Treating Infidelity in Same-Sex Couples

Christopher R. Martell
Independent Practice and University of Washington, Seattle

Stacey E. Prince
Independent Practice and University of Washington, Seattle

Psychotherapy with same-sex couples does not differ markedly from standard couple therapies; this is also true for treating couples facing infidelity. However, same-sex couples often design their relationships differently,
without tradition and formal marital contracts to prescribe behavior. Based
on clinical experience and the empirical research, this article addresses
the differing norms involved in affirmatively treating infidelity in gay and
lesbian couples within the framework of integrative behavioral couple
therapy (IBCT). Two cases illustrate the process and outcome of IBCT
with same-sex couples. 2005 Wiley Periodicals, Inc. J Clin Psychol/In
Session 61: 14291438, 2005.
Keywords: couples; infidelity; psychotherapy; gay; lesbian; same-sex

Stereotypes abound that gay men do not have intimate, enduring relationships and that
lesbian women become psychologically fused with their partners. According to these
stereotypes, infidelity would be moot for gay men because they are considered rampantly
sexual, as well as for lesbian women because they cling desperately to one another.
Same-sex couples do, in many cases, approach relationships differently than their heterosexual counterparts, and there is great variability in relationships.
In this article, we explore the complexity in same-sex relationships as it relates to
infidelity and its psychological treatment. This understanding comes both from the nascent
empirical literature on the topic and from our combined years of experience working with
this population in clinical practice.
Monogamy, as practiced in the western world, has not been the norm across cultures
throughout history. The current understanding in the United States that marriage should
Correspondence concerning this article should be addressed to: Christopher R. Martell, Ph.D., 818 12th Avenue, Seattle, WA 98122; e-mail: martellc@u.washington.edu; or to Stacey E. Prince, Ph.D., 818 12th Avenue,
Seattle, WA 98122; e-mail: sprince38@hotmail.com.

JCLP/In Session, Vol. 61(11), 14291438 (2005)

2005 Wiley Periodicals, Inc.
Published online in Wiley InterScience (www.interscience.wiley.com). DOI: 10.1002/jclp.20192

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be between one man and one womanas represented in the Defense of Marriage Actis
not universal. In response to a proposal to amend the U.S. Constitution to prohibit samesex marriage, the American Anthropological Association published a statement opposing
such an act on the grounds that marriage between one man and one woman is not a
universal norm, and that a vast array of family types . . . can contribute to humane
family societies (American Anthropological Association, 2004). When it comes to infidelity, however, most people think of one man and one woman in a relationship in which
one or both partners have breached the commitment to a sexually exclusive relationship.
In fact, relationships are more complex than this heterosexist norm would dictate, and
same-sex couples exemplify this complexity.

