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Over half of all US households

(172 million) have Internet

access, making the 40 million

sexually explicit Web sites, chat

rooms, bulletin boards and

interactive games a virtual smor-

gasbord for anyone who cares

to partake ( Tanner, 2003; Dew,

2005). An estimated 20 to 33 per-

cent of Internet users go online

for sexual purposes; most are

male, about 35 years old, married

with children, and well educated

(Cooper et al., 2000; Dew, 2005).

As many as 17% become addict-

ed to online sexual behaviors

(Cooper et al., 1999, 2000).

The Internet threat to com-

mitted relationships differs from

other threats in two significant

ways. The first threat is due to

what Cooper (1998) describes

as the “triple engine affect.” The

Internet is extremely acces-

sible, affordable, and the sense

of anonymity helps people

rationalize that they can engage

in behaviors that will not be

discovered. Second, because

the process provides steady

intermittent reinforcement, and

thereby continually stimulates

the reward pathways of the

brain, the behavior is proving

to be highly addictive to some

(Cooper et al., 1999, 2000; Fisher,

2004; Dew, 2005). Serious rela-

tionship problems are reported

in virtually all marriages in which

one partner is cybersex addicted

(Schneider et al., 2000; Young et

al., 2000). Even if the user does

not become addicted, problems

related to online behavior are

reported.

Often, dialogue in a chat

room or e-mail begins as a

distraction from boredom or

emotional distress (Young et al.,

2000; Chaney & Chang, 2005).

Behaviors that had once been off

limits due to personal inhibitions,

social controls, or lack of sexual

scenarios within a marital rela-

tionship are suddenly available

through the Internet (Leiblum

& Döring, 1998). Anyone seek-

ing to connect with a potential

partner via the Internet can

maximize the presentation of

self while being careful to omit

what he or she doesn’t want

others to know (Schnarch, 1997).

What started innocently can

easily advance to an offline

emotional and/or physical extra-

marital affair. However, even if

the behavior never advances

to meeting offline, many part-

ners* view cybersex chatting

and/or pornography viewing as

a form of infidelity, a threat to

the marriage, and as emotion-

ally distressing as a “live” affair

(Bergner & Bridges, 2002; Bridges,

Bergner & Sesson-McInnis, 2003;

Nelson et al., 2005; Schneider,

2000; Whitty, 2003, 2005; Zitzman

& Butler, 2005). (*Partner refers

to the person in the relationship

who feels betrayed; user refers to

the person who is engaging in

online behaviors.)

Other problems include

loss of trust, a decrease in self-

esteem, and a sense of isolation.

Users who compulsively mastur-

bate have difficulty becoming

aroused by their partners, fear

erectile difficulties, so avoid

sex, and experience emotional

distress in their marital relation-

ships (Galbreath & Becker, 2004;

King, 2005). In Schneider’s (2000)

study of 94 respondents who

sought therapy as a result of a

spouse’s cybersex behavior, one

third of partners and 52% of

cybersex users lost interest in

relational sex.

In the coming years, as the

number of households with

Internet access grows, it can be

expected that more and more

marriage and family therapists

will be presented with a variety

of problems related to online

infidelity.

Online Infidelity as an Attachment Injury To be in a secure love relation-

ship is to be desired and held in

the mind of the other as special.

It is to be the main source of

security and comfort. There is a

special type of communicating

between the brains of both part-

ners resulting in a kind of limbic

resonance where both feel

emotionally safe and connected

(Lewis el at., 2000; Siegel, 2003;

Fisher, 2004).

Infidelity of any kind disrupts

this limbic resonance and one or

both partners no longer have the

sense of being connected in a

secure, safe haven. When events

within or outside the relation-

ship cause enough anxiety, fear,

or other emotional distress to be

unmanageable, a partner seeks

proximity of the other for sooth-

ing and meaningful responses.

In the case of Internet infi-

delity, when a partner suspects

the user is engaging in cyber-

sex behaviors, he or she may

become hyper-vigilant, seeking

evidence of the user’s behavior.

