Are You Living with a Sex Addict? Identifying Addiction in a Relative – Frequently Asked Questions

1. “Would I know right away if I was living with a sex addict?”

Doubtful.  Spouses and partners of sex addicts are often unable to readily identify the fact that they are living with a sex addict.  Sex addiction thrives on secrecy and compartmentalization and the addict will go to great lengths to wall off his or her addictive sexual behavior. 

2. “I wonder if my imagination is running away with me.”

Sometimes the addict will make the partner think that he or she is crazy and imagining things (sometimes called “Gaslighting” after the old movie).  Often sex addicts can function well and appear normal to a great extent; working hard, spending time with the kids, volunteering at church, etc.  Don’t expect a straight answer at first!  Trust your instincts.

3. “So what should I look for?”

  • The lists of addiction criteria available under the “defining addiction” tab are probably not going to help unless you already have a lot of information.  Some of the “collateral indicators” might be relevant.
  • An obvious risk factor would be a life history involving another addiction, such as drugs, alcohol, work, spending, gambling or food.  Addictions are like potato chips, most people have more than one. 
  • You can look for whether the person is spending an unusual amount of time on the computer and look into what sites are being visited.  Looking at pornographic websites or videos more than once in a great while is probably cause for concern.
  • We all need our privacy, but you can check around and look for indications that the person has a whole separate life.  Are there a lot of sexual magazines, books or other sexual printed material stashed somewhere.
  • If you feel that your relationship is not as intimate or feel alienated in some way, get to the bottom of it, don’t allow yourself to be brushed off or placated. 
  •  If you have a strong intuition, use technology to monitor the person’s email and other computer use.  Many sex addicts get help only after they are found out by their spouses, partners or parents.
  •  Be vigilant to subtler signs of your partner being mentally “out to lunch”, eager to get away from previously enjoyed activities, and being depressed for no reason.  These aren’t necessarily signs of sex addiction; just don’t wear blinders to whatever might be going on. 
  •  Last but not least, check on where the money is going, e.g. massage parlors, clubs etc.

4. “What can I do if I find out that I am living with someone who may be an addict?”

Call or email one of the people or programs listed under “getting help” or email me at the “ask Dr. Hatch” tab with your questions.  You can also make an appointment to talk to a sex addiction therapist who can help you get help for the person in question. 

Have a counseling session together.  Problems between people or an episode of infidelity do not mean there is sex addiction.  Many people have affairs who are not addicts, i.e. it’s not necessarily part of a pattern of compulsive behavior.  However, couple counseling does sometimes reveal the presence of addiction.

Don’t blame yourself or think that you can fix it by being more supportive.  If it is a spouse, don’t try to be more sexual — that’s not the problem. 

Living with a recovering sex addict is a big undertaking at best.  Remember, sex addiction can derail a life, wreak havoc with a relationship and have a negative future impact on children.  It’s OK to be vigilant.

Sex Addiction is an Intimacy Disorder

Sexual addiction has as one of its antecedents, a failure of normal early attachment due to some disruption in the relationship to a primary caregiver.  Sex addicts are often sexually abused as children but they are more often emotionally neglected and tend to come from families that are rigid, authoritarian or sexually repressed.  This failure leads to an inability to trust and to bond normally with another.  Some attachment problems also arise through accidents of fate such as the illness or absence of a caregiver.  (There is also thought to be both a genetic and environmental predisposition to addictions in general, which may be passed on as a predisposition to addiction in the case of sexual addiction as well.)

Being so-called “intimacy-abled” means being able to form a healthy attachment with a partner in adulthood.  That implies the ability to trust your partner, to trust your own ability to set boundaries, to communicate your feelings in the moment, to be able to commit, and to relate to a partner with all aspects of yourself – mental, emotional, physical and sexual.  The untreated baggage of a disordered attachment history leads to mistrust, fear, distancing, sexual conflicts, feeling unlovable, and lack of experience with healthy communication.  For more see What is Healthy Sex…


Dating for Sex Addicts: How to Create a Sober Dating Plan

 Some people in sexual recovery are in a relationship or marriage that existed prior to their being treated and often prior to their addiction being found out.  These people are on a journey that already involves a partner and are motivated enough to work on transforming that relationship and making it succeed in a healthy way.  However, there are those whose marriages did not survive or who have no partner in their lives and find themselves in recovery and wishing to find a romantic relationship.

