you are someone living with chronic pain, it is important to know that chronic pain does not have to shut down your life, stop you from living a meaningful life. A therapist, knowledgeable of the challenges of living with chronic pain, can help you to prevent this from happening. This article addresses how a therapist can be helpful to you.

Assisting you in leading as active a life as possible, reversing the tendency of chronic pain sufferers to become sedentary, physically inactive. 

Reduced physical activity and a sedentary life style is a common consequence of chronic pain and can actually increase your physical distress. Reduced physical activity leads to muscle inflexibility, loss of strength and physical stamina, weight gain due to inactivity. It can increase sleep difficulties, contribute to a sense of uselessness, and intensify feelings of depression and hopelessness. A therapist, with an understanding of how chronic pain differs from acute pain (which yells STOP as we are causing damage to our bodies) can help you:

·   To manage understandable fears of injury that will prevent you from resuming safe physical activities

·   To learn how to avoid exacerbating pain symptoms by pacing physical activities, learning safe exercises, and managing the urge to overdo activities on days you’re feeling better.

·   To overcome reluctance, feelings of intimidation to communicating to medical and health providers important lifestyle activities ( work, hobbies, recreational activities, travel) you hope to be able to resume, to getting advice on safe ways to resume these, and to keep providers informed of symptom changes that may need further attention.

By promoting a healthier state of mind, fostering hope  for a better future.

A therapist who works with chronic pain patients needs to be knowledgeable of the mind-body connection. This means knowing how physical pain can affect emotions and thinking patterns, and how emotional distress and negative-pessimistic thinking can intensify already existing pain.  An experienced therapist can help with:

·   Self-calming strategies and techniques to reduce the physical tension that stress creates that can increase pain, interfere with restful sleep, and wear you down. These strategies and techniques can also reduce the need to rely on medications that have troubling side effects.

·   Managing overly pessimistic and unrealistic thinking that can intensify feeling of depression and hopelessness, and make it harder to cope.

·   Assistance in facing and resolving conflicts or stress in important relationships that can intensify pain.

·   Gaining acceptance of the loss of hope for a cure, and facing the reality of a future life with some degree of pain.  This is a difficult pill for anyone to swallow, but it is particularly hard if you’ve experienced significant painful losses earlier in life.  However it is necessary for constructive coping to replace the desperate and unrealistic searching for a cure.

A therapist can help prevent the social withdrawal and isolation that can occur with chronic pain.

When living with chronic pain, there can be an understandable tendency to withdraw from family and friends as part of a desire to not burden or distress them, or to avoid having to deal with misunderstanding, skepticism or negative judgment from others.  This can be particularly strong when you don’t have any obvious handicap or physical abnormality.  This tendency to withdraw in anticipation that people will disappoint or let you down can be very strong if you’ve had repeated experience of disappointment, hurt, or rejection from important people earlier in life.  This withdrawal from people and loss of emotional support, understanding, and comfort can intensify feelings of isolation, loneliness, and depression. A therapist can help you:

·   To manage fears of disappointment and rejection so you’re more willing to lean on others for support, understanding, encouragement, comfort.

·   To overcome fears of assertiveness or a tendency to be submissive so you can advocate for your needs for understanding and information in order to take good care or yourself, make informed decisions about your medical care.

·   To be able to voice understandable fears of burdening loved ones or of them “getting fed up” with your pain, so that important emotional connections are not lost.

·   To resume and strengthen sexual relationships that have been curtailed by chronic pain.

A therapist can work with you to find ways to live as full and constructive a life as possible.

This is extremely important as we all need to feel a sense of purpose in life, to experience ourselves as making a valuable contribution, as being needed by and helpful to others. A therapist can be helpful to you:

·   By supporting your efforts to face the loss of previously gratifying and valued activities, roles, jobs and either redefine these, or create new ways to contribute that are equally satisfying for you.
·   By helping you manage the frustration, uncertainty, self-doubts, and fears you may encounter so you don’t give up on the difficult but important work of fashioning new ways for you to lead a full and meaningful life.