How Does Parts Work Therapy Like IFS and Ego States Therapy Help You to Understand Yourself?

The current article discusses how Parts Work Therapy, including IFS (Internal Family Systems) and Ego States Therapy, can help you to understand yourself.

What is Parts Work Therapy?

Let's start with the basics about Parts Work.

Parts Work Therapy

Parts Work Therapy is a type of Experiential Therapy which incorporates the mind-body connection.

Parts Work Therapy is a general term that encompasses different types of therapy including IFS and Ego State Therapy.

Ego States Therapy was developed by John Watkins, Ph.D and Helen Watkins M.A. in the 1970s to treat traumatized clients. Ego States Therapy combines elements of psychodynamic psychotherapy and hypnotherapy to look at various parts of a client's personality.  The Watkins developed Ego States Therapy to work with traumatized clients.

IFS (Internal Family Systems) Therapy was developed by Richard C. Schwartz in the 1980s.  Similar to Ego States Therapy, IFS also looks at various aspects of a client's personality. Schwartz, who is a family therapist, began to notice patterns in his work as a family therapist, including certain alliances and conflicts between family members, which were similar to various parts of an individual client's personality. Similar to Ego States Therapy, IFS was developed to work with traumatized clients.

How Does Parts Work Therapy Work?

Regardless of whether a psychotherapist uses Ego States Therapy or IFS, she uses Parts Work to explore the various aspects of a client's personality.

Parts Work Therapy

IFS and Ego States Therapy practitioners believe that everyone is made up of various personality subparts that might be in conflict with each other or might be aligned (similar to individual family members who might be either aligned or in conflict with each other).

Each of these parts has their own individual perspectives, beliefs, thoughts and feelings. 

These parts are often unconscious, which makes it difficult to work with on your own before you're familiar with Parts Work.

The goal of Parts Work Therapy is to identify the various parts related to the client's presenting problem, engage with each part compassionately, resolve conflicts between parts and integrate the various parts so they work together in a healthy way.

Example of Parts Work Therapy   

The Client's Presenting Problem:

The following example,which is a composite of many cases with all identifying information omitted, is a simplified illustration of Parts Work Therapy:

Joe's presenting problem is that he feels scared and conflicted about whether to take a new job.  

Part of him would like to take the new job offer because he would make more money and he would advance in his career. But another part of him is afraid he will fail if he takes the new job.

Parts Work Therapy

The Parts Work therapist's job is to help the client to explore and identify the various parts involved in the presenting problem.

There can be many different types of parts and combinations of parts involved in any given presenting problem.  This example represents a simplified illustration where there are three parts involved (in many cases, there are more than three parts).

Using Parts Work Therapy,  Joe and his therapist identify three parts of himself that create his inner conflict:

• A Younger Child Part:  A six or seven years old frightened child part

• An Inner Critic Part: A part that developed around the age of seven that internalized the clients' critical parents

• A Caretaker Part: A part that developed in the client's early teens who has a compassionate attitude towards the client

Joe discovers that the younger child part of himself is frightened to make a change. He also realizes that this is the part that tends to get frightened whenever he is considering making a change.

He also discovers that the inner critic part is adding to the younger child part's fear by engaging in negative talk like, "You're not good enough to take this other job. You're better off sticking with the job you know, even though you're making less money, because if you take the new job, you're going to fail. Stick with what's familiar so you're safe."

Joe recognizes that this inner critic part, which integrated his critical parents, also developed early in his childhood. 

His Parts Work therapist helps Joe to see that, even though this part comes across as critical, it also has "good intentions" because it's trying to protect Joe from the possibility of failure.  

Joe identifies the caretaker part of himself which developed during his teenage years when he had to fend for himself most of the time because his parents were preoccupied with their own problems. Since he couldn't rely on them to help him, he had to develop (on an unconscious level) this caretaker part to help him through difficult situations.

Joe discovered in Parts Work Therapy that the caretaker part integrated aspects of several important people in his life including his high school basketball coach and his English teacher.

Joe's Parts Work therapist helped Joe to have a dialog with each of these parts so he could understand them better. Then, his therapist helped to facilitate a discussion among the three parts so he could understand their dynamic together and how their ongoing dialog created inner conflict for him.

Through these discussions, Joe's Parts Work therapist helped Joe to befriend and speak compassionately to his inner critic. 

