Another Marriage Destroyed By “Sex Addiction” Treatment

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Maria’s disgust with porn, and her insistence that “it’s porn or the marriage, take your pick,” wasn’t discussed in Xavier’s sex addiction treatment.

Why Xavier continued going to massage parlors instead of having sex with his wife wasn’t discussed in Xavier’s sex addiction treatment.

Maria’s sexual withdrawal wasn’t discussed in Xavier’s sex addiction treatment.

I wasn’t able to give Xavier or Maria what they wanted from couples counseling. We eventually stopped treatment, all three of us disappointed and frustrated. I blame Xavier’s sex addiction treatment, which they had started before seeing me, and continued during our work.

Treatment for “sex addiction” is booming, even though it frequently destroys marriages and the individuals it “treats.” It’s expensive, moralistic, and is obsessed with sex while understanding very little about it.

In fact, most professionals offering sex addiction treatment (including the movement’s 1985 founder, Patrick Carnes) have no training in human sexuality. Very few sex therapists—the country’s clinical experts in human sexuality—offer such treatment, because they don’t believe in the so-called disease.

But “sex addiction” fits with two popular narratives: that porn drags people away from happy relationships, and that when reasonable people behave self-destructively and hurtfully (infidelity, sex workers, “emotional affairs”), it’s because they’re out of control, in the grip of a mental illness. The “sex addiction” concept provides the dignity of something that sounds like a medical diagnosis, which gratifies both betrayer and betrayed.

Sex addiction treatment simultaneously trivializes sex, and sees everything involving a penis as sexual. The treatment typically ignores a couple’s power dynamics; how painful it can be to lose not just sex but touching and affection; the huge range of normal sexual desire and expression; and the simple fact that for most people, sex is about more than sex. Way more.


And sex addiction treatment never addresses this overwhelmingly common problem: what’s an emotionally healthy, loving person supposed to do when their mate simply isn’t into sex very much?

Or worse, withholds sex as a punishment? Or refuses to acknowledge that their lack of sexual interest is an expression of anxiety, trauma, depression, body dysmorphia, or something else that could actually be addressed?

So this couple’s 20-year backstory was familiar to me. Xavier was unhappy about Maria’s lack of sexual enthusiasm. She rarely initiated, and frequently rebuffed Xavier’s invitations. Over time, they quarreled about this more and more. As he worked full time, and she raised their two kids while working part time, they grew apart. Six months of dealing with Xavier’s father’s stroke didn’t help. They became emotionally distant, and she withdrew from ordinary physical affection.

Like most reasonable people deprived of a sexual connection, Xavier masturbated. Almost every night. After a co-worker mentioned porn websites, he checked them out. Soon his masturbation typically included videos of naked women. Some of them were masturbating, some were making love with other women, some were middle-aged women enthusiastically having sex with young men.

When Maria inevitably “caught” him—and blew her top—he said he would stop. He didn’t. She caught him a few more times, and he always said he would stop. He didn’t. That made him not just a porn-user, but a liar. She was angry about both.

She lost all respect for him, she said, and came to hate the whole arena of sexuality. She loathed what she called his “infidelity” and “his video whores.”

After a serious work injury, Xavier’s doctor sent him to a physical therapist. The PT’s simple touching moved him—“I almost cried the first time he did it,” he recalled during session.

When Xavier’s insurance coverage ran out, he stopped for a while. Then he went to a massage parlor for a massage (sadly, it was cheaper than PT). Soon enough he was offered a Happy Ending, which he accepted. “I hadn’t had a hand on my penis in what, 8 or 10 years,” he said. “It felt so amazing, so comforting.”

He felt alive driving home. Which he had to hide. He felt guilty, too. Which he had to hide.

What to do?


He returned to House of Gentle Hands, and then returned periodically. “Just one more time,” he would tell himself. “And then we’d fight, or my daughter and her husband would visit and Maria would fawn over their baby, and I’d feel empty and abandoned. So I’d do it again.”

