The reactions of the betrayed spouse resemble the post-traumatic stress symptoms of the victims of catastrophic events. The most severely traumatised are those who had the greatest trust and were the most unsuspecting. The involved spouse may fear that they will be punished forever for the betrayal while they grieve for the lost dreams associated with the affair. The first issue to be addressed in therapy is clarifying whether the purpose of treatment is rebuilding the marriage, resolving ambivalence about whether to remain married, or separating in a constructive way. One spouse may want to reconcile while the other spouse is still ambivalent or has decided to leave.
Most family therapists work with the couple together as the primary approach.
However, an ambivalent spouse or a severely agitated spouse may also need some individual therapy sessions. One way to help couples rebuild marriages after the disclosure of infidelity is based on an interpersonal trauma model - a process of recovery and healing leading to forgiveness. The first stage of recovery after the impact of the disclosure establishes safety and addresses the painful emotions and traumatic symptoms. Understanding the vulnerabilities for the EMI and telling the story of the affair comprise the middle stage. Integrating the meaning of the affair into the present and moving on into the future is the final stage of healing and forgiveness.