He let the inner critic part know that he understood the inner critic's primary goal was to protect Joe from failure and disappointment. However, he needed the inner critic to step aside temporarily so he could make a decision about the new job offer.

In his dialog with the inner critic, Joe assured the part that he wasn't getting rid of him--he was merely asking him to take a back seat temporarily. 

In saying this, Joe recognized that there were aspects of this critical part that could be useful (without the criticism) to help him in the future. 

Parts Work Therapy

For instance, the inner critic part tended to be careful and cautious. If that part could be softened so it was no longer critical, it could be valuable in another situation that was risky. However, in the current presenting problem, Joe knew objectively that he would most likely succeed in the new job--he just didn't feel that way because of the conflict between the parts.

Once the inner critic part had a chance to be heard, it was willing to step aside, as many parts are often willing to do when asked to do so. That allowed the caretaker part to soothe the younger child part so that Joe no longer felt conflicted about his decision.

How Parts Work Therapy Like IFS and Ego States Therapy Help You to Understand Yourself

The example above, which is a simplified version of this type of therapy, illustrates how Parts Work Therapy can help you.

The client identified the presenting problem. Then, the Parts Work therapist helped the client to identify the various aspects of himself that were involved with the problem.

If the same client presented with a different problem, he might identify a different set of parts.

Parts Work Therapy Can Be Done Online

Once the parts were identified, the client discovered how each part functioned individually as well as how they interact with each other. He also realized how a certain part, the inner critic, was getting in the way.  

At the same time, he realized that no part is bad and no part is meant to be discarded or gotten rid of because every part has good intentions, even though they might be going about things in a distorted way. The problematic part just needs to be worked with so it can function in a healthy way.

Once Joe was able to ask the inner critic to step away, he was freed up to allow the caretaker part to nurture the frightened child part so that Joe could make the decision that he objectively knew was best for him.

Once Joe's dilemma was resolved, he could choose to end therapy or he could remain to deal with the underlying trauma that created aspects of these parts. It would be his choice.

There is more to Parts Work Therapy than can be presented in a blog article, but I hope this gives you an idea of how it works.

Conclusion

Parts Work Therapy recognizes that everyone is made up of many aspects.

Various parts work might together in a harmonious way while other conflicting parts need to be identified and worked with for the well-being of the client.

Parts Work Therapy

There are no bad parts.

As in the example above, there might be parts that need to temporarily step aside to work through the presenting problem. Sometimes this is easier said than done, especially with recalcitrant parts that are attempting to protect the client but who function in skewed way.

In the simplified example above, for the sake of explaining Parts Work Therapy, there was only one part that needed to step aside, but in many cases there might be many parts.  

Sometimes there are several parts and they function in a blended way so that each one needs to be identified separately, determine how they function together and how they might be in conflict with other parts.

Parts Work usually isn't accomplished in just one or two sessions. Depending upon the client, the presenting problem and the parts involved, it could take months or longer.

Parts Work Therapy can be used in combination with any other type of therapy, including psychodynamic therapy, cognitive-behavioral therapy, EMDR, Somatic Experiencing, AEDP, hypnotherapy and other modalities.

As previously mentioned, Parts Work Therapy, both Ego States Therapy and IFS, was developed for trauma, but it can be used for any problem.

An important aspect of Parts Work Therapy is that, once a client becomes attuned to their parts, they can do aspects of the work on their own.  

I have had many clients who became adept at identifying their parts and having dialogs with these parts, including asking a particular part to step aside temporarily.

Getting Help in Parts Work Therapy

If you have been unable to work through problems on your own, you could benefit from getting help from a Parts Work therapist.

Parts Work Therapy

Rather than struggling on your own, seek help from a licensed mental health professional who does Parts work so you can lead a more fulfilling life.

About Me

I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Parts Work/Ego States/IFS, Somatic Experiencing and Sex Therapist.

I have over 20 years of experience helping individual adults and couples to resolve their problems.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

See my other articles about Parts Work Therapy:

How Parts Work Therapy Can Be Empowering

How Parts Work Can Help You to Be More Creative

Understanding the Different Aspects of Yourself That Make You Who You Are

Is an Unconscious Part of You Running Your Life?

Discovering and Giving Voice to Different Parts of Yourself

 

What is Trauma-Related Dissociation?

Daydreaming and dissociation are related to each other, but they differ in terms of their duration, severity and underlying mechanisms.