Generally, if the partner finds

some evidence and then ques-

tions the user’s behavior and

motive, the questioning reflects

the partner’s increased level

of anxiety and fear. If the user

responds with denials despite

some evidence, or minimizes

or rationalizes the behavior, the

partner views this behavior as

further evidence the user is no

longer physically or emotion-

ally available. The attachment

process is disconnected and

thus injured. Johnson (2002)

describes this as an attachment

injury, defined as a violation of

trust resulting from a betrayal or

from a sense of abandonment at

the moment of intense need or

vulnerability. This type of injury

creates an impasse in the rela-

tionship and the couple will con-

tinue to engage in their “marital

dance” of attack and defend, or

pursue and withdraw (Johnson

2002, 2005) until the injury is

addressed.

Types of Couples Seeking Therapy Couples present in levels of

severity and various situations.

Occasionally, both members

agree there has been a betrayal,

and the goals are to get beyond

the event, recover from the

betrayal, try to resolve what

M. Deborah Corley, PhD

Fa m i l y Th e r a p y m a g a z i n e38

CLINICAL U P DAT E

Online Infidelity

M. Deborah Corley, PhD

led to the betrayal, and grow

the relationship. More often,

therapists see the couple when

the partner experiences the

situation as a betrayal, the user

is ambivalent about giving up

the Internet behavior because

he or she believes no real harm

has been done, and the couple

is stuck.

If the user has had some

significant consequence such

as a job loss, an arrest, media

involvement, or a health concern,

it is common to have the couple

present together to determine

how to get through the immedi-

ate crisis at hand. Couples also

present because the user has

become addicted to the Internet

behavior or the Internet behav-

ior is a continuation or relapse of

his or her sex addiction behavior.

Generally, the couple presents

after discovery of evidence that

the user has been engaging in

chat room conversations or has

been viewing pornographic

images and keeping it secret.

There are two common responses

by the user. He or she may make

an initial good will disclosure

about some aspect of the behav-

ior to “test” the water. This user is

fearful of losing the relationship

with the partner (and children,

pets, assets) and at the same time

also fearful of loss of the cyber

behavior. He or she usually only

discloses what he or she thinks

the partner has already discov-

ered, or is likely to discover or be

told by an outside party.

The other typical response to

discovery is the user who believes

he or she has done nothing

wrong and the behavior does not

constitute a betrayal or infidel-

ity. A partner may have asked if

the user is chatting online or

visiting pornographic Web sites

only to be told that the partner

is crazy or the user minimizes

the behavior by labeling it as an

accident that happened while

looking for or chatting about

something else. This user is con-

vinced he or she does not need

therapy or is ambivalent at best.

Unless there are external conse-

quences for the user’s behavior,

it is difficult to get this user

to consider change. He or she

wants to avoid having to admit

any wrongdoing at all costs.

Other common complaints

include the user requesting or

demanding sexual behaviors

that the partner finds offensive,

or the user avoiding sex with

the partner after having what

the partner reports as a “good”

sex life. The partner may have

noted a significant change in

sleep patterns, the demand for

privacy, and the user making

more excuses for engaging in

isolating behaviors.

A partner may then become

hyper-vigilant, and after some

investigation, locate more evi-

dence of online behavior. The

user may try to avoid blame,

rationalizing the behavior by

criticizing the partner, indicating

that if the partner would engage

in sexual behaviors previously

requested, the user would not

be “forced” to seek satisfaction

by viewing pornography or

chatting with someone online.

Partners feel betrayed because

the user has been sharing infor-

mation that has been thought

to be private within the coupled

relationship, especially if the

dialogue contains examples of

emotional intensity or sexually

suggestive flirtations, or the user

has arranged to meet with the

other person offline. Meeting

someone, engaging in sexual

contact, and keeping it secret

constitutes a betrayal.

Sometimes a user discloses

that he or she is a sex addict.

After such a disclosure, partners

who know nothing of sex addic-

tion may seek the therapist’s

opinion about the children’s

safety or if the user can be cured.

