Thursday, June 22, 2017

PTSD and infidelity

This is the script of a podcast to be added to my soundcloud library at Dr. Shults (< link)

One of the lesser known complications of PTSI is sexual misconduct – infidelity – affairs. Let me say at the outset that I am not going to let anybody off the hook by claiming their PTSI caused them to be unfaithful to their spouse. Let me also say that I’ll be using language associated with traditional marriage, but the principles still apply to all relationships where there is an expectation of monogamy.

The point of this podcast is to warn those suffering with anxiety and trauma related issues – and you’ll notice that I’m trying to get in the habit in both writing and speaking to use PTSI rather than PTSD. PTSI is post trauma stress injury and differs from PTSD only in the label. The idea in referring to the changes that stress, anxiety, and trauma impose on the brain as an injury rather than a disorder is to help educate folks about the reality of the physiology of the brain changes, and hopefully remove some of the stigma that the word “disorder” can have. Going back to the image of General Patton in WW2 slapping and insulting a soldier stricken with shell shock, there is still a prevalent idea that overcoming PTSI is a matter of the will – and certainly there is an element of self-help that is essential in recovery from PTSI – and the idea that courage and character are all that are needed to will oneself out of PTSI.

For those of you listening who have vestiges of that thinking about PTSD, let me tell you from experience about the courage and character and heroism I’ve seen in first responders whose work has resulted in PTSI. There is no courage deficit here folks.  But let’s move ahead.

Let’s talk about infidelity without PTSI first. Because of the mostly secretive nature of sexual affairs, it isn’t easy to get an accurate view of how prevalent it is. And, with shifting views of marriage and sexuality, getting a clear definition of what “cheating” is.  I’ll be using the old fashioned definition of adultery which basically means having sex with someone you’re not supposed to be having sex with.

Another question, of course, is whether intercourse is the ultimate definition of adultery or if physical touch less than intercourse counts, and wildly significant in the internet age, whether entanglement with pornography, on-line relationships, and Facebook flirtation lies within the circle of damaging extra-marital affairs. From my conservative moral position (and, let’s face it, from most women’s standpoint) anything that strays from loyalty and focus on your partner is damaging to the health and trust of the relationship.

Let’s be satisfied for now that infidelity is anything you know darn well would be hurtful to your spouse, that he or she would never approve, and that whether you’ve talked it over or not, you know it’s wrong, you keep it a secret, and the cost of being found out could be the end of your relationship. I think we can all agree on that.

The most commonly cited statistic on infidelity, according to the Psychology Today website, is a long term annual survey from the University of Chicago that shows an average of 10% of spouses admitting to cheating in every annual survey since 1972. (

That’s the average between genders with 12% of men and 7% of women. There’s bound to be a lot of lying going on here, and those raw numbers don’t reveal how long these things go on, or if it’s a one time thing, or if there is serial adultery or multiple illicit partners, nor does it specify whether the cheating is with opposite sex or same sex paramours.

As quoted in an article from (, whose author reports that infidelity in marriage is grossly overstated and over estimated:
“In general, based on the above data, we can conclude that over the course of married, heterosexual relationships in the United States, EM sex occurs in less than 25% of committed relationships, and more men than women appear to be engaging in infidelity (Laumann et al., 1994; Wiederman, 1997). 

Further, these rates are significantly lower in any given year. […] (Blow & Hartnett, 2005)” 
If we use a number of studies and methods, it looks like there is about a 6% occurrence of extramarital affairs in any given year, and a 25% occurrence over the course of a relationship over time. This is considerably less than most people glibly say when you hear conversations about cheating, where 50% is often touted as the number – but that is a number found nowhere in scientific research. (I might add that the 50% divorce rate statistic often quoted is also far from accurate, but that’s another program)

Now, let’s move to the subculture of the first responder world. Years ago I was a National Guardsman called out to man fire stations where the fire department had gone on strike. I was at the station for security due to some arson and vandalism fears associated with the disaffected union employees. It took several days for the women who apparently were regular visitors at this particular fire house to realize there was nobody there to “entertain” them. There are police and fire departments whose agency cultures actually encourage adultery, or at least wink at it, and certainly few that attempt to strengthen families and discourage sexual flings.

I’ve worked for a department where affairs were all but expected, from the Chief down, and I’ve worked for departments where family and ethical expectations were high. So, from a purely anecdotal viewpoint, my guess is that cheating in these male-dominated, testosterone infused professions is higher than normal.

Let me read more from the article, thank you author Dr. John Grohol
“And to put cheating into perspective too, the relationship (or one of the people in the relationship) needs to be lacking in something. As my previous article on the topic noted, these risk factors typically include: significant, ongoing, unresolved problems in the primary, long-term relationship or marriage; a significant difference in sex drive between the two partners; the older the primary relationship; a greater difference in personality than perhaps the partners realize; and having been sexually abused as a child.”