What is the Difference Between Daydreaming and Dissociation?

Daydreaming is usually a harmless activity where an individual imagines certain people, places or events. 

Daydreaming is Pleasant and Relaxing

Daydreaming is often a pleasant and relaxing experience (unless someone spends an excessive amount of time engaged in it to the detriment of other things in their life). 

Daydreaming, getting absorbed in a book and forgetting the miles driven on a familiar road are all light forms of dissociation.

Dissociation involves a detachment or interruption from either thoughts, feelings, current surroundings, memories or an experience of oneself.  Under ordinary circumstances, light dissociation is a temporary detachment or interruption.

Dissociation is a common response to stress.

Dissociation is also a common response to trauma and, under severe conditions, it's a response to posttraumatic stress disorder (PTSD) and Dissociative Identity Disorder (DID) which was formerly known as Multiple Personality Disorder.

Dissociation is on a continuum. Mild dissociation can last up to a few minutes minutes and, on the other end of the continuum, severe dissociation can last days or longer.

Comparing daydreaming to more serious dissociation: Ordinary daydreaming is usually not disruptive to one's life, but severe dissociation can be a distressing experience.

What is the Connection Between Trauma and Dissociation?

Dissociation is an unconscious defense mechanism.

During a traumatic event, the fight or flight response can get activated.

Trauma-Related Dissociation

If an individual is unable to fight or flee, the freeze response gets activated as a way to protect the individual through dissociation.  

One example of the freeze response is the "deer in the headlights" reaction. 

So, for instance, if someone is walking down a deserted street and someone suddenly jumps out to attack them, the person who was walking alone might freeze as part of being shocked.  

The freeze response is an unconscious defense mechanism. As part of the freeze response, the person who is shocked might be unable to speak, run or fight because they are immobilized by the traumatic shock of the attack.

What Are the Signs of Dissociation?

Signs and symptoms of dissociation include (but are not limited to):

• Feeling disconnected from your body, also known as an "out of body experience" (depersonalization)

• Feeling separate from the environment around you. The world around you might feel unreal or distorted (derealization)

• Experiencing lightheadedness, dizziness or a racing heart

• Feeling emotionally numb or disconnected

• Having difficulty feeling emotions

• Feeling unsure of who you are

• Forgetting significant events or times in your life or personal information which could include big gaps in your memories, including memory gaps in your family history

• Feeling disconnected from your body so that you don't feel pain when you would normally expect to feel pain

• Experiencing flashbacks including emotional flashbacks

What Are Some Ways to Cope With Dissociation? (non-DID dissociation)

Some of the following activities might be helpful:

• Writing in a journal
  

• Practicing mindfulness
  

Mindfulness and Square Breathing to Cope With Dissociation

• Practicing Square Breathing
  

• Making self care a priority
  

Getting Help in Trauma Therapy

The suggestions above for coping with dissociation can be good strategies to manage your dissociation, but if you want to overcome trauma-related dissociation, you need to seek help in trauma therapy (see my article: What is a Trauma Therapist?).

Getting Help in Trauma Therapy

Regular talk therapy often has limited success for working through unresolved trauma, which is why certain forms of trauma therapy, like EMDR, AEDP, Somatic Experiencing, IFS, Ego States Therapy and clinical hypnosis, were developed.

All of the above modalities are Experiential Therapies (see my article: Why Experiential Therapy is More Effective Than Talk Therapy to Overcome Trauma).

Unresolved trauma can linger for months, years or even a lifetime, so getting help in trauma therapy sooner rather than later is important.

Once you have worked through unresolved trauma, you can lead a more fulfilling life.

About Me

I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, Somatic Experiencing, IFS, Ego States and Sex Therapist.

With over 20 years of experience as a trauma therapist, I have helped many individual adults and couples work through trauma.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

What is the Difference Between Trauma and PTSD (Posttraumatic Stress Disorder)?

The terms "trauma" and "PTSD" (posttraumatic stress disorder) are often used interchangeably, but there is a difference.

Understanding the Difference Between Trauma and PTSD

What is Trauma?

Trauma is an emotional response to an overwhelming event which could include shock trauma or developmental trauma .

Shock trauma is a one-time event like a robbery, an accident or the devastating effect of a hurricane, to name just a a few examples of shock trauma.

