Is My Spouse a Sex Addict?

The road to discovering your spouse’s sexual addiction takes many forms. Sometimes, compulsive sexual behavior can be completely hidden for years before it is found out. It may happen as a single, devastating revelation or as a series of smaller discoveries.  

Perhaps you already knew about their sexual compulsivity but hoped that marriage would somehow temper this behavior. But each promise that your spouse makes to change becomes yet another broken commitment.

Sexual addiction can have devastating consequences for the addict as well as their spouse. It’s essential to understand what it is, how to diagnose it, what causes it, and what a healthy path forward looks like for a marriage dealing with sex addiction.

Defining Sex Addiction

While still relatively new to psychology, sexually compulsive behavior is becoming an increasingly recognized phenomenon with a reasonably well-defined set of features. It is not merely an extension of a Christian worldview. Regardless of their religious background, a large number of researchers and therapists now specialize in the treatment of sex addiction.

The point of this article is not to preach against or shame sexual desire. After all, sex addiction is not necessarily about having a high sex drive. Just because you or your spouse enjoys having sex does not make either of you a sex addict.

Only You Forever has several certified sex addiction therapists on our team. We have years of experience in working with sex addicts, and we know how crucial it is not to confuse the enjoyment of sex with sexual addiction.

Sex addiction involves sexual expression or activity that is excessive, problematic, or out of control in either men or women. It can look like hypersexual or destructive sexual behaviors characterized by compulsivity, secrecy, or continuation of a behavior in spite of negative consequences.

These behaviors are harmful to at least one person if not more. The addict, their spouse, their lover, their family, their employer, or other members of society can be affected by their behavior. These effects span economic, health-related, psychological, social, or relational impacts.

It is a real problem, one that takes a substantial amount of courage and commitment to address. But recovery is possible.

Diagnosing Sex Addiction

DSM-V Proposal

The North American standard for articulating diagnostic criteria for disorders (the DSM-V, or Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) has not yet officially addressed sex addiction. However, a hypersexual disorder has been proposed.

Based on this proposal, individuals must have the following symptoms:

1. Over a period of at least six months, recurrent and intense sexual fantasies, sexual urges, and sexual behavior in association with four or more of the following five criteria:
   1. Excessive time is consumed by sexual fantasies and urges, and by planning for and engaging in sexual behavior.
   2. Repetitively engaging in these sexual fantasies, urges, and behavior in response to dysphoric mood states (e.g., anxiety, depression, boredom, and irritability).
   3. Repetitively engaging in sexual fantasies, urges, and behavior in response to stressful life events.
   4. Repetitive but unsuccessful efforts to control or significantly reduce these sexual fantasies, urges, and behavior.
   5. Repetitively engaging in sexual behavior while disregarding the risk for physical or emotional harm to self or others.
2. There is clinically significant personal distress or impairment in social, occupational, or other important areas of functioning associated with the frequency and intensity of these sexual fantasies, urges, and behaviors. In other words, it is impacting the quality of your life.
3. These sexual fantasies, urges, and behaviors are not due to direct physiological effects of exogenous substances (e.g., drugs of abuse or medications), a co-occurring general medical condition, or manic episodes. These or other specific causes of sexual hyperactivity are not indicators of sex addiction.
4. The person is at least 18 years of age.

The above evaluation is just one set of criteria to help you see if your spouse is a sex addict. If you notice that they are consistently meeting these criteria, you might be looking at a problem here.

Sexual Addiction Screening Test (SAST)

The SAST is another set of criteria that can help diagnose sex addiction. It is currently one of the most widely-used screening tools. It’s used in at least eight published, peer-reviewed empirical studies. Outside of research, it is also used in practical applications by certified sex addiction therapists and in inpatient residential treatment centers in the United States and around the world.

Initially created in 1989, the SAST has been revised to help adjust to homosexual and female populations. It exists as part of a larger package of assessments known as the Sexual Dependency Inventory (SDI). The SDI is a comprehensive bundle of evaluations that help psychologists and therapists establish a basis for planning treatment.

The SAST is available for free at https://www.recoveryzone.com. 

PATHOS

If the SAST is too long for you, you can also use a system called PATHOS. It’s just six questions long (one for each letter of the acronym), and several studies have established its validity.

1. Preoccupied. Do you often find yourself preoccupied with sexual thoughts?
2. Ashamed.  Do you hide some of your sexual behavior from others?
3. Treatment. Have you ever sought help for sexual behavior you did not like?
4. Hurt. Has anyone been hurt emotionally because of your sexual behavior?
5. Out of control. Do you feel controlled by your sexual desire?
6. Sad. When you have sex, do you feel depressed afterward?

