ABSTRACT
Substance use and behavioral disorders may play a significant role in a relationship’s etiology and ongoing dynamics impacted by infidelity. Relationships damaged by betrayal and trauma from infidelity, also presenting with an undiagnosed substance use or behavioral disorder, add another dimension of assessment to establish appropriate treatment goals and priorities. Substance misuse and active addiction create increased risks for impulsivity, poor judgment, and disinhibition, with potential consequences of sexual or emotional relationship betrayal. Comorbidities, while oftentimes requiring additional individually oriented attention and support, should also be addressed from a relational perspective. Addiction, including process addictions, is another level and aspect of betrayal that, if not addressed, will likely impact the effectiveness of couple therapy for affair recovery. Additionally, serial affairs and ongoing and long-standing sexual behaviors outside the relationship that have created distress in the relationship may reflect dysregulation in the partner, akin to addiction, and not necessarily a symptom of relationship unhappiness or dysfunction. A protocol for couple assessment to assess and address substance use and behavioral disorders is suggested in this chapter.