Developmental trauma is ongoing trauma experienced during childhood due to stressful and traumatic events including physical and emotional abuse, physical or emotional neglect, violence, and chronic instability.

The effects of trauma can include (but are not limited to):

• Sadness
• Anxiety
• Depression
• Avoidance of people, places and things related to the trauma
• Anger
• Dissociation
• Confusion
• Exhaustion
• Numbing emotions and numbing yourself to your environment
• Nightmares

Symptoms from shock trauma and developmental trauma can persist for weeks, months, years or a lifetime.  

When symptoms of trauma persist and evolve over time, these symptoms can develop into posttraumatic stress disorder (PTSD) if the symptoms of trauma go untreated.

What is Posttraumatic Stress Disorder (PTSD)?

Even though PTSD and trauma are closely related, they are not the same.

Understanding the Difference Between Trauma and PTSD

"Post" in posttraumatic stress disorder refers to the physical, emotional and psychological impact after trauma occurs.

Whereas trauma is a response to an overwhelming event, PTSD is a more serious mental health condition.

The effects. of PTSD are divided into four categories:

• Re-experiencing symptoms: Flashbacks including emotional flashbacks, nightmares and frightening thoughts

• Avoidance: Avoiding people, places and things related to the traumatic event(s) and avoiding related thoughts and feelings

• Arousal/Reactivity: Getting easily triggered, having difficulty falling or staying asleep, problems calming down, getting easily frightened and experiencing intense anger

• Mood and Cognition: Problems remembering details of the trauma, a negative view of oneself and a lack of interest in hobbies or interactions that were pleasurable before

What is Trauma Therapy?

Trauma therapy includes a variety of therapy modalities including (but not limited to):

• EMDR (Eye Movement Desensitization and Reprocessing) Therapy

• AEDP (Accelerated Experiential Dynamic Psychotherapy)

Understanding Trauma Therapy

• Somatic Experiencing (also known as Somatic Therapy)
  

• Clinical Hypnosis (also known as Hypnotherapy)

• Parts Work Therapy (also known as Internal Family Systems or IFS and Ego States Therapy)

Why is It Important to Seek Help in Trauma Therapy?

Whether you're experiencing unresolved trauma or PTSD, symptoms often get worse over time so seeking help in trauma therapy sooner rather than later is recommended.

Understanding the Importance of Trauma Therapy

Both trauma and PTSD symptoms can carry over intergenerationally, which means that your unresolved trauma can have a significant impact on your children and future generations (see my articles: What is Intergenerational Trauma?).

Getting Help in Trauma Therapy

If you have been struggling with unresolved trauma, you could benefit from working with a trauma therapist (see my article: What is a Trauma Therapist?).

Getting Help in Trauma Therapy

After you have worked through your trauma, you can free yourself from your traumatic history so you can live a more fulfilling life.

About Me

I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Somatic Experiencing and Sex Therapist.

I have over 20 years of experience working with individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Why is Family History Important in Psychotherapy?

New psychotherapy clients, who have never been in therapy before, often ask why therapists ask about family history as part of the beginning phase of therapy.

Talking About Family History as a First Step in Therapy

Why is Family History Important in Psychotherapy?

Here are the main reasons why asking about family history is so important to the success of therapy:

• Family Dynamics: The family dynamics often reflect how someone in that family sees themself and how they interact in their relationships with others, including romantic relationships. Family dynamics, which are internalized at an early age, often remain unconscious until someone begins therapy and learns to see connections between their early experiences and their adult relationships (see my article: Children's Roles in Dysfunctional Families).

• Attachment Patterns: Attachment patterns developed at an early age tend to affect adult relationships. Similar to internalized family dynamics, attachment patterns are often unconscious so that a client is often unaware of it until they develop insight about the affect of these dynamics in therapy (see my article: How Your Attachment Style Can Affect Your Relationship).

Attachment Styles Develop Early in Childhood

• Transmission of Psychological Trauma: It's not unusual for there to be unprocessed trauma that gets transmitted from one generation to the next in a family. When an individual gets help in trauma therapy, they can see the origins of their trauma and process the trauma so it no longer affects them and it doesn't get passed on to the next generation (see my article: What is Intergenerational Trauma?).