Whisman & Snyder (2007) also found support that the likelihood of infidelity decreases the more religious you are, as you age, or if you’re better educated. They also found that the risk for cheating was greater for women who were remarried (compared to those who were on their first marriage), or for either gender with the greater number of sexual partners you have.

So these are characteristics often found, according to researchers, of partners involved in cheating. These may or may not pre-exist in a PTSI involved couple, these conditions may be worsened or heightened during the stress of a PTSI journey, or a stress or brain injured person may have none of these circumstance and the infidelity comes as complete shock to the partner and maybe even to the cheater.

I point that out – in a Captain Obvious kind of way – to say that if you are in a relationship with a person who is in a relationship with a department that does nothing to strengthen marriage and family loyalty, then as a couple your challenge is much greater.

As a law enforcement veteran, as a chaplain, as a researcher, as a counselor, I look forward to a day that has yet to come – a day when the moral and mental health of first responders is one of the foundational training goals in our professions. For cops that means fighting, shooting, driving, knowledge of the law, and sustainable mental health should hold an equal standing as values for professionalism. I didn’t buy it as a rookie and I don’t  buy it now – that cops can use their tough job as an excuse to be an ass.

Now, we come to the added stress of PTSI and related brain and behavior issues. We regulate our behavior by our choices within a framework of moving toward positive things and away from negative things. Brain science tells us that we attend to the negatives much more than the positives. Negative thoughts have greater survival value: watch out for the stick it might be a snake! Don’t go in there! He’s giving you a dirty look! Compare that to positive thoughts – what a pretty sunset, can’t wait to go fishing, etc. Negatives always try to bully their way in front of positives. This is certainly the emergency worker’s life isn’t it!

Our behavior is also governed in a significant way by brain chemistry that is activated in a whole variety of ways that depend on a whole variety of factors – diet, rest, health, context, environment, etc etc.  This is the crux of the health problems associated with PTSI – the part of the brain associated with warning of danger and the hijacking of thoughts and body functions to marshal against a perceived danger are in over drive and don’t allow the body to recover to a point of pre-danger, normal alertness.

Among friends and colleagues who have engaged in affairs, the PTSI connection (if there is/was one in any particular case – I’m not disallowing plain old bad behavior) is often a diagnosis after the delinquent behavior. In other words, sexual acting out may be a sign of PTSI rather than something that happens after a person is struggling with a diagnosis. So, for the partner, even if you can’t deal with the unfaithfulness, you might have the presence of mind to tell the cheater than he or she needs to see a therapist to screen for PTSI if nothing else.

The list of body functions – and resulting feelings – is long with PTSI. So – are there characteristics of PTSI brain chemistry changes that either increase the risk taking behavior associated with infidelity, or decrease the control factors that would normally keep a person’s hands to himself? Let’s look to the diagnostic criteria in the DSM and see.

The DSM is the diagnostics and statistical manual that serves as the library of mental health and behavior characteristics that are diagnosable with a label like PTSD. Let’s review:  The list of criteria include :
·         Overly negative thoughts and assumptions about oneself or the world
·         Exaggerated blame of self or others for causing the trauma
·         Negative affect
·         Decreased interest in activities
·         Feeling isolated
·         Difficulty experiencing positive affect
  • Irritability or aggression
  • Risky or destructive behavior
  • Depersonalization. Experience of being an outside observer of or detached from oneself (e.g., feeling as if "this is not happening to me" or one were in a dream).
  • De-realization. Experience of unreality, distance, or distortion (e.g., "things are not real").
If you do an internet search on PTSD plus adultery or infidelity, you’ll find that most of the results are about PTSD as a result of an affair, rather than the other way around. So let’s visit, for a moment, the reality that spouses of PTSI sufferers are likely to have some level of trauma merely from living with a traumatized partner. Many spouses come to the relationship teetering on the brink of PTSI wholly apart from their partner’s trauma. So, in reality, when we consider behavior associated with PTSI in a relationship, we are ALWAYS dealing with 2 affected persons, whose alertness, lack of trust, and loss of their old identity are the context in which they live.

To quicken my analysis, let’s lump those criteria I mentioned above into one bucket we can call “Loss of Identity” . PTSI can rob us of our sense of worth through self-doubt and depression. This can result in a lot of different delinquent behavior including substance abuse, violence, and infidelity. PTSI constantly whispers “what the hell – you don’t feel anything, nobody could care about you, your old good life is gone, what is there to lose”. PTSI puts a dent in the things that kept us behaving.

