Overcoming INFIDELITY: For Mental Health Professionals

Why Full Disclosure Is Imperative For Ethical, Evidence-Based Care

By Mark D. Lerner, Ph.D.

Chairman, The National Center for Emotional Wellness

Principal Consultant and Creator, AI-Integrated Emotional Wellness

A marital therapist shared with a couple that infidelity occurs when something is missing in a relationship. While this may be true for some, I've found that infidelity more frequently reflects what's missing within the partner who strayed—clear boundaries, sound judgment, integrity, decency, and, in particular, respect for the person they claimed to love.

“I promise to be faithful in sickness and in health.” Infidelity is not the sickness. The sickness is the deliberate withholding of the truth—condemning the betrayed to live a lie—and the ethical and professional failure of some mental health providers who enable this deception—under the guise of "treatment."

Once infidelity has been disclosed, far too many mental health professionals make a crucial mistake that flies in the face of evidence-based care. They project their personal beliefs such as asserting, “You now know she's been unfaithful; now you have to make a decision—move on—or accept it.” While this may be your belief, it's likely not in the best interest of your client(s) and certainly not evidence-based care.

To overcome infidelity, the betrayed person has a right to know the truth—to understand the reality of what happened in their relationship, with whom it happened, what happened, and where it happened. And the betrayer has a responsibility to accept accountability and provide full disclosure of that truth.

From a clinical perspective, betrayal trauma presents with symptom patterns characteristic of acute stress reactions, complex trauma, and posttraumatic stress. The betrayed partner’s intrusive thoughts, obsessions, rumination, hypervigilance, exaggerated startle response, insomnia, and emotional lability are not signs of pathology; they're often normal responses to frequent doses of deception, “Trickle Truths,” and flagrant lies.

Responsible, professional, ethical mental health care requires the caregiver to understand that trickle truth is not honesty—it’s continued betrayal that can compromise your client's/patient's safety and well-being.

Recognize that when you encourage partners to “move on,” it’s likely a manifestation of your need to move on—not your client’s need. I know a psychiatrist who shared with his client, an older man who had never been with anyone but his wife, his high school sweetheart—“Most people have had many partners. You’ve got to accept that she was with someone other than you. Remember the sexual revolution?” This wasn’t his patient’s need; it was this misinformed psychiatrist’s need. This "intervention" was not person-centered, trauma-informed, or evidence-based; it was invalidating and devastating to his patient—so damaging that it prompted him to contemplate suicide.

Counselors and psychotherapists who discourage discussion about the truth, reinforcing avoidance—the reality of what happened in their clients’ relationship—are secondarily victimizing and retraumatizing the betrayed. Only through honesty—learning the truth about what happened in the client's relationship—can the process of healing and, potentially, acceptance begin.

It’s also critical to understand gaslighting—when the betrayer psychologically manipulates their partner to believe that there’s something wrong with them. Gaslighting can compromise one's reality testing and ultimately precipitate decompensation—a worsening of symptoms and a significant deterioration in functioning.

Today, Artificial Intelligence (AI) can be an invaluable adjunct to mental health care. The reality is that most of your clients or patients will turn to AI modalities whether you suggest them or not. This reminds me of the patient who “educates” their physician based on what they learned from ChatGPT, or the client who generates a "motion" for their attorney to submit to the Court based on AI-generated content.

Technology can assist by offering accessible psychoeducation—guided relaxation and grounding techniques, affect regulation and emotional awareness tools, cognitive restructuring techniques, structured journaling, decision-making frameworks, values clarification, and between-session support.

AI-Integrated Emotional Wellness (AIEW) incorporates both accessible strategies and tools with a clear understanding of the need for authentic, genuine, person-centered care. 

AI must never be positioned as a substitute for human presence. Relationships are not repaired with strategies and tools—but through interpersonal relationships. Healing occurs within the safety and presence of people.

One of the most compelling statements I have ever heard came from an exemplary therapist, Ester. When her client asked her for specific strategies and techniques to cope with his obsessive thoughts and images of his wife being intimate with her lover, she declined—instead offering a safe place in which he could fully explore his feelings. From an evidence-based humanistic perspective, her restraint was the intervention. By refusing to provide answers, she empowered him to find the answers within himself. That was the moment he chose to climb the proverbial ladder—from survivor to thriver.

As a mental health professional, you must advocate for and promote honest and transparent face-to-face interpersonal disclosure of truth, accountability, and reality—not as punishment, but as a prerequisite for professional, ethical treatment aimed at overcoming infidelity.

Finally, it's important to recognize that many couples learn to harness their painful emotional energy from infidelity—and use that energy to propel them to cultivate an even stronger relationship. While this is certainly within the realm of possibility for some couples—only by addressing truth, accountability, and reality is there a possibility for this sublimation.

Betrayal does not end when the affair ends. It ends when the whole truth is told.

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