What We Know About Same-Sex Couples

Much of the published literature has compared same-sex couples to either legally married
or cohabitating mixed-sex couples. Such comparisons have found that relationship quality and satisfaction are similar across types of couples (e.g., Blasband & Peplau, 1985;
Kurdek & Schmitt, 1986). Research has also indicated that sexual nonmonogamy is common in gay male relationships (Blumstein & Schwartz, 1983; McWhirter & Mattison,
1984), and that lesbian women are more likely to remain friends with ex-partners after
becoming involved with a new partner (Clunis & Green, 2000). Findings that confirm
common-sense notions based on gender have also been found, such as research suggesting that gay male couples maintain greater autonomy than lesbian or heterosexual couples, and that there is a stronger interpersonal focus in lesbian couples compared to gay
male or heterosexual couples (Kurdek, 1998). Lesbian couples and gay male couples also
tend to be more egalitarian in divisions of labor than heterosexual couples (Kurdek,
1993; Solomon, Rothblum, & Balsam, 2004). Same-sex couples use more positive emotions when initiating a negative conversation than do heterosexual couples, but gay male
couples have greater difficulty recovering after a negative interaction than do lesbian or
heterosexual couples (Gottman, Levenson, Swanson, et al., 2003). Nonetheless, predictors of relationship success or dissolution are generally the same for all types of couples,
and relationships tend to work on similar principles (Gottman, Levenson, Gross, et al.,
2003; Kurdek, 1992).
Nonmonogamy versus infidelity must be discussed before we address treatment of
infidelity in same-sex couples. It is important to note that sexual relationships outside of
the primary relationship are not de facto affairs, and that the context of the couples
agreement with one another about outside sexual activity is crucial in understanding what
impact such activity will have on the couple. This is true regardless of whether the couple
is heterosexual, lesbian, or gay.
Although some heterosexual and lesbian couples agree to nonmonogamous relationships, this particular arrangement is more relevant to gay couples. For some gay men,
nonmonogamy is viewed as a political statement, a rejection of dominant cultural norms
that have been oppressive to them (Greenan & Tunnell, 2003), and such sexual activity
is viewed as recreational rather than as a betrayal of the primary relationship. Several
studies have confirmed that such arrangements are not detrimental to the primary relationship, and that sexually nonmonogamous versus monogamous couples have comparable levels of relationship satisfaction (e.g., Blasband & Peplau, 1985; Blumstein &
Schwartz, 1983).
The relational context is critical in the impact of nonmonogamy on the couples
relationship; this includes agreeing on parameters for what is and isnt acceptable, changing

Infidelity in Same-Sex Couples

1431

the parameters if one or both partners become uncomfortable, and agreeing on degree of
disclosure. A brief case will serve to illustrate these points.
Steve and Richard, ages 39 and 36, had been together for 4 years and living together
for 2 years. They came to therapy looking to work primarily on communication. In particular, Richard wanted to work more on being assertive and talking about problems as
they came up, rather than storing up resentments. Steve, on the other hand, tended to
dominate the relationship in many ways. He made most of the major decisions for the
couple; verbally, he was quick to process and to express anger, and was impatient with
what he saw as Steves passivity. Steve and Richard had a nonmonogamous relationship
and had agreed to the following parameters: they would disclose to one another whenever
sex outside of the relationship had taken place; they would always practice safe sex both
in and outside of their relationship; sex with close friends was not allowed; and if sexual
encounters occurred with the same individual more than three times, it would be discussed and the outside relationship would possibly be terminated, as both partners agreed
that this frequency of sexual encounter might lead to a level of intimacy that could threaten
their own commitment. In fact, most of the outside sex that Steve and Richard had consisted of brief, anonymous encounters either at the gym or when one of them was out of
town. Not only did their nonmonogamy not appear to detract from their primary relationship, but it enhanced their sexual connection at times, as they would sometimes tell one
another about their outside encounters. Both found it exciting that their partner was found
attractive by other men. This case illustrates the importance of the therapist being aware
of differing norms for same-sex and heterosexual couples.
Integrative Behavioral Couple Therapy With Same-Sex Couples
Several large-scale clinical trials of couple therapy have been conducted with heterosexual couples, but few clinical trials to date have included same-sex couples. Psychotherapists have been doing effective work with same-sex couples for decades and have proposed
excellent suggestions for affirmative treatments (e.g., Berzon, 1988; Clunis & Green,
2000; Greenan & Tunnell, 2003). A promising therapy, combining traditional behavioral
couple therapy and experiential therapies, referred to as integrative behavioral couple
therapy (IBCT; Jacobson & Christensen, 1996), has produced clinically significant improvements in distressed heterosexual couples (Christensen et al., 2004) and has been applied
clinically with same-sex couples (Martell & Land, 2002). Simply stated, IBCT therapists
attempt to balance change techniques with acceptance and tolerance techniques. The
therapist identifies themes around which the couple has difficulty, why they are vulnerable to these difficulties, and how they have polarized around problems, and then helps
them turn the problems into opportunities for greater intimacy, acceptance, or tolerance.
In addition to behavior change, IBCT emphasizes emotional acceptance that is designed
to increase intimacy even in the context of problems that seem impervious to change.
Some readers may be less familiar with IBCT than with its predecessor, traditional
behavioral couple therapy (TBCT; Jacobson & Margolin, 1979). This approach focused
primarily on skill-building and change strategies, including the exchange of positive
behaviors, improving communication skills, and problem-solving strategies.
IBCTs approach to infidelity is different from TBCTs in several significant ways.
First, the IBCT therapist will not refuse to treat a couple in which an affair is ongoing.
The TBCT approach would be to inform the individual having the affair that, unless the
affair is stopped, therapy cannot continue. However, such a stance often has the effect of
the affair going undisclosed to the therapist, the partner, or both, thus maintaining relationship distress and making it difficult for the therapist to help the couple work on

