Infidelity Kills?

It's a problem, for health.

The Frontier Psychiatrists is a health-themed publication. We talk about “social determinants of health” in medicine as if they were a rounding error. In most people’s lives, “what is happening in our lives” is the “whole show.” The social determinants are the life. The health status is supporting cast.

Marriages and other long-term pair bonds are the bedrock of our lives. Monogamy is the most common assumption, although more and more individuals are discussing non-monogamous relationship models. However, no matter what relationship model one subscribes to, none of those relationship models make breaking your partner’s heart by lying to them fit in well. And yet, people cheat on each other.

This happens all the time. As a therapist, I came up with a term for this category of behavior, which I referred to as f*cked up people sh*t (FUPS). When other individuals would say, "How could he possibly do that?” But it was the kind of thing that happens all the time because people reliably do things that are transgressive, against their values, against the values of their partners and their families because we are imperfect. Predictably awful. This is predictably awful behavior. I called it “FUPS”—where others would say, “How could you?!” …with shock and surprise, while it's the kind of thing that happens all the time.

There is little scholarship on this topic. Here's some of the data that we have at our disposal. When it comes to incidence (how much infidelity happens per year—which is assuming monogamous marriages for this sample):

it is estimated that about 2–4% of spouses engage in sexual infidelity in any given year

Remember, the numbers are just under double that per dyad since there are two spouses per marriage. The pattern is also predictable:

infidelity shows a seasonal pattern with a peak in the summer months, a period associated with travel that likely facilitates sex with a partner in a geographically different location thereby decreasing the chance of detection

People are so predictable. One large-scale sample estimate over the lifespan:

conservative estimates suggest that infidelity occurs in 20–25% of all marriages¹

Among those not married, the rates are estimated to be even higher. Meanwhile, infidelity is deemed somewhere between bad (immoral) and awful:

Although the majority of Americans disapprove of infidelity (in a Gallup Poll 90% view it as immoral and 65% say it is “unforgivable”

For a brief detour into the nature of “the unforgivable,” I will lean on philosophy for a moment. For something to be forgiven, the individual is essentially signing up to let the thing go and not resent the letting go. This is the hard part,

“Foreswearing resentment”

And, if the transgression is so far beyond the ability to ever move past it, that becomes unforgivable. Some unforgivable acts make moving pastness impossible, and thus those:

cases that fall into this category [“unforgivable”] understandably tend to involve “levels of evil that elicit resentment so deep as to be accompanied by rage, indeed outrage.”²

Now, most loving couples are not in the business of philosophy; they are in the business of arduously forgiving each other endlessly for myriad slights, lies, transgressions, and failings in any life of any messy pair of humans. Suffice it to say, forgiveness is hard work, and sometimes it’s reasonable for one or the other party to choose to call a mulligan and walk away instead of doing the work on both sides or getting to a resentment foresworn. It’s a high bar.

Infidelity, in addition to being common, is a driver of suicide attempts. In one sample of women in Italy, a husband’s infidelity led to a 4,400% (44-fold) increased risk of suicide attempts in their female partners.3. This was a stronger predictor of attempted suicide—in this admittedly traditional society—than threats of physical assault and intimate partner violence.

Studies on those who die by suicide are by their nature more limited, but one investigator found, in suicide notes:

Lester et al. (2004), found that men more frequently reported love or romantic problems, whereas women were more likely to have “escape from unbearable pain” as a motive in their suicides (p. 34).

Whereas other authors found the opposite, when it comes to the gender balance:

Problems in a marriage or relationship was a major risk factor associated with suicide death within a number of retrospective studies (Busuttil et al., 1994, Logan et al., 2011). With Kurtaş et al. (2012) observing that suicide letters written by men focused on financial problems, while for women interpersonal relationship problems with a spouse or boyfriend were more dominant.³

Regardless, both men and women who die by suicide regularly tell the world that the problems in their relationships are enough of a problem to highlight in their final communication to the living they leave behind.

Infidelity—the lives we try to withhold from our loved ones—is toxic. The behavior is common. Human sexual behavior beyond what we explicitly agree to in agreements between partners won’t stop— if I had to make a bet. However, the degree to which we choose to acknowledge it, be less sh*tty to each other about it, and the degree to which we work on a cultural context for forgiveness might be able to change. These changes could be lifesaving.

We buy life insurance policies based on tiny risks. We discuss minute details of a wedding’s seating arrangement or other life details that don’t matter. However, we don't spend time addressing the completely predictable infidelity that will happen in many long-term relationships. We don't agree—in advance— on how we will talk to each other about what is likely to occur. This leads to lies, shame, self-recrimination, and unrealistic but deeply harmful blaming of the self for the behavior of others. We can't change how humans behave easily around sex, but we can change the fact that we don't talk about it honestly. Admit it's predictable. Admit it's likely to happen. Planning via uncomfortable conversations could save our partner’s life, our own, or both. We need more realism in these conversations, understanding, and less default to the existentially unforgivable.

1. Fincham, F. D., & May, R. W. (2017). Infidelity in romantic relationships. Current Opinion in Psychology, 13, 70-74. https://doi.org/10.1016/j.copsyc.2016.03.008

2. Formosa, J. P. D. (2015). The Unforgiven and the Unforgivable: On the Nature and Limits of Forgiveness(Doctoral dissertation).

3. Kazan, D., Calear, A. L., & Batterham, P. J. (2016). The impact of intimate partner relationships on suicidal thoughts and behaviours: A systematic review. Journal of Affective Disorders, 190, 585-598. https://doi.org/10.1016/j.jad.2015.11.003