Here you’ll find Infidelity Conference summaries from Alex Katehakis and Tammy Nelson, focusing on sexuality and eroticism.

Dr. Alex Katehakis

Alex primarily works with very severe sexual addiction at the Center for Healthy Sex in Los Angeles. Her clients lie, deceive and can spin out of control. Infidelity is commonplace among them. They may destroy their marriages, friendships, get arrested or get fired.

Her excellent presentation on “Surviving the Ravages of Sexual Addiction in a Monogamous, Committed Relationship” laid out the long progression of treatment for the addict, the partner and the couple. It is impossible to recount all the details of her very meaty presentation, so I will highlight just a few.

She described sexual addiction as originating from:

• A problem in affect dysregulation based in early relational trauma. In other words, it’s a problematic attunement in the mother/infant dyad, which can result in disruptions in the Autonomic Nervous System and the HPA axis.
• A problem of insecure attachment that is compounded by other unresolved trauma.

She explained that the problem manifests as an intimacy disorder in adulthood as chronic, frequent infidelity, and compulsive behaviors.

The clients in Alex’s practice repetitively violate their own value systems. They crave increasing intensity to maintain a similar level of reward to the brain as their previous compulsive behaviors gave, so they are unable to abstain on their own.

A thorough process of treatment involves resolution of the early trauma as well as significant behavior change.

Let’s now focus more on issues that affect the couple, rather than on treatment for the addict themselves.

Alex highlighted the problems of rebuilding trust and of how full disclosure is handled. She stressed the importance of full disclosure done in a very careful and controlled setting.

Alex quoted research from Corley and Schneider, 2002. The statistics showed that despite the pain of listening and going through the process of hearing about all the betrayals, 81% of partners initially felt that disclosure was the proper course and in retrospect, 96% felt that full disclosure was essential in order to re-establish trust. (This is within couples where both partners are in treatment, working to repair and rebuild.) However, the time for disclosure cannot be rushed.

The addicts must be prepared to reveal themselves fully and the partner must be receptive to hearing without immediately threatening to end the marriage.

Alex also traced the process of recovering trust, stressing that trust is recovered slowly through actions and not words.  The addict follows a clearly delineated recovery plan usually including 12 step, individual therapy and couples therapy. The partner is always involved with and aware of the plan. When necessary, full access is allowed to email, voice mail and phone records. At times, in more severe situations, regular polygraphs may be included in the plan.

Alex continually reminded us that her clients are not those seen in the average private practice setting. Her clients have hit bottom. Their addictive behaviors are so far out of control that they can’t stop the compulsive, acting-out behavior. They are in danger of being arrested, going to jail, and losing their families.

Dr. Tammy Nelson

Also on the last day of the conference, Tammy Nelson presented on “Erotic Recovery After Infidelity: Working with Couples on Affair Repair.”  She reminded us how little material is available in this area for repair of a relationship using couples therapy or sex therapy.

She traced some common sexual stages in committed partnerships: attraction, longing, attachment, safety, boredom, detachment, crisis and reassessment.  It is common for the erotic connection to be split off during the detachment phase.

She challenged those of us in the audience to think about our work with infidelity couples and to ask ourselves whether we led the couple to a state of forgiveness, or led them beyond that to repair their erotic connection.  Tammy stated, “Infidelity is an erotic injury to the relationship, and if the partners choose to stay together, the commitment must be renewed through step by step erotic recovery work in order to move forward.”

She recommended a weekly “sex date”. This does not mean weekly intercourse, but rather a time set aside as sacred, without interruption. The time could be used sensually or sexually.

For Tammy’s clients, the choice to stay together after infidelity is only made after the couple processes the crisis, realigns their communication, and revises how they are relating erotically. She views erotic fantasy as “both an example of how a couple replays their early wounding, and how they can be taught to move forward developmentally into new realms of erotic growth.”

Working with couples after infidelity is revealed is challenging. Have you worked with couples to rebuild trust and eroticism after infidelity? Have you worked with sexual addiction? Have you wondered how and when to best confront a lying partner? Please share your thoughts on these below. As always, I look forward to reading your comments and I hope they lead to a meaningful professional discussion here.

We help couples struggling with infidelity in Menlo Park, San Francisco, San Mateo, Redwood City, San Jose, Campbell and the surrounding areas.