If your spouse answers “yes” to three or more of these questions, then you need to see a Certified Sex Addiction Therapist (CSAT) because this is an informal, self-reported assessment. The CSAT will be able to verify its accuracy and give you a formal diagnosis.

Remember that you do need to see a professional clinician. For example, based on these questions, a 22-year old porn addict might easily appear to be a sex addict to a non-professional. However, this would be an incorrect diagnosis. While porn addicts can arrive at sobriety in 10-14 counseling sessions, a sex addict might need 3-5 years to get to the same level of mental health.

So make sure to see a medical professional before concluding on your own that your spouse is a sex addict. These tests are just to help you know when it might be serious enough for you to seek a clinical diagnosis.

Why Do Some People Become Sex Addicted?

It can be easy to stop seeing sex addicts as fully developed humans and start only to see them as their addiction. Because of all the stigmas and moral connotations with this particular addiction, it becomes necessary to remember that all addictions are maladaptive coping mechanisms.

In no way does this diminish the impact of the addiction, particularly on you, the spouse. However, this serves as a way to ground the situations and establish a point of empathy and understanding–sex addiction at its core is a very human reaction.

It might be helpful to look at the situation on a much smaller scale. Imagine a scenario where you’re really upset and have had a terrible day. On an impulse, you go to the freezer and start eating ice cream straight from the carton. You might consider how gross you’ll feel after binging or how much weight you might gain, but in that moment it doesn’t matter: you just want to feel better, regardless of the consequences.

Sex addiction is similar to this, just on a much more severe scale. It affects you, your relationship and your finances. And it goes even further because it is more than just something you do when you are upset. There is a deep, deep level of pain behind it.

Sex addicts suffer from high levels of shame, and their addiction often is preceded by physical, emotional, and/or sexual abuse in their past. The numbers are shockingly high:

• 72% have experienced childhood physical abuse.
• 81% have experienced sexual abuse.
• 97% have experienced emotional abuse.

Many people who suffer from sex addiction have yet to see the source of their compulsive behavior: an attempt to medicate deep wounds. However, after hearing their story and evaluating their history, their addiction begins to make sense.

For some, the addiction numbs the pain they feel. For others, they are desperate to find intimacy to fill the void they feel inside. Sometimes addicts use these behaviors to find approval. Still others find addiction to be the only way they know how to respond to the traumatic wounds of childhood abuse.

People who suffer from sex addiction are more than just their labels. As morally wrong and devastating as their behaviors might be, their reasons are discoverable and understandable. When you listen to sex addicts in recovery and listen to their stories, their addiction begins to make sense.

Again, the purpose of this is to build empathy, not excuses or rationalization. But if you truly understood the circumstances that led to the development of their addiction, would you judge them in the same way? Now that you can see the pain they’ve been carrying, perhaps you can help them face it and search for healing.

The pain does not justify the behavior, but knowing the reasons can help you understand why your spouse might find themselves in the situation of doing what was unthinkable even to them.

Impact on Spouses

As dangerous as it is to deny the depth of the pain sufferers of sex addiction experience, it is also dangerous to deny the pain that their spouses suffer as a result of the addiction.

The trauma that betrayed spouses experience can often lead to symptoms similar to PTSD. Repeated relapses then exacerbate these symptoms. Maybe they manage to become clean for a while, but when they relapse, their spouse experiences intense betrayal trauma.

If you decide to tough it out in a marriage with a sex addict, you will have two primary tasks:

1. To help yourself heal from the trauma of sexual betrayal.
2. To play a constructive role in help your spouse recover from sex addiction.

These are heavy burdens to bear, particularly given that betrayed spouses are often blamed in some way for their partners’ addiction. While at the end of the day, it is your spouse’s fault, not yours, it can also be helpful to examine the possibility that you might have helped to enable the addiction.

Spouses of sex addicts often go through similar experiences:

1. Denial

Sometimes spouses knew explicitly that the sexual behaviors were occurring. Sometimes they might even have been involved in the acting-out. Maybe they allowed the addict to rationalize or normalize some of the actions.

Spouses have also reported that they are affected by their addicted spouse’s twisted thinking. They might believe some of the rationalizations that were given to them.

It can be challenging to recognize and to admit this.