When recovering from sexual addiction you cannot just assume that you know how to go about the dating process in a normal way.  In fact you may never have approached the possibility of dating in way that was not somehow distorted by your addiction.  When you begin dating in recovery you must be especially conscious of what you are doing.  I knew a woman in sexual recovery who had been addicted to acting out bondage scenarios.  She told me laughingly that in early recovery, she thought she could find a normal relationship and then act out her bondage scenarios within that relationship.  But even if you are very strong in your recovery, you must be aware that your addiction can seep into your relating in ways you are not aware of.  That is why you need to be vigilant as you proceed.

When you were active in your addiction you may have had a relationship that appeared normal and was totally separate from your acting out behavior, but the partner you chose was certain to be different in many ways from the partner you would choose in recovery.  Why?  Because in your addiction the part of you driven to sexual acting out, your “addict”, was in charge of choosing your partner.  You chose a partner who in some way served your need to pursue your addiction, someone who wore blinders, someone who was needy and enabling, or someone who was just “checked-out” in one way or another.

High drama relationships or relationships built around unhealthy sexual or emotional scenarios, unavailable or abusive partners, etc. may have been part of your life before recovery.  These relationships most likely related to a pattern laid down in your earliest experiences with intimacy and sex.  They may reflect fear of abandonment, the need to dominate, the need to degrade or be degraded in order to feel adequate, or any of a number of unhealthy emotional “scripts”.  When you start dating in recovery you need to be vigilant as to the people you choose to date, but you also need to be aware that your own behavior patterns may include seductiveness, predatory flirting or objectification.

Even in recovery, you are still going to be susceptible to that peculiar feeling of “instant connection” with someone, that feeling of “familiarity”. That feeling should be a warning signal to take stock of the situation and be aware that an instant connectedness may indicate that you have come across someone who fits your past pattern of relationships in which healthy love and commitment are not possible.   In other words it may be an illusion.  Can you ever Trust your instincts?  My own feeling is that the healthier you become the more you can rely on your intuitions and your first impressions.

Many people have questions about how and when to share their sexual history with a person they are dating.  Obviously if the person you go out with is also in sexual recovery then it would be appropriate to share your histories with each other right away.  Likewise, it is easier to tell more sooner if the person already knows that you have been receiving treatment for sexual addiction.  In this case, the process of eventually disclosing everything and relating in an open way will be accelerated.  As to people with no knowledge of your sexual recovery issues, it will be necessary to get yourself to begin to share something about your problem right away.  This will not have to be the whole story, but remember, you will be taking the dating process more slowly and carefully than many other people and you will need to let the person know what’s going on with you in general so they can make sense out of the experience.

As you get to know someone you are dating, you will have to share more of the “gory details” of your story so that the other person can know the real you; don’t forget to include the part about how well you’ve done in your recovery!  If and when you want to be really intimate and committed, you will have to be prepared to share everything – no secrets.  Anything less will sooner or later come home to roost as a betrayal.  This is because the other person will feel that regardless of whether things have gone well or badly, they were not able to base their own decisions and behavior on reality.  They will likely feel that their reality has been manipulated and will correctly see this as less than caring on your part.

The sober dating plan outline will ask that you put down in some detail your own individualized plan relative to the key questions about dating including some rules about how and when you will let a relationship become sexual.  It is important to realize that having sexual feelings for someone you are spending time with and even having sexual fantasies about them are most likely normal experiences and as such should not cause any alarm.  The problems arise when you allow yourself to believe that your sexual attraction to someone means they are automatically right for you.  It takes considerable effort and feedback from trusted advisors to hold on to the reality that you still do not really know a person and that you may not be compatible with them and may not even like them.  Until you figure these things out, you may be headed for a casual sexual encounter.  This would not be part of the plan for recovering sex addicts.  Also you should bear in mind that fantasies are one thing, but if you begin to obsess about or sexually target a person, even someone you know well, this is a definite red flag.

The time to construct a sober dating plan is before you start dating, even before you think you are really ready to start dating.  Many addicts in recovery are fearful of dating.  They may think they have something to be ashamed of, they may not know how to go about it, and they may have spent years hiding in their addiction.  Make a plan and try to stick to it (or modify it if you need to – nothing is perfect.)  Remember to check in with others as you go along and listen to their opinions.  It’s a learning process.



This is Your Brain on Cyber Porn

Cyber porn is known as the crack cocaine of sex addiction.