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conflicts that are likely behind both the affair and their distress. Furthermore, despite the
severe relational crisis that disclosure of an affair often engenders, the IBCT therapist
views such a crisis as an opportunity to help the couple begin to examine and improve
their relationship. Thus, the IBCT therapist will not refuse to continue therapy with a
couple in which one partner is having an affair. However, like a TBCT therapist, the
IBCT therapist will refuse to treat couples where the person having the affair refuses to
disclose it to his or her partner. For example, if the affair is revealed during an individual
session that takes place as part of the assessment phase, the IBCT therapist will strongly
encourage disclosure of the affair, either between sessions or ideally in the presence
of the therapist during the subsequent couple session. If the individual refuses to disclose,
the therapist will require the person having the affair to tell his or her partner that he or
she is insufficiently committed to couple therapy, and will make it clear that therapy will
not continue unless the secret is revealed. The therapist should be ready to provide support to both partners should the affair be disclosed.
For the IBCT therapist, once the affair has been disclosed, the continuation of therapy is not dependent on immediate termination of the affair, even though this might be
the couples ultimate decision. In subsequent sessions, the IBCT therapist will help the
couple explore the meaning of the affair for both partners, the impact the affair has had
on their relationship prior to disclosure, the affective impact of the disclosure, and the
best course of action. For the majority of couples, this will mean discontinuation of the
affair, and the therapist may help the couple determine action they can take together,
such as writing and mailing a letter to the third party that terminates the affair and any
subsequent contact. Engaging in this activity together is a form of unified detachment, an important IBCT emotional acceptance strategy, as it encourages the couple to
work together against an outside adversary, in this case the negative impact of the affair
on their relationship.
The IBCT therapist also helps the couple to view the affair in light of their core
relationship conflicts. For example, it might be formulated as symptomatic of their distance and polarization, as an expression of one partners desire for more attention from an
overcommitted spouse, or as an attempt to rediscover passion in a relationship whose
sexual quality has diminished. This approach is not meant to excuse or minimize the
negative impact of the behavior of the person having the affair, but rather to deepen the
couples understanding of the relationship problems that caused the affair, so those core
problems can be addressed. Finally, validating and reformulating negative behavior, the
IBCT therapist models a nonblaming stance toward both partners, regardless of their
actions. The IBCT stance is that behaviors make sense, even if some may be deemed
unacceptable (Jacobson & Christensen, 1996). This viewpoint is more likely to lead to
increased understanding, closeness, and ultimately change, than simply condemning the
affair and its perpetrator.

Two Case Illustrations

Within the context of our understanding of same-sex couples, we present the IBCT treatment of two cases that illustrate psychotherapy of infidelity in same-sex couples.
Case Illustration 1: David and Ron. David and Ron represent a good example of the
several dynamics that differ in gay relationships from either heterosexual or lesbian relationships. They first sought couple therapy for repair after an infidelity occurred, but they
were not a couple that made demands of monogamy on one another.

