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Actress Kristen Stewart publicly apologized for her affair with director Rupert Sanders.  Stewart has been living with actor Robert Pattinson, and Sanders is married.

If Stewart feels sincerely sorry for having had a sexual relationship outside her primary one (and with a married man), then the question has to be asked, “Why did she have the fling to begin with?”  Put another way, “What was inside her mind?”

The same question could be asked of South Carolina Governor Mark Sanford (maybe the only man on the planet who answered truthfully in public, by the way), President Bill Clinton, the late Princess Diana and every one of the millions of male and female Americans who have had lots of wonderful things in their lives—including beautiful families—and have chosen to indulge their passion for another person.

Like or not—a hundred or more patients over the years have explained to me that a sexual union outside a primary relationship is not simply physical discharge of an animalistic need.

It is the expression of the need for a soulful, spiritual, loving connection with another human being when that need is not—or not fully—being served by the person to whom the individual is “committed.”

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If Kristen Stewart is like the hundred people who have shared their personal, intimate thoughts with me, she may have been acknowledging with her body that the necessary romantic poetry in her life—poetry that may contribute to her creative passion and even her desire to be alive—was truly fueled by her being vulnerable and loving and attentive and fully exposed to Sanders.

When my patients have set aside the moral positions related to the matter (which, some can argue are all that matter), they have admitted that sexual relationships can change the two people who engage them at a spiritual level, and that even one such encounter can change the people who participate in it, forever.

When wondering why people risk their reputations and professions and even their families to participate in such unions, it pays no homage to the truth to pretend that the “affair” was merely servicing a need like thirst.

Thirst quenches a physiological need.  Sex—when it is between two people who are emotionally and physically drawn to one another—quenches a thirst of the soul.  To insist that sexual affairs are nothing but crass and physical is to miss the psychological realities and the reasons why people keep using them to express themselves, their freedom and even their continued hope for the future.

Like it or not, longer-standing relationships, even ones that deserve to continue, may not provide that opportunity.  Their very architecture and repetitive nature, insulates them from certain gifts of insight and energy.

The psychological truth is that Kristen Stewart could be willing to donate a kidney to her boyfriend Robert Pattinson, while, at the very same time, being willing to take off her clothes and embrace Rupert Sanders.  And the truth is that many of the people I have talked to in depth, at a basic, human level, insist that there is beauty in both of those realities, even though they exist simultaneously.

Rupert Sanders may love his wife and may be willing to sever both his arms, in order to save one of her hands, yet want—at a powerful, spiritual, even, dare I say, truthful level—to hold Kristen Stewart in his arms.

You can hate that fact.  You can wish it were not so.  But you shouldn’t deny the fact.  Because my patients tell me that it is so, and everything I have learned about people and about life tells me that it is so.

In my psychiatric office, if Pattinson were to insist on jettisoning Stewart from his life exclusively because she had expressed herself sexually with another man, I would tell him he had never truly loved her.  And I would be right.