Sorting Out Individual Versus Couple Therapy for the Treatment of Sexual Addiction and Betrayal Trauma

Couples suffering the fallout of sexual addiction have a dizzying array of stressful choices to sort through. 

When broken trust is discovered or disclosed, couples first need to know their therapeutic options. Some of the first questions they should consider include: 

• How do we begin therapy?
• Will we enter couple therapy?
• Should we start with individual therapy?
• Can we combine couple therapy and individual therapy? 

Professional therapists can help answer your questions but, frankly, there is no one-size-fits-all approach. 

Keep in mind that therapists trained in different approaches will offer you different opinions and recommendations. Pray to have an open, discerning mind and ask your therapist how they reached their conclusions about your needs. 

If your primary need for therapy relates to sexual addiction, you’ll want a therapist who specializes in the treatment of sexual addiction and betrayal trauma. Therapists who are not equipped to treat sexual addiction are not prepared for the unique complications they and you are about to encounter in treatment. 

In my practice I recognize each couple is unique, and so is each spouse. In cooperation with my clients we enter an interactive assessment process to sort through the therapeutic options that give you the best opportunity to recover. 

Starting well in this manner, you’re more likely to finish well. Fail to consider these factors, and you may never get on the right track. Sure, recovery is possible, but it’s important to think strategically. Make the choices from the start that best support your end goal, and recovery from sexual addiction and betrayal trauma will be more attainable.

Now, let’s consider your options. Should you start with individual therapy, couple therapy, or a combination of the two? To make it simpler, let’s begin by looking at those occasions when couple therapy would not be appropriate. 

THUMBS DOWN FOR COUPLE THERAPY AS YOUR STARTING POINT

• Domestic Violence. Couple therapy is never warranted when physical domestic violence has occurred. Each spouse needs individual therapy first to establish clarification on what has happened, personal responsibility, respectful boundaries and actual safety. Individual therapy will help determine what steps you and your spouse must complete before safely entering couple therapy. 
• Boundaries. It’s better to enter individual therapy first if you lack the boundaries and assertiveness needed to protect yourself from non-physical forms of domestic violence including, verbal abuse, emotional abuse, manipulation, and gaslighting. 
• Addictions. If either of you have a chemical addiction or process addiction that leaves you incapacitated, postpone couple therapy and work on your individual sobriety. This would also include those times when a partner denies or severely minimizes his or her addiction. 
• Family Dynamics. Sometimes family dynamics are so complicated that it may be better to work on yourself before entering couple therapy. For example, blended family dynamics are frequently more difficult due to complex bonding and attachment issues. 
• Betrayal Trauma and PTSD. Sexual infidelity seriously breaks the foundation of trust in a marriage. Many betrayed partners experience signs and symptoms consistent with post-traumatic stress disorder. Depending on the severity of these symptoms, individual therapy might be a better approach for one or both spouses and could provide key support for future couple therapy.
• Enabling.  Individual therapy is recommended when one or both spouses are prone to enabling the other’s inappropriate and/or addicted behaviors. In this case you want to discern the underlying motivation of the behavior that enables the addict: is it trauma or is it codependency? 

 By now you can see that a simple answer is not always possible. You and your spouse will likely benefit from the guidance of a mental health professional when sorting through your options. 

Now, let’s consider the occasions when couple therapy or a mixed approach is indicated. 

THUMBS UP FOR COUPLE THERAPY AND/OR COUPLE AND INDIVIDUAL THERAPY

• Assessment. A few sessions or hours of couple therapy gives your therapist the opportunity to see how you interact. Each of you can present your concerns, and the three of you can begin to formulate a plan of action. However, a better assessment may also include a few sessions or hours of individual therapy. A combination of couple therapy and individual therapy will most likely be your best option. 
• Acceleration. If neither spouse has a pressing need for individual support, working together in couple therapy may accelerate your progress and help you reach your goals sooner. On the other hand, if one or both of you have significant issues that would be better served in individual therapy, then you should not skip ahead to couple therapy. 
• Communication. The couple that communicates well creates the safety net that makes working together realistic. If your current level of communication is fairly healthy, then couple therapy may be the right choice for you. 
• Mediation.  Couples who don’t communicate well and can’t resolve their conflicts may opt for couple counseling in which the therapist serves as mediator. In these cases, your therapist will most likely ask each of you to participate in individual therapy as well. 
• Focus. It’s easy to lose your way when sex addiction and betrayal trauma affect your marriage. Couple counseling can help to not only restore your mission and core values but equip you with practical strategies that help you stay on track.
• Enrichment. Some couples have already established a strong marriage over time but may have experienced a slip or relapse that now threatens their marital satisfaction and longevity. Knowing they intend to save their marriage, couple therapy can help refresh their ongoing efforts toward recovery. 
• Disclosure. The addict often needs help to disclose how he has broken his spouse’s sacred trust, and the spouse often needs help to process the betrayal in a way that minimizes that trauma. In this case, a hybrid of individual therapy and couple therapy will serve you better. 
• Discernment. Sometimes one spouse isn’t sure if he or she will work on healing the marriage or if they will end it. A skilled counselor can help couples make an informed decision that supports both biblical guidelines and their individual and collective needs. 

SO WHERE DO WE GO FROM HERE? 

After reading this article your next step may seem obvious to you. Perhaps it’s clear that you and your spouse need to start with individual therapy for one or both of you. Maybe you’re ready for couple therapy. Or, you may feel that combining couple therapy with the occasional individual session would offer you a better opportunity to recover. 

It's going to be important for you to flex with your individual needs and options. Rigid thinking and recovery don’t mix well. 

In any event, ask your professional counselor what he or she thinks about your conclusion. Share your needs, opinions, and insights into your choice on how to start. Prayerfully consider your counselor’s advice with an open heart and mind. Adjust your plans if needed. Then, embrace your recovery for God’s glory, for your own benefit, and for the future of your marriage.