Internet pornography is easy to get hooked on and hard to kick.  Of the more than 20 million people who are sex addicts in this country roughly 71% act out their addiction on the internet.  This takes the form not only of viewing pornographic imagery but increasingly provides a venue for exhibitionism/voyeurism, access to sexual chat rooms, prostitutes, “hook-ups” (finding others who are immediately available for anonymous sex in real life) and selling or trading of pornographic photos and videos. Not only is the internet is a place for cheap, easy access to sexually addictive material and behaviors, it is a significant gateway drug for young people.  The average first time contact with internet porn is age 11.  The largest consumers of internet porn are the 12 to 17 year old group.

Cyber porn is the great accelerator.

Sometimes it goes the other way.  A person prone to sexual acting out behavior discovers new kinds of imagery and behavior that they never thought of consciously before and quickly becomes compulsively fixated on these new scenarios, ultimately seeking to act them out in their life.  It is thought that this takes place because the new imagery acts to trigger something unconscious, something forgotten but not gone, in the psychosexual history of the person.  This is sometimes referred to as “accessing the unresolved”.  People see things they may have once seen fleetingly at an early age and enter a trance-like state in which these images stick.  Whether it comes before or after other kinds of sexually addictive behavior, the internet leads to rapid escalation and acceleration of sex addiction.

The chemistry of internet porn addiction.

Your brain on internet porn is getting a release of dopamine which activates the reward/pleasure centers.  This is addictive in itself (see Sex Addiction is a Drug.)  If accompanied by masturbation there are even more rewarding chemicals released.  People then use this drug as a reward, as an escape or as a relief from boredom or agitation.  Like any drug, the web can then become the person’s best friend causing “relational regression” i.e. the tendency to withdraw and replace the real with the digital.  This not only causes the person to become mentally withdrawn but may interfere with the ability to make any real human connections.  The person’s internet experience becomes their “perfect” reality.  As one patient put it “Miss January is always there for me, she always wants me.”  Intimate contact in reality spoils this fantasy.  There is a correlation between internet porn use and loneliness such that isolation is not only a result but a cause of cyber porn addiction.

Living in the cyber porn bubble.

I would add one other warning label to the whole cyber porn issue (aside from the obvious and growing danger of getting in trouble with the law for various internet related behaviors) and that is that internet pornography users find it extremely easy to sweep their behavior under the rug.  They can deny that it is a problem more easily than other sexual acting out behaviors because it seems to hurt no one.  They can argue that everyone does it, or that everyone wants to.  They can say that it doesn’t cost anything (forget that U.S. internet porn revenue exceeds revenues of ABC, CBS, and NBC combined), and they can say that it is not compulsive, even as it takes over more of their lives.  So your brain on porn is also an increasingly delusional brain, which feeds the vicious circle and makes it the growing epidemic that it is.


Sex Addiction is a Drug

Sexual behavior in its various forms can be used to cause the release of chemicals in the brain which have the effect of taking the person away from unpleasant emotional states.  Sexual behaviors can become obsessive when they are used in response to these unpleasant internal states to repeatedly block them through brain chemicals relating to pleasure, excitement, or numbing, depending on the type of behavior.

Chemicals released in the brain which relate to specific sexual functions are: dopamine, norepinephrine, serotonin, oxytocin, vasopressin, opioids and epinephrine.  These have the ability to create a desired state of one kind or another, numbing, energy, fantasy/dissociation, or pain (releases opioids) which can be used to “self-medicate” undesirable feelings or traumatic reactivity of one sort or another.

Sexual acting out behavior is usually categorized into one of three types depending on the desired end state.  (1) Arousal created by high-risk behaviors or high drama relationships, for example, act like cocaine and amphetamines (2) numbing created by behaviors such as compulsive masturbation mimics the effects of heroin or alcohol, and (3) fantasy or a trance-like state is achieved by behaviors such as obsession with internet pornography or fantasy charged situations which resembles sedation.  Further, when the sex addict refrains from sex a predictable set of withdrawal symptoms arise.  For more see This is Your Brain on Cyber Porn.



What is Healthy Sex for a Sex Addict?