• Learned Behavior: Individuals often learn patterns of behavior early in their childhood. They might not be aware they learned this behavior, including how to express emotions, how to deal with stress and how to interact with others, until they become aware of these dynamics in therapy. During therapy their therapist helps them to make connections between their current behavior and what they learned (explicitly or implicitly) early in life (see my article: Developing Skills to Manage Your Emotions).

• Genetic Factors: Certain mental health conditions have a genetic component. This includes anxiety, depression, ADHD (Attention Deficit Hyperactivity Disorder), autism spectrum disorder and other mental health conditions. Knowing about the possibility of genetic factors can help a client to understand their risk for developing these conditions, help with early detection and make informed mental health treatment decisions.

How Do Psychotherapists Use Family History Information?

Different therapists use family history information in different ways.

As an Experiential therapist with a specialty in trauma therapy, I like to get a family history during the early phase of therapy.  This is part of history taking which, depending upon what the client wants to work on, includes family history, current family dynamics, the history of other significant relationships as well as the history of the presenting problem.

By having the family history, the client and I can work towards:

• Identify recurring patterns

• Understand the context of the client's current problems

• Develop coping skills, strategies and internal resources to do trauma therapy.

• Process the trauma using various forms of therapy (see below)

Conclusion

Getting a family history during the beginning phase of therapy is an important first step in helping clients to overcome their emotional challenges.

Experiential therapists know the client's awareness and insight isn't enough to heal (see my article: Healing From the Inside Out: Why Insight Isn't Enough).

Insight is only the first step before the therapist helps clients to work through and overcome their problems through a variety of Experiential Therapy including:

• EMDR Therapy (Eye Movement Desensitization and Reprocessing)

• Somatic Psychotherapy
  

• AEDP (Accelerated Experiential Dynamic Psychotherapy)

• Hypnotherapy (also known as Clinical Hypnosis
  

• Parts Work Therapy (Internal Family System also known as IFS as well as Ego States Therapy)

• Contemporary Psychodynamic Psychotherapy (also known as depth therapy)

All of these Experiential therapy modalities are effective types of therapy depending upon the client and the presenting problem.

Getting Help in Therapy

If you're struggling with emotional issues you have been unable to resolve on your own, you could benefit from working with a licensed mental health professional.

Getting Help in Therapy

Rather than struggling on your own, seek help from a skilled psychotherapist so you can lead a more fulfilling life.

About Me

I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Somatic Experiencing and Sex Therapist.

I have over 20 years of experience working with individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Compulsive Gambling and "March Madness"

The NCAA Division Basketball Tournament, also known as "March Madness," is just around the corner. 

March Madness is one of the most challenging times for compulsive gamblers. Sports gambling has become a very popular pass time, especially among college students. Online gambling is a big business. 

Compulsive Gambling and March Madness

Online gambling brought in over $5 billion from gamblers, some as young as high school age. High school and college students, who are very savvy about using these online sites, are getting caught up in gambling, and many of them are becoming compulsive gamblers.

You might think that completing a tournament bracket for $5 or $10 is harmless, but for some people, it's the beginning of compulsive gambling. Just like some people can have a couple of drinks and not become an alcoholic, some people can gamble and not become a compulsive gambler. But for many people, it's just the beginning of a downward spiral on a slippery slope.

What Are Some of the Warning Signs of Compulsive Gambling?

• Preoccupation with gambling: thinking about it frequently, talking about it a lot, checking the stats often

• Feeling a "high" or "rush" before placing a bet

• A need to bet increasing amounts of money to get that same "high" or "rush"

• Repeated attempts to stop that are unsuccessful

• A need to continue gambling when you're winning

• A need to return to gambling to chase losses

• Feeling irritable and uncomfortable when you try to stop

• Jeopardizing family relationships or your job due to gambling activities

• Borrowing money from family and friends due to gambling activities

• Using gambling activities as a maladaptive coping strategy to deal with stress or uncomfortable feelings or situations

If you have one or more of the above warning signs and symptoms, you have a compulsive gambling problem and you need help. Just like any other addictive or compulsive behavior, compulsive gambling is a progressive disorder that usually gets worse over time.

For more information about compulsive gambling, go to: http://www.gamblinghelp.org

About Me
I am a licensed psychotherapist in New York psychotherapist, hypnotherapist, EMDR, EFT (for couples), AEDP, Somatic Experiencing and Sex Therapist. 

