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Dealing With A Sex-Addicted Spouse

John Schaffer, LPCC

Medically reviewed by

John Schaffer, LPCC

February 25, 2019

Finding out about a spouse’s sex addiction can be heartbreaking, and hard to understand. Sex addiction may be treatable with behavioral therapy, medications, and support groups. If left untreated, sex addiction may lead to infidelity, loss of job, or sexually transmitted diseases.

What Is Sex Addiction?

Sex addiction (hypersexuality) is a progressive intimacy disorder characterized by compulsive sexual thoughts, and acts. Like other addictions a person suffering from a sex addiction may seek out sexual desire, despite potential health risks, financial problems, broken relationships, or legal problems.

Addiction is defined as a chronic illness, which means that it’s characteristics are similar to diabetes, hypertension, and asthma. Sex addiction is a behavioral disorder that can be defined as mild, moderate, or severe based on the risk it presents to an individual or others.

Many people suffering from a sex addiction don’t go past excessive viewing of pornography and masturbation, but others may take part in illegal activities such as prostitution, exhibitionism, child molestation, or rape. Because sex addiction is considered progressive, even those who compulsively view pornography are more likely to resort to more serious sexual behaviors.

Compulsive sexual disorders are broken up into eight categories of paraphilic behaviors. Paraphilic behaviors refer to behaviors that are considered to be outside a normal range of sexual behaviors and include:

  • Exhibitionism – a disorder characterized by an individual to expose their genitals in public.
  • Voyeurism – the practice of gaining sexual desire from watching others undress or engage in sexual activities, often without consent, or on the Internet.
  • Pedophilia (Paedophilia) – a disorder in which an adult or older adolescent experiences a sexual attraction to prepubescent children.
  • Sexual Masochism – a disorder in which an individual has desires, fantasies, and urges that involve the act of being beaten, or humiliated in order to achieve sexual excitement, or climax.
  • Sexual Sadism – a disorder in which an individual has persistent fantasies, or urges to inflict psychological or physical suffering on a sexual partner.
  • Transvestic Fetishm (Transvestism) – a disorder in heterosexual males that’s characterized by recurrent sexual fantasies, or act of cross-dressing to the point that it causes significant distress, or impairment in their life.
  • Fetishism – compulsive use of an object, or part of the body as a stimulus in the course of sexual gratification.
  • Frotteurism – a disorder in which an individual gets sexual pleasure from rubbing their genitals against another person, especially in a crowd.

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Sex addiction may also include problematic behaviors such as excessive masturbation, cybersex, pornography use, sex with multiple partners, telephone sex, strip club visitation, and others.

Sex Addiction In The United States

Research indicates that roughly three to six percent of the United States population suffers from a sex addiction. That means that anywhere from 9,693,000 to 19,386,000 Americans suffered from sex addiction in 2016.

Sexual disorders often occur during adolescence, and become worse in early adulthood. Eighty percent of the people treated for sex addiction in the United States are men.

Signs And Symptoms Of A Sex Addiction

Oftentimes a sex addiction can be identified, and addressed before it damages self-esteem, relationships, career, health, or other people. The signs and symptoms of sex addiction include:

  • Using sexual behavior as an escape from loneliness, depression, anxiety, or stress.
  • Having recurrent sexual fantasies, urges, and behaviors that take up a lot of an individual’s time, and may be out of their control.
  • Trying to reduce sexual fantasies, urges, or behaviors but unsuccessful.
  • Continued engagement in sexual behaviors that have serious consequences, such as sexually transmitted diseases, financial difficulty, problems at work, loss of relationships, and legal problems.

“From the phase of searching up until the actual sexual activity, the subjects concerned may feel some benefits: reassurance, well-being, an almost manic excitement, a narcissistic shoring-up, and sensations of pleasure. But as soon as the sexual act has taken place, certain subjects can be gripped by sadness, remorse, as well as by feelings of shame, and guilt,” (National Library of Medicine).

Causes Of Sex Addiction

The exact causes of sex addiction aren’t always clear, but like drug addiction, they may include psychological, physiological, and environmental factors.

Sex addiction is believed to have contributing factors including an imbalance of chemicals in the brain, changes in brain pathways, and conditions that affect the brain such as epilepsy or dementia.

When an individual repeatedly seeks the rewards from sexual activity, they change their brain’s neural circuits. As is the nature of addiction, recurrent pleasure seeking causes the brain to crave increasing amounts of the stimulus to achieve the same effect.

Risk Factors Of Sex Addiction

Sex addiction can happen in both men and women, yet research states that men are more likely to develop this disorder. Nonetheless, sex addiction can happen to anyone no matter their age, religion, sexual orientation, or gender.

The risks factors for a sex addiction vary from person to person, and no two cases of this disorder are exactly the same. The risks of sex addiction may include emotional or physical factors, such as:

  • a history of being sexually abused, or molested
  • having a mental disorder (depression, anxiety, or personality)
  • having a substance use disorder
  • having a parent, or sibling who suffers from sex addiction
  • easy access to sexual content
  • solitude and loneliness

Substance Use Disorders And Sex Addiction

A substance use disorder (SUD) is a progressive condition characterized by drug use that leads to significant physical or mental impairment, and distress. SUD often leads to problems at work, school, or home. A SUD that occurs with a sexual disorder would be considered a co-occurring disorder.

Comorbidity (coexistence) is common among sex addiction and SUD, which may include: alcohol, opioid, stimulant, and sedative use disorders. For example, a person suffering from an alcohol use disorder (AUD) may exhibit compulsive sexual behaviors while intoxicated.