A user may present alone, espe-

cially if the therapist specializes

in this type of treatment or if

the user is motivated by some

external source (i.e., an employer,

family members, an attorney or

other authority figure).

Assessment and Diagnosis Prochaska and DiClemente

(1983, 1992) introduced an inte-

grative framework describing

the process of behavior change.

In this model, change is viewed

as a progression from an initial

precontemplation stage, where

the individual is not considering

change and does not view the

behavior as a problem, to con-

templation, where the person is

ambivalent but seriously evalu-

ates the positive and negative

aspects of change; and then to

preparation where a commit-

ment to and plans for change

are made. These initial stages

provide essential ingredients

for motivating self to take action

for specific behavioral change.

Successful completion of the

action stage leads to the fifth

and final maintenance stage of

39m a r c h a p r i l 2 0 0 6

change, in which the individual

sustains long-term change.

During therapy, each person in

the relationship may enter, move

from one stage to the next, or

revert back to a previous stage at

differing paces.

Recent research (Reid, in

press) has indicated that the

majority of individuals seeking

therapy enter in the contempla-

tion stage of change. If someone

is forced to go to therapy, he

or she often enters in the pre-

contemplation stage of change.

Ambivalence about change must

be resolved before a focused

treatment plan can be collab-

oratively developed with clients.

Without knowing where the cli-

ent is in the stages of change, the

therapist can get ahead of the

client’s readiness to change and

the client will drop out of ther-

apy. The Stages of Change Scale

(McConnaughy, DiClemente,

Prochasks, & Velicer, 1989) can be

used to formally assess stage of

change; however, it is as effective

to describe the stages of change

and inquire from the client with

which stage of change he or she

identifies.

Couples go through a crisis

phase, a rebuilding phase, and a

consolidation phase when deal-

ing with online betrayal. During

those phases, each person may

go in and out of the various

stages of change.

During the crisis phase, the

primary focus is on de-escalating

the situation and obtaining indi-

vidual stability and clarity about

the desire to stop the online

behavior and the future of the

relationship. Depending on the

severity of the problems associ-

ated with the online behavior,

both may have some acute stress

symptoms including intrusive

or obsessive thinking about the

other’s behavior, problems sleep-

ing, difficulty focusing at work,

and dealing with other tasks

requiring attention to detail such

as driving.

A partner may be so revolted

or so angry by what the user has

done, that a period of separation

may be useful until some trauma

resolution or shame reduction is

accomplished. This is especially

the case if the user has arranged

for or participated in anony-

mous same-sex encounters, or

engaged in illegal behavior such

as arranging for a prostitute,

downloading pornography of

a minor, or soliciting a minor

through chat room activity. Help

the partner determine boundar-

ies for safety and stability. If a

user has had unprotected sexual

contact outside the relationship,

the partner will have strong feel-

ings about exposure to sexually

transmitted disease or infection,

and testing for both can be

framed as part of responsible

self care. Assess issues associated

with acceptable physical touch

and clarify sexual boundaries,

reframing this a form of respect

and a time for healing.

Job loss and/or legal con-

sequences associated with

online use exacerbate the crisis.

Assess for risk of suicide, iden-

tify additional support systems,

and make safety plans when

consequences are severe or par-

ticularly shameful for the partner

or user.

To determine if the user is

addicted, assess for evidence

of loss of control, type and fre-

quency of behaviors, behaviors

that go against personal values,

continuation despite negative

consequences, and compulsive

patterns of use. Because of the

shame associated with some

online behaviors, it can be use-

ful to have an individual session

with the user to obtain sexual

and online history.

If the user is a sex addict and

the Internet behavior represents

a continuation of a history of act-

ing out, determine if the user has

re-engaged in a recovery plan.

Assist and support the user in

development of harm reduction

plans for any further computer

use, accountability measures,

scheduling 12-step or support

group meetings, and an absti-

nence contract for an agreed

upon period of time.

