Marital Conflict versus Sex and Love Addiction

In the past decade a new self-help group has joined the ranks of twelve-step programs: Sex and Love Addicts Anonymous (SLAA), (Hope and Recovery, 1987; Hunter, 1989; Sex and Love Addicts Anonymous, 1986). Cames (1983a, 1983b, 1989,1991) introduced and developed the concept of sexual addiction and related co-dependency, positing a disease model for treatment of compulsive sexual behavior that closely parallels the treatment of addictions to alcohol and other drugs. Sexual addiction can supposedly manifest itself in a series of extramarital sexual encounters, although Cames (198310) acknowledged that not all such episodes are symptomatic of sexual addiction. I have worked with persons and their partners, individually and jointly, who are recovering from alcohol and drug use. The disease model of addiction prevails in the field of chemical-dependency treatment, and twelve-step programs are a standard adjunct to professional practice. As awareness of sexual addiction has grown through the media and among chemicaldependency counselors, more clients are questioning whether they or their partners should be diagnosed as sex and love addicts and join selfhelp groups like SLAA. My clinical practice with clients has raised serious questions about the assessment and treatment of marital and family dysfunction, especially in cases in which a partner has engaged in extramarital sexual behavior. The following case, similar to others in my professional experience, illustrates some of the confusion in this dilemma of clinical assessment, problem definition, and intervention. Alex was a high-school-educated, working-class, white male approaching 40 years of age who sought individual therapy for what he identified as sexual addiction. Married for approximately 20 years to a woman whom he had dated steadily since their high school years, Alex had been separated from his spouse and adolescent children for a few months. In his early thirties, Alex was diagnosed as alcohol dependent and underwent intensive group therapy at an outpatient clinic. He maintained abstinence while continuing to attend AA meetings regularly. The month before seeking therapy, Alex began attending SLAA meetings because, as he stated, “My wife says I’m a sex addict, and she’s probably right. ” Mona, Alex’s spouse, learned of sexual addiction and related self-help groups through area counselors and through members of her Al-Anon group. On the basis of the information she acquired from these sources, she defined Alex’s problem and the necessary course of action to solve it. Alex stated that for the first 10 years of his marriage he had been a faithful husband. When his drinking became excessive, at a time when the family experienced conflict over the academic and disciplinary problems of one of the children, he had a brief affair of several weeks with a woman he had met while socializing. He also admitted that he had a one-night stand with another woman he met the same way. During and after his alcoholism treatment, Alex claimed that he had not engaged in any extramarital encounters. However, during the past year he had become sexually and emotionally involved with a single woman with whom he worked, a person whom he described as “someone I like a lot and can’t break off with easy. ” His spouse’s discovery of the relationship precipitated the marital separation. Alex found it difficult to live without his children but expressed considerable doubt about living with Mona for the test of his life. He expressed regret that he had married her in his late teens and forfeited a college education