I have helped many clients to overcome their addictive and compulsive behavior so they can lead fulfilling lives.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Rebuilding Relationships After Infidelity

I introduced the topic of infidelity in my prior article, Common Relationship Problems After Infidelity by using two composite vignettes. 

Rebuilding Relationships After Infidelity

In the current article, I'll continue to focus on these two vignettes and show how couples sex therapy can help.

Clinical Vignettes

The following composite vignettes were discussed in my prior article:

Maria and Sal: A Relationship With a Monogamous Agreement

Recap From the Prior Article: 

Maria found out that Sal was cheating on her with another woman after she found his sext messages. Initially, Sal denied he was cheating but, eventually, he admitted it but he said the other woman "meant nothing" to him.  But he agreed to stop seeing the other woman. Both of them agreed to put the matter behind them and "move on." After that, their sex life became much more passionate than it had been in years, but that only lasted a short time. And, despite their agreement to "move on", Maria became highly suspicious of Sal's behavior and even his thoughts.  As a result, they stopped having sex altogether and they didn't know how to repair their relationship.

Rebuilding Relationships After Infidelity

Couples/Sex Therapy for Maria and Sal:

When they couldn't repair their relationship on their own, they sought help in couples sex therapy (see my articles: What is Emotionally Focused Therapy (EFT) For Couples and What is Sex Therapy?).

The couples sex therapist told them that a lot of couples want to avoid the difficult stage of repairing their relationship so they decide to "move on" to avoid difficult emotions. She told them this is a common mistake and to achieve a lasting reconciliation, they couldn't avoid dealing with their emotions.

During couples sex therapy Maria learned how to communicate her hurt and pain and Sal learned how to respond in an empathetic way and to express his genuine remorse. The therapist normalized that, even with couples who want to stay together, their relationship doesn't improve overnight. 

Maria admitted that, after she found out Sal was cheating, she wanted to prove to Sal and to herself that she could be just as sexy and passionate as she imagined the other woman had been. But this stage didn't last long because her anger, resentment and suspicion grew and she felt even more resentful when she thought that Sal might think "everything was okay" just because she was having sex with him.

The therapist also told Sal that, if he wanted Maria to forgive him (and not just brush their problems under the rug), he needed to understand her upset and be accountable to her--even if the reconciliation didn't happen as quickly as he would like. 

They worked on improving communication and rebuilding trust, which was especially difficult for Maria because she realized, once she allowed herself to feel the emotions she had been suppressing, she was hurt and angry (see my article: Learning to Trust Again After Infidelity).

Over time, they both realized that, even though Sal sought Maria's forgiveness and Maria wanted to forgive him, forgiveness isn't a one-and-done process--it comes in stages from surface to depth (see my article: Stages of Forgiveness).

As Maria healed emotionally and began to rebuild trust in Sal, she was open to trying to have sex with him again. At first, there were times during sex when she thought about Sal being with the other woman and she became so upset that she had to stop.

Over time, Maria and Sal accepted that, due to the betrayal, they wouldn't be able to "go back" to the same relationship they had before. They realized they needed to mourn the relationship they had before and develop the next phase of their new relationship. Along the way, there were setbacks, but they continued to make progress (see my article: Setbacks Are a Normal Part of Therapy While You're on the Road to Healing).

Bob and John: A Relationship With a Consensual Nonmonogamous Agreement

Recap from the Prior Article:

Bob and John were in a long term consensually nonmonogamous relationship when Bob found out that John had gone against their agreement by getting emotionally involved with another man (their agreement was that they could have casual sex with other people but not see them more than once to avoid forming emotional ties). John admitted he broke their agreement. He told Bob he never meant to hurt him. He also told him that he wanted to remain in their relationship, but he also wanted to continue to see the other man.  Bob was so hurt that, even though he didn't want to end his relationship with John, he knew it would be excruciating for him if John continued to be emotionally involved with the other man. So, he distanced himself emotionally and sexually from John. Both of them felt stuck and they didn't know what to do.

Rebuilding Relationships After Infidelity

Couples Sex Therapy for Bob and John:

Since they were at an impasse, they decided to seek help from a couples sex therapist.

As John took responsibility for cheating, he realized that he would need to make a painful decision after Bob gave him an ultimatum: Either John would choose to work on their relationship or, if John wanted to continue to see the other man, they would breakup.  

After considering Bob's ultimatum, John chose to work on their relationship and he ended his relationship with the other man. He said he realized he didn't want to lose Bob and that their relationship was the most important relationship in his life.