Sufferers may feel a numbing of emotions and seek out something that will make them FEEL again. Or they may feel so separated from, and damaging to, the people they love the most that they  feel more separation would be the best thing for everybody.  A good read is an article I’m posting a link to in the script blog to this podcast. ( You can find it at or follow the blog link from my website While I’m promoting those sites, let me shamelessly remind you that I have two books of interest for sale there. One is THE BADGE AND THE BRAIN and the other is FORWARD I GO which is a daily inspirational book. Take a look at them at You’ll also find a link to, dedicated to speaking out and defending officers and the law enforcement profession. You’ll notice a donate button and anything you give will help keep these podcasts going.

Ok back to the subject – so there are some dynamics working here – the isolation and withdrawal can get twisted into a blaming of the partner from whom the PTS injured person is withdrawing from – which isn’t fair to the partner but that’s the way the stress injured brain can work -. In any case the separation can seemingly justify attaching to another.

Or the stress injured person can have such an emotional numbing that the normal emotional responses that help navigate self-control can be reduced. Numbing can also create a vacuum of sensation causing the stress injured person to seek something to create some feeling, which can be any behavior that involves risk and the potential for thrill or some degree of the old self. The numbing can also contribute to the “what the hell” attitude that nothing really matters and things can’t get worse so why not let loose and go for it?

Sexual dysfunction with the PTS injured person and their legitimate partner is also common. A brain that is in survival mode just can’t make an exception and take a break to be sexually aroused while it thinks it is fighting to survive the next minute and the next. PTSI robs from every body function in order to prepare for fight, flight, or freeze. This can lead to frustration and resulting inappropriate behaviors and responses.

Aggression can increase with heightened amygdala – that’s the lizard brain alert system – and sexuality and aggression have long been linked. Illicit sex can serve the same purpose as any displaced aggression that is really aimed at the cosmos and life, but is expressed in futile ways. It may be a way of punishing one’s self, or leaving consequences to fate as in some types of suicide attempts. Kind of a “let’s see if anybody cares” move.

We often hear PTS injured persons lamenting their behavior and responses and feelings. They’ll say “That just isn’t me” – and it isn’t the old them. This sense of not living in reality, the de-realization and de-personalization, can allow a person to do what they normally wouldn’t have done because prior to the PTS injury, they would have had the emotional capacity to foresee the bad consequences of sexual acting out and stop themselves.

Now, one of the other issues frequently involved in the lovely PTSI bouquet of experiences is the additional factor of brain injury. Concussions that damage or change parts or subparts of the brain that influence moral and emotional decision making, can be a huge component of behavior changes. 

Even if the primary trauma associated with PTSI is not a head injury, consider that, in the case of law enforcement certainly, there are plenty of career opportunities to get a blow to the head that may or may not be diagnosed or dealt with, and that may not be associated with the presenting problems of PTSI. So even in cases of cumulative PTSI – a stress disorder that may not be pinned on one life-threatening experience – the pre-existence or concurrent existence of some additional brain injury is a real possibility.We also cannot ignore issues of chronic pain often associated with PTSI trauma, nor the overwhelming challenge of ego and identity loss that can come with loss of employment in emergency services if PTSI or other injuries prohibit a return to work and the financial pressures that can pile up on top of all the other issues. 

In summary, let me reiterate that I’m not trying to give a pass to PTSI related sexual delinquency. Jerk behavior may be just because a person is a jerk and had weak moral foundations for relationships before they ever responded to an emergency. Nor am I implying that PTS injured persons should be immediately forgiven by the victim spouse, or that any of this knowledge reduces the pain of cheating and loss of trust. I’m also not saying that PTSI inevitably gets associated with infidelity (although sexual dysfunction and changes in intimacy are more common than not). 

If anything, the victim partner may be able to take some solace in accepting that they were not the reason for the infidelity, they did not “drive” their PTS injured spouse into someone else’s arms, and that resolving the PTSI with therapy over time will necessarily resolve some of the marital tension that comes with stress injury and illness. The victim partner should be aware of the increased risk of infidelity, and should be doing all they can for self-care, to reduce their own risk of developing PTSI. The decision to save a relationship wounded by infidelity is a difficult one, but it is possible when everyone involved does the healing work and recognizes that success may come in small steps over a long time.

If you have comments or questions about this topic – or anything really-  please email me at, check out my website at or call me toll free at 1 855 5SHULTS – 1 8 triple five S-H-U-L-T-S

Thanks for listening and remember that the script for this program with some article reference links are available on my blog that can be linked from my website.  I’ll leave you with 2Timothy 1:7  For God gave us a spirit not of fear but of power and love and self-control.