Infidelity in Same-Sex Couples

1433

David and Ron had been dating for about 8 months prior to therapy. They had begun
dating immediately following the dissolution of Davids 5-year relationship with another
man. Ron had never had a permanent partner, and the longest he had been in a relationship was 5 months. For the first 6 months of their relationship, David and Ron continued
to see other men and to date outside of their relationship. As their relationship became
more serious they had discussions about expectations regarding monogamy.
Davids previous relationship had become nonsexual for the final 2 years, and he did
not want to repeat such a passionless existence with Ron. However, he also wanted to
start with a clean slate, to develop his relationship with Ron in what he considered to be
a healthy union. It was important to David to put old relationships behind him. He expected
that both he and Ron would cease relationships with men that they were casually dating.
Ron wanted a long-term relationship, and hoped that he and David would develop such a
bond. Though he and David had talked about taking their relationship to the next step, he
was not certain as to what that meant. He occasionally continued to have sex with a
friend, Albert. When David became suspicious of Albert and asked Ron if they were
having sex, Ron, fearing that David would terminate their relationship, denied it. David
asked Albert if he was still having sex with Ron, and Albert said that they were. David
confronted Ron with this news, and Ron admitted that he had not told the truth when
asked previously. David felt betrayed, and feared that Ron would not be a trustworthy
partner. He considered ending the relationship. At Rons request, David agreed to see a
therapist before making a final decision to end the relationship.
The therapist working with David and Ron met with them both together and then
with each individually to gather individual histories prior to developing a formulation to
present to them in a feedback session. The main themes that captured the couples problems, understandably, following Rons sexual indiscretion, were trust and commitment.
Given that one of the goals of IBCT is to help the couple engage in conversations that will
promote acceptance of one another as human beings, it was important that David understood Rons behavior and that Ron understood why David was having such difficulty
forgiving him when they did not have a clearly monogamous relationship.
Ron was the eighth child in a family of nine children. His parents were conservative Catholics and had high expectations of their children to live according to the moral
principles the parents had set down. When Rons eldest sister became pregnant out of
wedlock at the age of 18, Rons parents sent her away to have the baby quietly and
the child was placed in adoption, never to be spoken of again in the family. Ron, only a
child at the time this occurred, discovered the story one night when his father, in a fit of
anger, referred to his eldest sister as that whore and her baby. Rons father had died
prior to Ron coming out openly as a gay man. His family was relatively accepting,
though some told him that they prayed for him to change. Rons previous boyfriends
had been emotionally distant, and discouraged him from talking about his inner life.
Though David wanted to be frank and open in the relationship, Ron was unsure what
that meant, because his history of being forthright in relationships had led to the dissolution of several.
Davids family was quite different from Rons. His parents were both college professors who, though espousing strict ethical standards, did not raise their four children in
a religious tradition. David was the eldest child. He was expected to help raise his younger siblings, and from the age of 13 was the family babysitter at least one or two evenings
a week. One of the values strongly instilled in David was trustworthiness. His experience
had taught him that many mistakes could be overlooked, like the time he fed his younger
siblings popcorn for dinner when his mother had left lasagna in the refrigerator, as long as
one took responsibility for the mistake.