Similar to Maria and Sal, they had to go through many of the same steps to try to repair their relationship--improving communication and rebuilding trust.

During the early stage of couples sex therapy, they agreed not to see other people until they repaired their relationship. Bob was also fearful that, if they did open their relationship again to have casual sex with others, he wouldn't be able to trust John.

Bob and John worked hard in therapy to rebuild their relationship over time. Gradually, Bob believed John had a deep sense of remorse for his betrayal. John also admitted he had been selfish to cheat on Bob.

The first few times they tried to have sex, Bob got distracted with thoughts about John being with the other man. During those times, Bob had to stop and he turned away from John. He couldn't help feeling insecure in terms of what the other man's body looked like compared to him.  

They were able to talk about it in their couples sex therapy and, over time, John learned to stay focused on remaining emotionally and sexually engaged with John instead of focusing on thoughts about John being with the other man.

When they had rebuilt their trust, which took time, they talked about their consensual nonmonogamous agreement in light of John's cheating and reiterated that they would only have casual sex with others and refrain from having sex with the same partner more than once to avoid developing emotional attachments.

Conclusion

Infidelity can occur in any type of relationship--regardless of whether you and your partner have agreed to be in a monogamous or consensual nonmonogamous relationship.  

If the partners decide to remain together, they need to go through the repair process without skipping or avoiding steps.

Couples sex therapy can help people in relationships to heal and develop the next phase of their relationship.

Getting Help in Couples/Sex Therapy

Couples sex therapy is therapy for people in a relationship where they're having emotional and sexual problems--whether it's about infidelity, differences in libido, communication problems or other relational and/or sexual problems.

Getting Help in Couples/Sex Therapy

If you and your partner are stuck in a dynamic that isn't working, rather than struggling on your own, seek help from a licensed mental health professional who has an expertise with the problem you're having.

The best chance for success in couples sex therapy involves seeking help sooner rather than  later.

About Me

I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Somatic Experiencing and Sex Therapist.

I work with individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Common Relationship Problems After Infidelity

I have written several articles about infidelity in the past (see the links for these articles throughout and at the end of this article).

In the current article I'm discussing on some of the most common problems people in relationships experience after infidelity.

In the next article, I'll discuss steps to repair emotional and sexual intimacy.

Repairing Intimacy After Infidelity

What Are the Most Common Relationships Problems After Infidelity?

Different people will face a variety of problems after infidelity  (see my article: Coping With Infidelity).

Here are some of the most common problems:

• Lack of Trust: Lack of trust can include the betrayed partner questioning their other partner's behavior, thoughts and feelings even when the partner who cheated tries to assure them that they are no longer cheating (see my article: Learning to Trust Again After Infidelity).

• Feeling Devastated: After infidelity is discovered, the betrayed partner can feel emotionally devastated including feeling sad, angry, resentful, ashamed, humiliated, confused, self blaming, powerless, "not good enough" and questioning their desirability. The partner who cheated can also feel emotionally devastated with guilt, shame, sadness, regret, and fear of losing their partner.

Feeling Emotionally Devastated After Infidelity

• Barriers to Communication: It's common for both people to have problems communicating with each other after an affair. Both people can have problems expressing their feelings to each other.

• Struggling With Uncertainty About the Relationship: Even if both people want to repair the relationship, they might also be struggling with uncertainty as to whether or not the relationship can be repaired and, if it can, what the relationship would look like in the future (see my article: Should You Stay or Should You Leave Your Relationship?).

• Struggling With How to Begin the Healing Process: Emotional healing can be a challenge for both people. The betrayed partner might not know how to begin the individual healing process--even after they have decided to try to repair the relationship. The partner who cheated also might not know how to heal especially if they feel they don't deserve to heal because they cheated and caused their partner pain.

• Struggling With Forgiveness: Forgiveness involves more than just the partner who cheated saying "I'm sorry" and the betrayed partner saying "I forgive you" (see my article: Stages of Forgiveness).

Struggling With Forgiveness After Infidelity

• Rebuilding Emotional and Sexual Intimacy: People often struggle with how to rebuild emotional and sexual intimacy after an affair. This is especially challenging if they have waited a while to seek help and they have fallen into a pattern of emotional and sexual  disconnection.  Even if a couple has resumed having sex, they can't assume this means the relationship has been repaired if they haven't gone through the repair process. When couples don't go through that process, there are often unspoken emotions that come to the surface in many different ways (see my article: Have You and Your Partner Stopped Having Sex?).

