Amy Wilhelmi, LMFT
Few experiences shake the foundation of a relationship like betrayal. Infidelity, emotional or physical, can devastate a partner’s sense of safety and lead to deep rupture in intimacy. But repair is possible when we address not only the act of betrayal, but the attachment wounds and trauma it reactivates.
This week, we’ll explore a composite couple case to show how an integrative model — weaving together Ketamine-Assisted Psychotherapy (KAP), Emotionally Focused Therapy (EFT), EMDR, and trauma-informed sex therapy — can help partners rebuild trust, intimacy, and connection.
1. Meet “Jason and Mia”
Jason and Mia are in their late 30s, married for 10 years, and struggling after Jason disclosed an affair. Their dynamic reflects a common attachment cycle:
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Mia: Anxiously attached, pursuing reassurance but also erupting with anger.
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Jason: Avoidantly attached, retreating into guilt and shutting down when confronted.
Infidelity amplified both patterns. Mia felt abandoned; Jason felt inadequate and withdrew further (Bartholomew & Horowitz, 1991; Johnson, 2004)
2. The Integrative Path
Here’s how integrative care supported Jason and Mia:
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KAP (Conjoint Session): During a carefully prepared ketamine session, Jason accessed grief tied to his father’s emotional absence and expressed remorse with unusual vulnerability. Mia tapped into fears of abandonment rooted in childhood neglect. KAP opened emotional doors that months of talk therapy had not (Dore et al., 2019; Khalifian et al., 2024)
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EFT: With new emotional access, EFT helped the couple map their pursue–withdraw cycle. Mia practiced voicing softer longings (“I need to know I matter”), while Jason risked staying present instead of shutting down (Johnson, 2004).
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EMDR: Individually, each partner worked through trauma memories that fed the cycle — Jason reprocessed humiliation by his father, Mia processed childhood panic around maternal threats to leave. EMDR reduced their emotional reactivity and reframed shame (Shapiro, 2018).
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Sex Therapy: Once emotional safety grew, trauma-informed sex therapy introduced gradual exercises: sensate focus, non-demand touch, and verbal intimacy rituals. Over time, playfulness and sensuality re-emerged (Green & Mitchell, 2015; Halstead et al., 2021).
3. Lessons from Their Journey
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Infidelity is an attachment injury. Repair requires addressing the deeper wounds it reactivates, not just the act itself.
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Integrative therapy is synergistic. KAP unlocked grief, EFT created safety, EMDR reduced triggers, and sex therapy rebuilt embodied trust.
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Repair is possible. With time, the couple reported greater vulnerability, reduced conflict, and renewed intimacy.
4. Why This Matters for You
If you’re a therapist, this model shows how integration can create momentum for couples who feel “stuck.” If you’re in a relationship navigating betrayal, know that healing is not linear — but with safety, openness, and structure, reconnection is possible.
For background on how integrative therapy flows, revisit Week 6: Building a Flexible Healing Plan. To see an individual case example, read Week 7: Healing Attachment Wounds.
Next week, we’ll explore how trauma and intimacy are shaped by culture, race, gender, and identity — and why culturally responsive care is essential.
Selected References
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Bartholomew, K., & Horowitz, L. M. (1991). Attachment styles among young adults. Journal of Personality and Social Psychology.
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Dore, J., et al. (2019). Ketamine-assisted psychotherapy for treatment-resistant depression. Journal of Psychoactive Drugs.
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Green, B., & Mitchell, S. (2015). Sexual trauma and dissociation. Journal of Sex & Marital Therapy.
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Halstead, M., et al. (2021). Trauma-focused sex therapy: Integrating safety and embodiment. Sexual and Relationship Therapy.
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Johnson, S. (2004). The Practice of Emotionally Focused Couple Therapy. Brunner-Routledge.
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Khalifian, C., et al. (2024). Integrating psychedelic-assisted therapy with attachment-based interventions. Journal of Contemporary Psychotherapy.
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Shapiro, F. (2018). Eye Movement Desensitization and Reprocessing (EMDR) Therapy. Guilford Press.