Is There A Treatment For Sex Addiction?

Sex addiction is not officially recognized as a medical disorder, and there are currently no approved guidelines to treat sex addiction. Yet overcoming a sex addiction is possible, and with the right treatment approach, a husband or wife may be able to overcome their compulsive sexual disorder.

Sex addiction is a behavioral issue, and therefore may be corrected with behavioral treatment. It’s important to treat a sex addiction as early as it presents itself, because waiting to do so might minimize the importance of the issue, or make the behavior seem “okay.”

Evaluating A Sex Addiction

The first step to treating a sex addiction is getting a professional evaluation on the issue. During an evaluation, patients are asked questions about past or present sexual thoughts or behaviors, drug use, relationship or family issues, and other problems caused by sexual behavior. In some cases, with the consent of the patient, loved ones may be asked to evaluate their sexual behavior.

Treatment Approaches For Sex Addiction

Once the disorder has been diagnosed, an individual is ready to be treated for their sex addiction. The programs used to treat sex addiction may be residential or outpatient treatment, and may include:

  • Individual Therapy – provides a patient with an outlet to talk about their feelings about sex, while learning healthy behaviors to replace unhealthy sexual activity, and focusing on reducing or controlling compulsive sexual behaviors.
  • Cognitive Behavioral Therapy – focuses on identifying triggers of sexual behaviors, changing feelings about sexual behaviors, and relapse prevention.
  • Psychodynamic Psychotherapy – explores the conflicts or situations that drive negative sexual behavior, and increases awareness of unconscious thoughts or behaviors related to sex.
  • Couples Therapy – aims to help build trust, minimize guilt or shame, and establish a healthy sexual relationship between partners. This type of therapy helps married couples approach sex addiction as a team, rather than by placing blame.
  • Group Counseling – focuses on team building, and educating patients about sex addiction. Group counseling can help patients realize that they aren’t the only people who suffer from a sex addiction, and that they don’t have to overcome it alone.
  • Medication-Assisted Treatment – there are no medications approved by the Food and Drug Administration to treat sex addiction, although Naltrexone, an opiate antagonist has been evaluated in the treatment of sexual disorders. Antidepressants, mood stabilizers, and anti-androgens have also been used to help treat sexual disorders, and related symptoms.
  • Self-Help Groups – one of the most commonly used sex addiction treatment methods is the self-help group, and 12-step programs like Sex Addicts Anonymous (SAA). SAA is group that gives members fellowship, education, structure, support, and accountability for their actions. Membership for Sex Addicts Anonymous is free.

Complications With Treating Sex Addiction

One of the biggest complications with treating compulsive sexual disorders is that there is no biological proof that the treatment is working. Therapists, and spouses must work in confidence that the individual receiving treatment is actually benefiting a remaining abstinent from unhealthy sexual activity.

Some of the complications faced by therapists, and patients are intense feeling of shame or remorse. Comorbid mental disorders such as depression, or anxiety may also contribute to a person’s urges, fantasies, or acted sexual behaviors. Some patients engage in substance abuse as an attempt to cope with emotional, or psychological stressors caused by treatment, which is seriously risky, and may lead to further health, relationship, or legal consequences.

How To Talk To A Spouse With Sex Addiction

It can be really hard to find out that a spouse is addicted to sex, but how to handle the situation can determine their likelihood of getting help. Most people act defensively when questioned about compulsive sexual behaviors, so it’s important to come at the idea with grace, and concern.

Talking to a sex-addicted spouse should be done from a loving, and marital standpoint. This doesn’t always prove to be easy, and sexual infidelity is a leading cause of divorce in the United States. When sex addiction is approached as a treatable disorder, a marriage might be saved.

Sex Addiction Triggers And Relapse Prevention

Triggers for a sex addiction can present themselves in many ways, including partial nudity in cinema, risque photographs on social media, junk email related to sex, or phone calls or texts from previous sexual partners. For an individual to completely avoid all the triggers of compulsive sex would be next to impossible. Yet a behavioral treatment may be able to teach an individual to identify sex addiction triggers, and handle them appropriately.

Sex addiction relapse prevention may include filtering explicit content on personal devices, including cell phone, computer, or television. Relapse prevention may also include regularly attending self-help groups, and interventions that include enhancement of self-esteem, and self-image, and educating children about the dangers of Internet pornography.

Preparing For Sex Addiction Treatment

It’s time to take action, if a sex-addicted spouse is ready to commit to treatment. The first thing for them to do is to evaluate their sexual behavior, and think about how it may have affected their relationships, work, financial, or legal problems. The next step is to write down what things have consistently triggered their sexual behavior. Patients are encouraged to ask themselves questions like:

  • Why am I doing these things even when it’s hurting my spouse?
  • What type of treatment might be right for me?
  • How can I better manage my persistent, intense sexual urges?
  • Would a support group or a 12-step program be helpful for me?

An individual may need to take an honest inventory of any past trauma, substance abuse, medications, or mental illness that may be contributing to the sexual disorder. It can be emotionally draining to revisit a past of negative sexual behavior, but it may be necessary to get the core of the issue, and overcome sex addiction.

Contact today to find rehab centers that treat compulsive sexual disorders.

U.S. National Library of Medicine - Sexual Addiction: Insights From Psychoanalysis and Functional Neuroimaging

U.S. National Library of Medicine - Understanding and Managing Compulsive Sexual Behaviors

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