Clinical Vignettes:

The following clinical vignettes, which are composites of many different cases to protect confidentiality, illustrate some of the common problems people experience after infidelity:

A Relationship With a Monogamous Agreement

    Maria and Sal:

Maria and Sal were married for 10 years when she discovered sexts from another woman on Sal's phone. At first, Sal tried to dismiss Maria's concerns by telling her these sexts didn't mean anything, which served to upset Maria even more because she felt Sal was dismissing her feelings and minimizing the problem.

Sexting and Infidelity

When he realized how distraught Maria felt, Sal took responsibility and admitted he had been having a sexual affair online and in person with another woman for several months. At that point, Maria told Sal that, although she was deeply hurt and angry, she didn't want to end their marriage especially since they had two young children. 

After Sal agreed to end the affair and never have contact with the other woman again, both Maria and Sal agreed to "put it all behind" them and "move on." 

At first, this was a relief to both of them, but over time they realized Maria was having problems trusting Sal. She was suspicious about every text he received and insisted on monitoring his phone. She also didn't believe him when he had to go on a business trip. In addition, she repeatedly demanded to know if Sal was thinking about the other woman and, when he said he wasn't, she didn't believe him.

Initially, after they agreed to remain together, their sex life became more passionate. Maria wanted to prove to Sal and to herself that she was sexually desirable and Sal wanted to prove to Maria that he found her desirable. But after a few weeks, their sexual passion began to wane because of the trust issues--until they stopped having sex altogether (see my article: Have You and Your Partner Stopped Having Sex?).

They didn't know how to talk to each other about these problems or where to begin to repair their problems with emotional and sexual intimacy.

A Relationships With a Consensual Nonmonogamous Agreement

    Bob and John

Bob and John were in a long term consensually nonmonogamous relationship (CNM). Their agreement was their relationship was primary. They also agreed they could have sex with other people, but neither of them would get emotionally involved with anyone else. 

In order to decrease the possibility of developing emotional ties with other men, part of their agreement was that they would only have sex with another person once and then never have contact with that man again.

Initially, they agreed they would have a "don't ask, don't tell" agreement where they could have sex with others, but they wouldn't let each other know about it. 

But, over time, this didn't work for them because they felt the secrecy was harming their relationship. So, they revised their CNM agreement so that they would talk about it before they got sexually involved with others (see my article: What's the Difference Between Privacy and Secrecy in Relationships?).

Their revised agreement seemed to be working out well--until Bob found out from his friend that John was having a long term affair with another man.

Infidelity Can Occur in Consensually Nonmonogamous Relationships

When Bob confronted John, he told him he couldn't believe John went against their CNM agreement. He was hurt and angry.

John admitted he broke their agreement, but he never meant to hurt Bob.  He also told Bob he wasn't sure if he wanted to stop seeing the other man--even though he knew this would cause John a lot of pain.

Both of them wanted to remain together, but Bob knew he couldn't tolerate John having an emotional attachment to another man.

After Bob found out about John's involvement with another man, he distanced himself from John emotionally and sexually.

They both felt stuck and they didn't know how to deal with their problem.

Next Article

In my next article, I'll continue discussing these two vignettes and how couples/sex therapy can help.

Conclusion

Emotional and sexual intimacy are often negatively affected after infidelity.

Many people want to remain in their relationship, but they don't know how to move forward.

Getting Help in Couples/Sex Therapy

If you're having problems repairing intimacy in your relationship after infidelity, you could benefit from working with a couples therapist who is also a sex therapist.

Getting Help in Couples/Sex Therapy

Most couples therapists have no training in sex therapy, so they might be able to help couples to repair emotionally, but they don't have the skills to help them repair sexually.

Rather than struggling on your own, seek help in couples/sex therapy so you can repair emotional and sexual intimacy in your relationship.

About Me

I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Somatic Experiencing and Sex Therapist (see my article: Common Misconceptions About Sex Therapy).

With over 20 years of experience, I have helped many individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Also See My Other Articles:

What is Emotionally Focused Therapy (EFT) For Couples?

What is Sex Therapy?

What Are Common Issues Discussed in Sex Therapy?