Therapist and relationship counselor LaRusso offers insight into the complexities of infidelity, emphasizing the emotional realities faced by individuals caught between their committed relationships and extramarital affairs. She urges those involved in affairs to realistically consider the implications of their choices, including the potential losses they will experience regardless of the path they choose.

LaRusso encourages clients to reflect on what their lives will look like without either their primary partner or their affair partner. She highlights the emotional difficulty of situations such as attending family events alone after severing ties with an affair partner who provided a source of validation and excitement outside of marriage. According to LaRusso, accepting the inevitable loss and the need to grieve are essential steps to avoid prolonged denial or living in a "fantasy space."

In her work, LaRusso challenges common stereotypes that frame infidelity as simply recreational or morally corrupt behavior. She explains that individuals who engage in affairs often do so because of complex emotional needs left unmet in their primary relationships. Many of these individuals seek affection, recognition, and care reminiscent of childhood experiences—needs that remain unfulfilled at home. Despite this, she notes, people involved in affairs frequently convince themselves they can maintain both relationships fully, a notion she says is unrealistic. "You can't have both," she explains, as the emotional investment required inevitably leaves one relationship suffering.

LaRusso also discusses the wide range of motivations behind affairs. Some clients are experiencing pain, neglect, or abuse within their marriages, and the affair becomes a desperate escape or a "cry for help." For these individuals, traditional avenues for addressing marital issues—such as therapy or honest communication—have often been exhausted or ignored. She describes scenarios where some spouses exhibit narcissism, emotional immaturity, or unhealthy entitlement, further complicating the dynamics. While an affair is not a solution to marital problems, it sometimes serves as a turning point that prompts individuals to end unhappy relationships.

However, LaRusso acknowledges that infidelity also occurs in seemingly stable or happy marriages. She attributes some affairs to manipulation, a sense of entitlement, or temporary lapses where individuals lose their way and form connections in everyday settings, like a fellow parent at their child's sports activity.

The impact of affairs on a marriage can vary significantly. LaRusso works with clients to re-examine their primary relationships, often encouraging them to recall the state of their marriage before the affair began. For some, this process leads to recommitting to their spouse and reporting greater happiness in the long term, even while recognizing the complicated feelings connected to the affair. Others, particularly those in later stages of life, come to the realization that their relationship has been disconnected for years and choose to move on as they envision their future.

LaRusso’s approach underscores the need for emotional maturity and honest reflection when navigating the painful terrain of infidelity, highlighting that while affairs can destroy relationships, they may also catalyze change and, in some cases, repair.