Through the use of geno-

gram, identify patterns estab-

lished in the family of origin that

have been brought to the cur-

rent relationship; assess patterns

of the couple’s “marital dance”

that have evolved from family

of origin rules, and core beliefs

about self brought to and rein-

forced in this relationship.

The crisis phase is over when

the initial emotional distress has

subsided and there is a tempo-

rary commitment to stay in the

relationship. Each person is tak-

ing appropriate responsibility

for their behavior and has begun

tracking family of origin patterns

that have evolved into this rela-

tionship’s “dance.” Ambivalence

is replaced by a desire to make a

plan and take action to improve

Fa m i l y Th e r a p y m a g a z i n e40

Clinical U P D A T E

■ List emotional triggers and strategies for com-

bating excuses to use.

■ Determine and list the behaviors that are off

limits and would signify a slip or relapse if

engaged in again. Tape reminders to the top

of the computer screen.

■ Utilize pictures of spouse, family or other

important people as a screen saver so the user

can see what is important to him or her each

time the computer is accessed.

■ Move the computer to an open area.

■ Arrange for accountability

– Identify who is appropriate to help with

accountability and discuss with them how

they can be helpful (it is not appropriate for

the spouse to be the accountability partner

until the couple determines they are a team

against the behavior).

– The accountability partner reports what to

whom? Is an accountability “team” needed?

■ Do NOT use the Internet when alone; go

online only when family members or the

accountability partner are present.

■ Use the computer only for specific, planned

tasks that have been reviewed with an

accountability partner.

■ Call the accountability partner before going

online and after online task is complete;

discuss how the emotional triggers of being

online were managed, what went well, and

where the user is still challenged.

■ Have periods of time when no online behavior

happens; set goals and healthy rewards for

reaching a certain percentage of goals.

■ Control Internet access:

– Add filtering or blocking software

– Use an Internet Service Provider that already

filters the Internet

– Use an Internet Service Provider that allows

the user to only visit pre-approved sites

– Use monitoring software that e-mails

reports of visited sites to a chosen person

(accountability partner).

Adapted from Orzack & Ross, 2000.

HARM REDUCTION STRATEGIES FOR COMPUTER USEE

the relationship.

The crisis/individuation

phase is followed by the rebuild-

ing/growth phase. The couple

moves from contemplation to

the preparation stage and sets

goals for rebuilding the relation-

ship including re-establishing

trust and their sexual relationship.

During this phase, couples thrive

on practicing behaviors that rep-

resent each being a best friend to

the other, incorporating use

of better conflict resolution

through softened startup when

discussing problems, turning

towards rather than away, and

reduction in criticism, defen-

siveness and stonewalling, as

described by Gottman (1999).

The final phase is the con-

solidation phase, in which a

new dominant story about the

relationship emerges. This new

story is a coherent narrative

of the couple’s ability to repair

problems, look for the good in

each other, and engage in new

dialogue about and approach

to long standing issues

(Atwood, 2005).

Treatment Both cognitive behavioral

therapy (CBT ) and emotionally

focused therapy (EFT ) have been

found useful for couples with

infidelity issues (Johnson, 2005;

Atkins et al., 2005). An addic-

tion sensitive model combining

stages of change, CBT and EFT

are outlined below.

During the crisis phase, part-

ners and users enter therapy in

the precontemplation or contem-

plation stage. Precontemplators

are either reluctant, resigned,

rebellious, or rationalizers;

they either fear change or

do not believe it can happen.

Contemplators see some value in

change but are still ambivalent

(Miller & Rollnick, 2002).

Once the client/couple iden-

tifies the primary problem from

his or her perspective, goals

for change can be established.

Reduce the ambivalence by hav-

ing the client identify the posi-

tive and negative consequences

of continuing behaviors versus

stopping or some form of modi-

fied change. (See Motivational

Interviewing: Preparing People for

Change [Miller & Rollnick, 2002]

for additional information and

strategies for helping clients

increase or maintain their moti-

vation to change.)