2. Feeling Responsible

It’s common for spouses of sex addicts to feel guilty because they think they might be, in some part, responsible for their partner’s sexual addiction. They might internalize thoughts like, “I’m not attractive/understanding/sensitive enough.”

You will need to do the hard work of owning what’s your responsibility and letting go of what isn’t. Recognizing and internalizing that difference is a complicated process.

3. Inability to Recognize Normal Behaviour

Year of lies, deceit, and manipulation can distort your understanding of “normal.” With each successive rationalization, the boundaries of normality get twisted until they are very far from the truth.

These distortions might cause you to make excuses for explicit sexual material at home, late nights, and unaccounted hours.

4. Fear

Because the spouse of an addict is hurt, traumatized, and confused, they can feel intense fear that they might lose their relationship. That fear can push them to extraordinary lengths to control and stabilize the situation.

You might look for extreme ways to seek approval or sexual compensation. Because of fear that you aren’t enough, you might attempt any way you can think of to change your perception in their eyes. Anything to keep the relationship intact.

5. Shame

You might even see your spouse’s actions as a direct reflection on you and your family. But in reality, your spouse has their own sense of self, of will. Their choices are theirs, but as their spouse, you might feel like somehow their choices are your responsibility.

6. Sexual Dependency

In extreme cases, spouses of addicts might attempt sexual activities they would otherwise never participate in for fear of abandonment. Sometimes these activities might be degrading, shaming, painful, unpleasant, or even immoral to them.

But because they don’t want the relationship to end, they do everything they can think of sexually to ensure that their partner will stay or will stop indulging in their addiction.

7. Emotional Dependency

Many times, the spouse’s feelings of worth or happiness might end up tethered to the addict’s emotional state. When the addict feels sad, angry, or disappointed, they do too. And unless the addict is happy, they can’t be.

The volatility of having your emotions tied to an addict’s can have a severe impact on the betrayal trauma that comes from discovering that your spouse has had this double life.

Because of the complexity and multifaceted nature of sexual addiction, counseling and therapy must be multifaceted and complex as well. The addict’s issues, their spouse’s, and their marriage’ s–each of these must be addressed by a therapist separately.

In taking this approach, there is healing. The journey is long and complicated, but through it, couples will be able to rebuild and recover even from this incredibly devastating addiction.

References

Carnes, Patrick J., Bradley A. Green, Lisa J. Merlo, Alexis Polles, Stefanie Carnes, and Mark S. Gold. “PATHOS: A Brief Screening Application for Assessing Sexual Addiction.” Journal of Addiction Medicine 6, no. 1 (March 2012): 29–34. https://doi.org/10.1097/ADM.0b013e3182251a28.

Carnes, Stephanie. “Sex Addiction, Neuroscience Trauma and More.” Lecture, 2016. https://www.naadac.org/assets/2416/stefanie_carnes_neuroscience-trauma_ac16.pdf.

Cox, Ruth P., and Michael D. Howard. “Utilization of EMDR in the Treatment of Sexual Addiction: A Case Study.” Sexual Addiction & Compulsivity 14, no. 1 (April 2, 2007): 1–20. https://doi.org/10.1080/10720160601011299.

Fong, Timothy. “Understanding and Managing Compulsive Sexual Behaviors.” Psychiatry (Edgmont), 2006.

Goodman, Aviel. “What’s in a Name? Terminology for Designating a Syndrome of Driven Sexual Behavior.” Sexual Addiction & Compulsivity 8, no. 3–4 (July 2001): 191–213. https://doi.org/10.1080/107201601753459919.

Levine, Stephen B. “What Is Sexual Addiction?” Journal of Sex & Marital Therapy 36, no. 3 (April 30, 2010): 261–75. https://doi.org/10.1080/00926231003719681.

Louie, Sam. “Behaviors Common to Spouses of Male Sex Addicts.” Psychology Today, 2015. https://www.psychologytoday.com/us/blog/minority-report/201510/behaviors-commom-spouses-male-sex-addicts.

Reid, Rory C., Bruce N. Carpenter, Joshua N. Hook, Sheila Garos, Jill C. Manning, Randy Gilliland, Erin B. Cooper, Heather McKittrick, Margarit Davtian, and Timothy Fong. “Report of Findings in a DSM‐5 Field Trial for Hypersexual Disorder.” The Journal of Sexual Medicine 9, no. 11 (November 2012): 2868–77. https://doi.org/10.1111/j.1743-6109.2012.02936.x.

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