Kevin B Skinner Ph.D.

Inside Porn Addiction

The Lasting Effects of Sexual Betrayal

Disturbing study results make a case for recognizing PTSD within relationships.

Posted Aug 13, 2015

Monkey Business Images/Shutterstock
Source: Monkey Business Images/Shutterstock

"What is happening to me? I feel like I'm going crazy."

These were the first words out of my client's mouth after she told me about her husband's affairs. She continued, "Ever since I found out about his last affair, I haven't been able to sleep, eat, or do anything. I walk around in a daze feeling like nothing matters. What is wrong with me?"

I looked at her and said, "I think what you're feeling is perfectly normal. You may feel like you're going crazy or losing your mind, but what you're experiencing is real. It's what we call betrayal trauma.”

"You mean there's a term for what I'm feeling?"

I told her yes. She looked relieved and said, "So I'm not going crazy?"

"It'll feel like you're going crazy," I said, "but that's a natural response when you feel unsafe and insecure in your primary relationship."

If your partner is cheating on you, looking at pornography behind your back, visiting topless bars, or sexually acting out in other ways, it is common to feel unsafe or fearful. In my research with more than 1,400 people in these situations, I found that a majority (more than 60%) experienced intense fear at least half the time. Another 55% reported that after they discovered their partner's sexual behavior, they had difficulty (at least half the time) determining who was safe and not safe to be around. In other words, when a spouse acts out sexually, more than half of those who responded to the survey felt unsafe and experienced intense fear.

Unfortunately, up until the last few years, professional therapists have used codependency as the primary model for treating partners of sex addicts. This was often confusing for a spouse since, in many instances, they didn't know of their spouse's sexual indiscretions until they caught them. Their initial discovery, often referred to as "D-Day," was so surprising that they could hardly believe what they heard or discovered. This didn't, and doesn't, fit with the codependency model of enabling.

What I believe to be a better model for helping partners of sex addicts is a trauma model. In 2005, I was talking with a therapist friend who used the term "Relationship Trauma." She said, "I think many of the partners I am working with show symptoms of post-traumatic stress disorder (PTSD)." As I reviewed the clients in my caseload it quickly became apparent that she was right: Many of my clients were showing signs of PTSD.

That same year we wrote an assessment to determine if the trauma we witnessed in our offices was similar for individuals not in therapy. In other words, we wanted to know whether trauma was present just in clients we were seeing or if it was present in the general population of individuals whose spouses were sexually acting out. This was one of the first assessments, if not the very first, that looked at trauma that stemmed from a spouse's sexual behaviors. Since that time 10 years ago, more than 5,000 people have completed our online survey. (You can take the survey here.)

The results have been stunning—and alarming to me as a therapist. After poring through the data, it has become clear to me that thousands of women and men are suffering deeply due to their partner's sexual behaviors outside of the relationship. Here are some categories, questions, and results from our research:

Fear and Questions of Safety

1. I feel violated due to my partner's sexual behaviors:

  • Never (2.87%)
  • Occasionally/rarely (9.86%)
  • About half the time (9.65%)
  • More often than not (25.05%)
  • Always (52.57%)

Relive the Event/Experience

2. When my partner tries to get close to me or we are sexually intimate, I cannot help but question whether my partner is thinking about me or things he/she has done.

  • Never (2.66%)
  • Occasionally/rarely (11.53%)
  • About half the time (15.96%)
  • More often than not (27.05%)
  • Always (42.79%)


3. I avoid sexual contact with my partner since discovering his/her behavior.

  • Never (11.66%)
  • Occasionally/rarely (24.89%)
  • About half the time (23.32%)
  • More often than not (23.77%)
  • Always (16.37%)

Negative Self Evaluation and Mood

4. I feel like my partner acts out because I am not good enough.

  • Never (9.89%)
  • Occasionally/rarely (21.61%)
  • About half the time (23.22%)
  • More often than not (23.22%)
  • Always (22.07%)

Emotional Arousal (e.g. anger, irritability)

5. After discovering my partner’s sexual behaviors, I find that I am increasingly angry in response to my partner.

  • Never (2.10%)
  • Occasionally/rarely (17.06%)
  • About half the time (23.13%)
  • More often than not (34.58%)
  • Always (23.13%)

Duration of the Disturbance

6. How long have you been experiencing the symptoms described in this assessment (e.g. recurrent thoughts, feeling anxious, being afraid)?

  • Less than one month (3.77%)
  • 2-3 months (4.95%)
  • 4-6 months (5.42%)
  • 7-12 months (10.85%)
  • More than one year but less than two (16.51%)
  • More than two years but less than five (25.47%)
  • More than five years (33.02%)

Distress or Impairment in Social, Occupational, or Other Important Areas of Functioning)

7. It has become difficult for me to fulfill important roles (that of employee, parent, etc.) since discovering my partner's sexual behaviors.

  • Never (11.53%)
  • Occasionally/rarely (26.82%)
  • About half the time (30.35%)
  • More often than not (21.88%)
  • Always (9.41%)

In reviewing the data above with many other responses, it became clear to me that the PTSD criteria model was a legitimate way to look at responses to infidelity and other sexual behaviors outside the marital bond. Betrayal trauma due to a partner's sexual behaviors is common, and the symptoms are real.

Now comes the difficult part: What do we do to help the millions of individuals and couples dealing with betrayal trauma in their relationship? Since our field is just starting to fully accept the trauma model for treatment, we are only in the beginning stages of identifying best practices. The learning curve for effective treatment is steep, but the need for professionals and all in the helping profession (e.g. religious and community leaders) to come together is crucial. Unfortunately, there are still therapists and others in society that do not understand the extent of the trauma that occurs when sexual misbehaviors happen in a relationship. In some situations, the pain is minimized or overlooked (e.g. It’s just pornography, what’s the big deal?). This can trigger more trauma as the pain is ignored.

Solutions for Individuals Seeking Help

You may feel that you are losing your mind or going crazy. In truth, what you are experiencing is common. There is a growing awareness that sexual betrayal triggers trauma. If you find that you identify with the symptoms described in this article, please reach out for help and support. There are people who understand what you are experiencing. You are not going crazy.

Fortunately, we now see a growing number of people who specialize in understanding and treating trauma. Experts such as Bessel van der Kolk, Peter Levine, and Pat Ogden are educating us on how to better understand and treat trauma. Their guidance provides a great model for treating betrayal trauma. For example, we now know that trauma is largely stored in the body and may best be resolved through using our senses (sensorimotor therapy). For this reason, yoga and meditation can be effective tools in healing from trauma.

Organizations for Professionals Treating Trauma

These organizations train professionals and have a list of therapists who specialize in the treatment of betrayal trauma:

Online Resources for Individuals Experiencing Betrayal Trauma

There are also professionals who provide valuable educational and support content online to help individuals dealing with betrayal trauma:

12-Step Support Groups

Many individuals find that attending a group is very helpful. You will be with others who understand what you are going through and will provide support outside of the group setting:

Note: Data Sample Information

The sample data from this survey is from mostly women who live throughout the United States and Canada. They come from different religious beliefs, educational backgrounds, and most are married (68%).  

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