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During the feedback session, the therapist used the historical information in making
a plausible formulation for the couple. Rons traditional beliefs about family and sexuality had led to feeling shame about his sexual behavior. He separated sex from emotions
more than David. He also, however, held heterosexual, married couples as the ultimate
models of commitment, and because he and David had not yet moved in together, he had
placed less emphasis on monogamy. Rons thinking was black and white: If they werent
going to be completely monogamous, what difference did it make if he and Albert continued to have sex? Ron had justified his behavior, and was surprised at how upsetting
this was to David. Ron had assumed that David was not very committed to him yet, and
he was also hedging his bets by continuing to have a sexual relationship with Albert.
Although David was not comforted by this explanation, he could recognize that Ron
was not trying to betray him. Now that Ron understood the distress that the affair had caused
he wanted to change his behavior. David, unlike Ron, was more likely to recognize the nuances
of relationships and commitments. Whereas Rons familys traditional mores had taught him
the physical trappings of a commitment and a home, Davids family background allowed
him to develop a strong sense that one could make ones own path in the world. He also
strongly believed that ones word is supremely important. His last relationship had lasted
for many years after the passion was gone and his partner had grown distant. David still honored his commitment to him, until he met Ron, and then he determined to end the relationship so he could be free to move on. He felt guilt about having done so, but wanted a
relationship that would be fulfilling. After Rons indiscretion, David began to worry that he
was, once again, committing himself to a one-sided relationship.
Following the feedback session, several more sessions were spent debriefing the
affair between Ron and Albert, and the impact it had on David. After 2 months of therapy,
the couple had reached an impasse, and David continued to have difficulty trusting Ron.
Ron suggested that they change their relationship to allow David to have sex with other
men, but that Ron would commit to being monogamous. The couple thought this might
create a sense of fairness and bring the relationship back into balance. They both agreed
to this arrangement and tried it for about 6 months. This maneuver helped assuage Rons
feelings of guilt, but did not make much of an impact on Davids mistrust. The couple
continued in therapy every 2 weeks for a year, and then reduced visits to once a month. In
the sessions, discussion of events that occurred over the previous weeks helped to increase
the couples feelings of intimacy, and over time David regained his trust in Ron. There
were still areas of vulnerability to be worked through, however. Because the couple still
did not live together, Ron spent evenings alone when he wanted to call David either for a
brief chat or to invite David over, but refrained from calling because he thought if David
wanted to spend that much time with me, wed be living together. In therapy, David was
able to make it clear to Ron that he wanted him to call whenever he wished, and that
Rons desires to talk to David would always take priority over other guests, even if David
needed to make a conversation short and plan another time to talk.
Following the 6-month period when Ron was monogamous but David was free to do
what he wanted, the couple decided that neither of them wanted to have a monogamous
relationship, but they agreed to nonmonogamy with very clear rules. The rules were that
they would not have sex with other men without full disclosure to one another, they
would not have sexual relationships with friends, and if either of them felt vulnerable or
threatened, they would cease extra-relationship activity. This arrangement worked well
for Ron and David generally, although they continued to negotiate the rules and to discuss
activities that either one felt uncomfortable about. Eventually they moved in together.
This was a comfort to Ron, who was better able to recognize their relationship as truly
committed when it looked more like a traditional couple living under the same roof.