I can’t tell you how many people in sex addiction programs are baffled about the issue of healthy sex.  They are pretty clear on what they need to not do, but they are at a loss to envision what a healthy sex life would look like for them.  Many addicts have never had the experience of what they see as “normal” sex with anyone. For example, they may have experienced their sexuality only in the two dimensional fantasy world of pornography, or they may have experienced sexual arousal only in very alienated or risky situations with strangers, illicit situations etc.  In other words, for most sex addicts in early to mid recovery strong sexual feelings have never been integrated in any way into their life and relationships.  Therefore, they have trouble seeing how they could ever feel intense sexual interest and gratification in the absence of their “acting out” behaviors.  They know it exists, but for them it is an empty concept.  The problem is further complicated if the addict is married or in a long term relationship in which they have been leading a double life.  Chances are that they have periods of aversion to sex with their partner and/or that they have a sex life with their partner in which they find ways to bring their addictive behaviors into the mix such as being lost in their addictive fantasies during sex, bringing other people into the situation somehow, etc.

What has been written about healthy sex may or may not help enlighten the addict in early sexual recovery.  Dr. Patrick Carnes’ writing is read by many recovering addicts and he has defined 12 dimensions of healthy sexuality which mostly have to do with the overall emotional maturity and relationship skills of the individuals in question.  Such things as the ability to nurture and be nurtured, a clear sense of self and good boundaries, comfort with sex in general, the capacity for genital and non genital sex with a partner and so on.  While these may be a necessary foundation for a sexually healthy person, they don’t help flesh out the concept of the sex life itself.  Likewise, most addicts at some time come across the saying that “intensity is not intimacy”.  Dr. Carnes spells this difference out in terms of ten different domains of functioning, e.g. high drama vs. problem resolution, or fear and arousal vs. passion and vulnerability.  So although a person may be aware that fear or drama are what escalate their arousal, they have no model in their mind for how to achieve that level of arousal any other way.  The awareness is important, but they would like to know where it’s all going.

So when we ask a sex addict to believe that he or she will be able at some point to enjoy the rewards of healthy sex are we able to offer any proof?  Are we simply saying that they should clap their hands to show they believe in Tinkerbell?  Well, in a way, yes.  We already know that the willingness to embark on any journey of recovery involves a leap of faith.  So sex addicts need to take it on faith that they will like what they get when they get there. But they also need to recognize some other realities about a healthy sex life with a committed partner.

First and foremost I think that addicts need to realize that healthy sex in the context of a good relationship may have a high degree of passion, variety and deep gratification, but it will not involve the same kind of hyper-arousal, the blast of instantaneous intensity that comes with acting out situations and fantasies.  The good news is that the need for that kind of “hit” dissipates in the fullness of recovery.  In other words you won’t have what you once had but it won’t matter as much as you think it will.

By the same token, addictive sexual behaviors tend to be the same every time.  The addict controls the script and the outcome, even to the point of building in the risk or fear to heighten the “fuel mix”.  The healthy sexual relationship has more room for the unexpected to happen, so that even though the context is one of comfort and safety, there is the possibility of genuine discovery.

Second, people tend to be unclear on the role of fantasy in their sexual life with a partner.  Although this is an individual matter, generally speaking sexual thoughts and images can and should be part of healthy sex as long as they do not remove you from the present situation.  Any kind of sexual fantasy may enhance your experience with a partner (or in masturbation for that matter) but it should be one that allows you to be more engaged in the real, physical experience at the time rather than less.  Fantasy as a means to check out, numb out or escape is likely to set up a pattern that is not conducive to healthy sex.

Another way to look at this trade off in recovery is to put it in terms of what the AA book entitled Twelve Steps and Twelve Traditions calls “the sacrificial spirit”.  We sacrifice something to get something more worthy.  In this case we sacrifice the need to focus only on ourselves and our own most perfect gratification and we behave in ways that have to do with the overall benefit to our lives and the lives of everyone around us.  As addicts change, they will likely come to see that addictive sex is a drug they want to put down and that it was only their most important need because it was an addiction.

Finally, an inescapable reality of intimate relationships is that they require some attention in order to be maintained.  So in terms of a healthy sex life the addict and their partner need to nurture all aspects of their relationship life, including the sexual.  Planning to have sex, setting up a time to have sex may seem like anathema to sex addicts starting out in relationship recovery because, again, it’s not the impulsive or mindless escape into the “hit” or the oblivion of acting out.  Sure, sometimes sex with a spouse or partner can be spontaneous and free and that’s great.  But taking care to have time to have sex is going to be part of taking care of your relationship, just like expressing affection, problem solving, negotiating, and guarding each others’ solitude.