An Addiction Sensitive Process for Resolution of Attachment Injuries from Online Infidelity

1. (Clarity of impact.) Either

person can start, but because

some discovery of online

evidence of betrayal has

usually been the catalyst for

therapy, the partner usually

starts. Encourage the partner

to describe the problem, with

an emphasis on the most

difficult part of the problem

for her or him. Have the

partner describe the impact

of the user’s behavior on the

partner’s sense of self, health,

the relationship, the family,

finances, sexual life, spiritual

connection, and other areas

of meaning.

2. (Help the user stay in pro-

cess.) Often the user is fearful

of loss, experiencing shame,

and uncomfortable with the

partner’s pain. To deflect their

own discomfort, the user may

deny, minimize, or start to

discount the partner’s recol-

lection, or will nonverbally

move away by turning away

or engaging in some form of

dissociation. Help the user re-

engage by being empathetic

to how much courage it takes

to be here and remind the

user that his or her job right

now is to be an emotionally

present listener, even if he

or she does not agree with

everything the partner says.

Remind the user there will be

an opportunity to talk about

the problem from his or her

perspective.

3. (Identifying feelings.) The

partner is encouraged to

elaborate about the feelings

connected to the impact on

her or him and why the user’s

behavior is experienced as a

betrayal. The therapist tracks

feelings, highlighting those

with attachment significance.

If in the past the partner

has made some attempt to

explain how she or he feels

to the user, the therapist has

the partner describe how

she or he made this attempt

and the partner’s percep-

tion of the user’s response.

(Begin to identify the pattern

of interactions used by both

members of the relationship.)

Also inquire about how the

partner may sometimes make

things worse. Generally, this is

the behavior that guarantees

she or he will not get what is

needed to repair the injury,

but is done to hide fear and/or

shame, and is part of a pattern.

The therapist clarifies this and

asks about the fear or shame.

4. (User begins to shift to

accountability.) When the

partner begins to speak

about the fear and shame,

often the user begins to hear

and understand the mean-

ing of the betrayal is related

to the normal attachment

needs of the partner and

reflects how much the part-

ner loves the user, rather than

how flawed the user is. The

therapist coaches the user

by asking the user to reflect

back what the user has heard

the partner say, acknowledg-

ing the impact on the part-

ner, the partner’s pain, the

partner’s own accountability

about how the partner has

made things worse at times

when trying to protect him or

herself, and how the partner’s

behavior has been attached

to fear of loss of the relation-

ship (or other attachment

issues). Provide information

about attachment styles

people use when angry,

afraid or in shame. Discuss

the patterns the couple uses

when experiencing these

emotional states, underlying

attachment needs, and differ-

ent ways to ask for and give

support during these times.

5. (User clarifies his or her behav-

ior.) Encourage the user to

elaborate on how wounding

events evolved for him or her,

what in the user’s life needed

to be resolved, and any

attempts the user made to

describe needs to the partner,

how she or he got the idea

this online behavior would

be a solution, and awareness

now about the maladaptive

nature of the online behavior

as a solution. It is important

for the therapist to help guide

the user to keep talking about

the underlying feelings that

the user was not sharing with

the partner that led to online

use. The user becomes more

accountable by indicating

where his or her thinking was

flawed due to shame, fear and

attachment needs.

6. (Formal authentic disclosure

and amends.) Even though

a user may have disclosed

or made amends, having a

formal session for presenta-

tion of disclosure and making

amends is useful for the heal-

ing process to solidify. Assign

a disclosure/amends letter to

the user as homework. Issues

to consider when

41m a r c h a p r i l 2 0 0 6

AAMFT N E W SOnline Infidelity

constructing the amends

letter include: identifying

behaviors that would be

considered a betrayal to the

partner; if another person

was involved, does the part-

ner know him or her; what

resources were misused; were

others asked to collude in the

betrayal; and what emotional

issues were not being talked

about in the relationship

with the partner. The letter

starts with declaring a goal,

such as to be accountable

and make amends. If new,

undisclosed information is

to be introduced in the let-

ter, have the user share the

most difficult information first.