Infidelity in Same-Sex Couples

1435

David and Ron are representative of treating the aftermath of an affair in a gay
couple for several reasons. First, Ron and David did not require absolute sexual monogamy, but they did require honesty in the relationship. Second, Ron and David had to
develop their own structure for their relationship, based on the values that they had each
developed as adults without the de facto rules and customs of formalized marriage. Third,
the case of Ron and David demonstrates the IBCT principle that behavior makes sense,
and that one need not vilify a person for offenses once one understands the contingencies
that may have contributed to the behavior. Finally, this case also demonstrates the necessity for therapists to understand the differences regarding sexual moreswhether they
are based on gender, culture, or sexual orientation.
Case Illustration 2: Jeannette and Sarah. Whereas David and Ron illustrate the
concept that sex outside of the relationship does not necessarily constitute an affair, our
next example illustrates the point that an affair need not contain or consist of sex in order
to have a deleterious effect on the primary relationship or to be treated as an affair in
couple therapy. Jeannette and Sarah, ages 30 and 35, presented for couple therapy complaining primarily of decreased intimacy. This included verbal and physical expressions
of affection as well as sex. Both reported that intimacy in their relationship was great in
the beginning, but had declined over the past 2 years. When asked whether they could
identify any precipitants, both said that it had been a very stressful couple of years for
them, with Jeannette completing graduate school and starting a new, highly challenging
job, while Sarah felt underemployed as a retail salesperson. Jeannettes busy schedule,
their frequent arguments about money, and Sarahs feelings about her lack of career goals
and that Jeannette judged her for not having a better job had all contributed to them
becoming increasingly distant and wary of engaging. Their discussions often led to conflicts, which they did not have the skills to resolve.
Differences in their communication and personality styles also contributed to their
relationship dissatisfaction. Sarah was quiet and introverted, whereas Jeannette was verbally articulate, outgoing, and by her own description could be overbearing. Jeannette
was also more often overtly critical; although Sarah sometimes felt irritation at Jeannettes behavior, she rarely voiced her feelings. These differences led to a classic demandwithdrawal interaction pattern (e.g., Christensen & Heavey, 1993), in which Jeannette
frequently brought up relationship problems or asked Sarah to change her behavior; Sarah
would withdraw from these interactions, feeling hurt and overwhelmed by Jeannettes
nagging. Sarahs withdrawal would frustrate Jeannette, who would push harder for a
response, sometimes escalating by raising her voice, resulting in Sarah withdrawing even
more, and so on. Although this pattern has been linked to gender, with women in heterosexual relationships more often in the demanding role and men in the withdrawing
role, we have observed that it also occurs frequently in same-sex relationships, and can
similarly lead to polarization and distress (see Martell, Safren, & Prince, 2004).
After meeting with the couple together and gathering the relationship history described
above, the therapist met with each partner separately, to collect individual history as well
as to assess the problems and strengths in their relationship. Jeannettes and Sarahs
family histories contributed to an understanding of their current interpersonal behavior.
Jeannette came from an open, loving, and boisterous family, in which she received a lot
of positive attention from her parents; conflict between siblings, and between the children
and their parents, was tolerated well. Sarah, on the other hand, grew up with a father who
was verbally and physically abusive toward her mother, her brother, and herself. She
described her father as simmering all the time, easily provoked to anger, and said that
the best strategy was to stay out of his way as much as possible. The few times that

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Sarah did stand up to him, usually in defense of her mother, resulted in severe beatings.
Sarah had done a great deal of individual therapy and had worked through many of her
family-of-origin conflicts, but in her adult relationships still found herself to be quiet,
withdrawn, and unassertive. Whereas Jeannette experienced Sarahs withdrawal as rejection, Sarah experienced Jeannettes intensity as frightening and overwhelming. Although
Jeannette had never been threatening or physically violent, Sarah felt that threat was
always under the surface, and felt it best to just stay out of the way.
In her individual session, Jeannette revealed that she had been having increasing
contact with a woman she had met at work, Syd. She said that at first their friendship was
confined to work, often having lunch together or working out at the gym before heading
home. However, after a few months their contact became more intimate, including writing letters and e-mails in which they disclosed a great deal about themselves personally,
and began to express affection and attraction toward each other. Jeannette found this
relationship to be an outlet for her worries about her new job; she confided in Syd and
described her as a great listener who could also provide sound advice. A few weeks prior
to beginning therapy, when Sarah was out of town, Jeannette spent a day and evening at
Syds apartment, spending the night in bed. Although they did not have sex, they kissed
and held one another. Jeannette had not told Sarah about this relationship beyond that
they were work friends. Although Jeannette did not want to leave her relationship with
Sarah to be with Syd, she did find the other womans attention powerful and reinforcing,
and was reluctant to give up the relationship, especially in light of the increasing distance
she was experiencing with Sarah. She was, however, willing to disclose the relationship
to Sarah and agreed to do so in the subsequent feedback session.
During the feedback session, the therapist began by providing the couple with a
summary of their strengths, problems, and relationship dynamics. A core theme that was
emphasized was their demand-withdrawal interaction, and the therapist highlighted the
family histories that helped to explain their behavior and reactions to one another. The
therapist then asked Jeannette to talk about what had been discussed in their individual
session. Jeannette told Sarah that she had gotten closer to her work friend, Syd, and that
the two of them had recently spent the night together. At first Jeannette blamed Sarah
for what she called her pseudo-affair, stating that Sarahs withdrawal had caused her
to get her needs met elsewhere. While validating Jeannettes point that the distance in
their relationship was distressing, the therapist discouraged Jeannettes blaming stance,
instead encouraging her to express her hurt and loneliness when Sarah withdrew from
her. Sarahs response to Jeannettes disclosure was characteristically reserved and stoic.
She said that she was not surprised by the news, and had suspected that Jeannettes
relationship with Syd had grown more intimate. She said that she was more upset by
hearing that Jeannette had begun to interact with Syd as her primary confidante, talking
to her about problems at work, than that they had been physically intimate. The remainder of the feedback session was spent discussing what each of them needed in order to
go forward with therapy. The therapist encouraged each of them to ask for what they
wanted. Jeannette said that she did not want to give up her friendship with Syd, but
Sarah asked her to agree to have no contact with Syd outside of incidental interactions
at work for a period of time while they commenced couple therapy. Jeannette agreed to
this. Their first homework assignment was for Jeannette to call Syd in Sarahs presence
to establish this boundary.
Subsequent therapy sessions focused on modifying their demand-withdraw pattern,
which came up in a variety of contexts, and on conceptualizing the affair as a manifestation of the distance that had been created by this pattern. The therapist helped them to
see that months of aversive interactions had led to withdrawal and avoidance by both

Infidelity in Same-Sex Couples

1437

partners, and Jeannettes dissatisfaction with the amount of closeness in the relationship
had led her to pursue emotional intimacy outside of the relationship. While not justifying or excusing the behavior, this reframing of Jeannettes infidelity helped the couple
to move past blame and to look at the interaction patterns that had contributed to getting
them to this point. The therapist utilized several emotional acceptance strategies, including debriefing recent negative interactions in order to facilitate unified detachment
from the problem, further explication of their personal histories that helped each partner
feel more empathic toward the others behavior, and increasing self-care strategies that
each partner could utilize in the face of the partners inevitable relapses into negative
behavior.
These strategies were designed to increase emotional acceptance, and unlike traditional behavioral couple therapy, behavior change was not emphasized from the outset.
Only after the partners had softened their positions toward one another did the therapist
introduce a more change-focused and skills-oriented approach. This included teaching
Sarah assertiveness skills and teaching Jeannette listening skills and to bring up problems
more gently, so that Sarah would feel safe to assert herself. They also learned and practiced conflict resolution skills, and used time-outs when Sarah felt overwhelmed or when
either partner felt that their interactions were becoming destructive.
After several months of therapy, both partners reported feeling more relaxed and
closer to one another. Final sessions focused on enhancing generalization and maintenance of treatment gains, including the couple having bi-weekly state of the relationship
meetings in which they could address conflicts that had come up since they last checked
in with one another. The latter intervention also helped to prevent the slow emotional
separation that had occurred prior to them entering treatment. Prior to termination, the
couple discussed Jeannettes relationship with Syd. Jeannette wanted to continue the
friendship, but Sarah asked that Jeannette not spend time alone with Syd outside of work
for the time being, and Jeannette agreed to this. The therapist also suggested that it might
be helpful for Sarah and Syd to meet, as a way to assert Jeannette and Sarahs primary
relationship with each other, and the couple did end up going out with Syd once before
therapy terminated.

Clinical Issues and Summary

These case examples demonstrate that working with infidelity in lesbian and gay relationships is not vastly different from mixed-gender couples, but therapists must be aware
of cultural norms that vary with same-sex couples. There will probably be even greater
variation in same-sex couples from different cultural and ethnic groups. Each therapy
needs to be tailored to the particular context in which the couple lives. The following list
of dos and donts will serve as our conclusion on treating infidelity in same-sex couples.
Do:
Use culturally sensitive norms when evaluating the meaning and impact of sexual
behavior outside of the relationship.
Remember that the functions of infidelity for the individual having the affair can
vary widely.
Model a nonblaming stance by reformulating the affair in terms of the couples
core themes.
Take seriously the hurt that the injured partner feels about a betrayal, and the
shame that the offender feels about having betrayed a trust.