Include information about why

the user did what he or she

did, awareness of the impact

the behavior has had on the

partner, and may continue to

have for sometime, and com-

mitment to stop the behavior

with recognition that actions

speak louder than words. The

user indicates the behavior

was wrong and destructive to

the relationship and to both

the user and the partner, and

makes amends. (“I realize what

I did was wrong and hurt you,

and I am sorry.”) In session,

the therapist declares that

amends work is part of “build-

ing a bridge” towards a new

kind of relationship and that

disclosure/amends is part of

being accountable. The thera-

pist then inquires if the partner

is ready to hear the letter. If so,

the user presents the letter.

(For additional information on

disclosure, especially to chil-

dren, see Corley and Schneider,

2002, 2004, & Corley, 2005.)

7. (Partner needs another oppor-

tunity to gain more clarity

about underlying emotions.)

The therapist inquires if the

partner is able to accept the

amends, or if there is more the

partner needs to articulate

about the injury. If the partner

has more insight or still needs

to talk about the injury, anoth-

er round similar to the above

can be implemented.

8. (Partner accepts user’s attempt

at repair.) The therapist

inquires whether the partner

feels heard and understood

and if she or he can accept

the user’s attempt to repair

and move forward to heal the

relationship. Using scaling

questions, inquire about the

level of change, repair of injury,

or progress.

9. (Summary of progress and vali-

dation by the therapist.) The

therapist reviews the attach-

ment desired by the couple

and inquires what has been

helpful to make a change.

Often, the partner offers a

disclosure or accountability for

her or his part in mismanage-

ment of emotional distress

from the past, and desire to

change patterns in the future.

The couple is invited to report

what they have learned about

their styles of interactions that

led to the disconnect, what

each could do differently when

an emotional trigger arises, the

level of commitment, and con-

fidence in moving forward to

build more trusting, emotional-

ly healing interaction patterns.

Implicit needs are identified

and boundaries are re-exam-

ined. Plans for managing fears

and expressing attachment

needs differently are reviewed.

The user continues to focus

on remaining accountable

and correcting patterns of

distorted thinking. The partner

focuses on managing fears,

supporting the user’s efforts to

be different.

10. (Re-establishing the sexual

relationship.) Encourage spe-

cific discussion about any frus-

trations or discomfort about

the sexual relationship, fears,

sexual shame, and attachment

needs associated with sexual

behaviors. If the couple has not

re-established a sexual rela-

tionship, discuss how to make

this experience a learning

experience to resolve shame,

honor self and each other. If

sexual difficulties continue,

specific sessions related to the

dysfunction can be scheduled

or a referral to a sexual thera-

pist may be in order.

11. (Plan for relapse.) At this point,

couples feel different, are

hopeful about the future, and

frequently want to discon-

tinue therapy. It is helpful to

predict relapse as a possibility

and to have the couple talk

about what to do if relapse

(with online activity or old

marital patterns) happens.

Help the couple identify and

discuss red flags and make

agreements for interventions,

including returning to therapy

rather than leaving the rela-

tionship. Role play a variety of

scenarios utilizing the emo-

tionally focused discussions of

the situation, underlying emo-

tions connected to attach-

ment needs, and interactions

that reflect new patterns

rather than old patterns that

make the situation worse.

12. ( Terminate therapy.) After

the couple has completed

enactments of two or three

scenarios related to pos-

sible relapse, therapy may

be terminated. It is helpful

to schedule a follow-up visit

in four weeks to reassess the

couple’s progress.

Professional Resources

Organizations and 12-Step Groups

SOCIETY FOR THE ADVANCEMENT

OF SEXUAL HEALTH – SASH (formerly

the National Council on Sexual

Addiction and Compulsivity)

www.sash.net or www.ncsac.org

Continuing education conferences

and a listing of professionals who

treat clients with sex addiction.

RECOVERING COUPLES ANONYMOUS

www.recovering-couples.org

12-step recovery groups for

couples in which one partner is a

sex addict.

SEX ADDICTS ANONYMOUS

www.sexaa.org

12-step groups for sex addicts.