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Dont:
Assume that sex outside of the relationship equals an affair.
Assume that an affair means sex.
Underestimate the partners commitment to one another or to fidelity if they choose
a nonmonogamous relationship.
Select References/Recommended Readings
American Anthropological Association. (2004). Statement on marriage and the family from the
American Anthropological Association. Retrieved December 1, 2004, from http://www.
aaanet.org/press/ma_stmt_marriage.htm
Berzon, B. (1988). Permanent partners. New York: Plume.
Blasband, D., & Peplau, L.A. (1985). Sexual exclusivity versus openness in gay couples. Archives
of Sexual Behavior, 14, 395 412.
Blumstein, P., & Schwartz, P. (1983). American couples: Money, work and sex. New York: Morrow.
Christensen, A., Atkins, D.C., Berns, S., Wheeler, J., Baucom, D.H., & Simpson, L.E. (2004).
Traditional versus integrative behavioral couple therapy for significantly and chronically distressed married couples. Journal of Consulting and Clinical Psychology, 72, 176191.
Christensen, A., & Heavey, C.L. (1990). Gender and social structure in the demand/withdraw
pattern of marital conflict. Journal of Personality and Social Psychology, 59, 7381.
Clunis, D.M., & Green, G.D. (2000). Lesbian couples: A guide to creating healthy relationships.
Seattle: Seal.
Greenan, D.E., & Tunnell, G. (2003). Couple therapy with gay men. New York: Guilford.
Gottman, J.M., Levenson, R.W., Gross, J., Frederickson, B.L., McCoy, K., Rosenthal, L., et al.
(2003). Correlates of gay and lesbian couples relationship satisfaction and relationship dissolution. Journal of Homosexuality, 45, 23 43.
Gottman, J.M., Levenson, R.W., Swanson, C., Swanson, K.I., Tyson, R., & Yoshimoto, D. (2003).
Observing gay, lesbian, and heterosexual couples relationships: Mathematical modeling of
conflict interaction. Journal of Homosexuality, 45, 6591.
Jacobson, N.S., & Christensen, A. (1996). Integrative couple therapy: Promoting acceptance and
change. New York: Norton.
Jacobson, N.S., & Margolin, G. (1979). Marital therapy: Strategies based on social learning and
behavior exchange principles. New York: Brunner/Mazel.
Kurdek, L.A. (1992). Relationship stability and relationship satisfaction in cohabiting gay and
lesbian couples: A prospective longitudinal test of the contextual and interdependence models.
Journal of Social and Personal Relationships, 9, 125142.
Kurdek, L.A., & Schmitt, P. (1986). Relationship quality of partners in heterosexual married, heterosexual cohabiting, and gay and lesbian relationships. Journal of Personality and Social
Psychology, 51, 711720.
Martell, C.R., & Land, T.E. (2002). Cognitive-behavioral therapy with gay and lesbian couples. In
T. Patterson (Ed.), Comprehensive handbook of psychotherapy: Vol. 2. Cognitive-behavioral
approaches (pp. 451 468). New York: Wiley.
Martell, C.R., Safren, S.A., & Prince, S.E. (2004). Cognitive-behavioral therapies with lesbian,
gay, and bisexual clients. New York: Guilford.
McWhirter, D.P., & Mattison, A.M. (1984). The male couple: How relationships develop. Englewood Cliffs, NJ: Prentice-Hall.
Solomon, S.E., Rothblum, E.D., & Balsam, K.F. (2004). Pioneers in partnership: Lesbian and gay
male couples in civil unions compared with those not in civil unions and married heterosexual
siblings. Journal of Family Psychology, 18, 275286.