And then Maria found out about that. Instead of being curious about why he did such a peculiar thing, she was bitter and judgmental. It confirmed her worst vision of him, as he seemed to be spiraling downhill. His shame reinforced her outrage.

This is just what the sex addiction folks love—a story of a man breaking promises to himself. Clearly, he was out of control—an addict! Since the “drug” was porn and Happy Endings, he was a sex addict.

But not according to me.

Like so many women, Maria had read about sex addiction on the internet. Their situation was described perfectly: an angry (and self-righteous) wife; a husband doing things he shouldn’t, and lying about it; a husband who wanted more sex than his wife; a wife who felt unattractive as she was getting older.

That’s when Maria’s emotional blackmail started: either admit you’re a sex addict, or I’m leaving. It’s what all those websites counseled.

And that meant a barrage of questions that she demanded he answer. Like most betrayed people, she was unsatisfied with the answers she got. The question sessions themselves—urged by sex addiction websites and betrayed wives websites alike—became the focus of enormous anguish for both of them. Maria obsessed on his answers whatever they were, and cranked out new questions every week.

The question that kept lingering was actually a good one: “If you’re not a sex addict, why would you do this?” But she seemed vindictive, not curious. So he hedged. And he wasn’t sure anyway. Week after week, I pushed him to discover the answer, and urged him to tell her, whatever it turned out to be.

After weeks of relentless cross-examination and guided introspection, he started one of our sessions with “OK, I’ll tell you why I’ve done this stuff and lied over and over.” I won’t say I held my breath in suspense, but…

“I’ll tell you why I masturbate so much, look at porn when I do, and eventually went to massage parlors,” he said. “It was a bunch of things. I was lonely. I felt invisible except as a father and a source of income. You stopped enjoying sex, then stopped wanting it. Sex became a chore for you, and so I felt diminished. Then you stopped wanting to touch or be touched. That’s when things really collapsed for me,” he said sadly.

“Plenty of people deal with all that without massage parlors or porn,” Maria said. Yes, I responded, but you did just reject the answer to your very important question. Do you want to discuss it or not?


She insisted he was broken, and that she wasn’t. I said that wasn’t helpful for the marriage.


Meanwhile, Maria got ever deeper into the sex addiction model, seeing herself as traumatized, a victim, virtually a martyr to her marriage. Various infidelity websites persuaded her that she can’t ever trust her husband again, because he has a lifelong disease. If he won’t go along with this concept, it’s his disease talking–it proves he isn’t serious.

In contrast to the sex addiction model, I emphasized the following points in treating this painful infidelity case:

~ Masturbation is not the same thing as porn use; if she objects to him masturbating, they can stop talking about porn. And I remind her that they had no premarital discussions or agreements about either one; she’s outraged that he’s doing something he didn’t originally promise to avoid.

~ Stop the full disclosure for now. The marginal benefit of her knowing about one more or one less Happy Ending is zero. And there’s no value in her knowing what age or race these women were, whether he climaxed standing or sitting, and so one. People emerge from these full disclosure sessions not with more understanding, but simply with more to obsess on.

~ He deserves to have a voice in what happens going forward. She doesn’t own the relationship as a consequence of his infidelity. They each should talk about what they want different if they stay together—this isn’t simply a matter of her dictating the conditions under which he gets his marriage back.

~ The sex addiction model sees sexuality as a potentially dangerous form of energy that needs to be restricted and controlled. This handicaps people in creating a vibrant sexual relationship, and it problematizes the person who wants to use sex as a vehicle for self-expression, exploration, creating novelty, and challenging their own ideas about intimacy. Whereas the goal of sex addiction treatment is the ongoing control of someone’s passion, my goal is supporting people in discovering authentic ways of expressing their ever-changing sexuality.

~ Contrary to the sex addiction model, I don’t support the idea that he’s out of control. Rather, I push him to discover why he’s making recurring decisions whose consequences he doesn’t like, and which don’t fit his values. As a bonus, this removes part of the basis for her self-righteousness.

~ I want him to work hard to understand why he did it, why he hides from her, and why he doesn’t want to do the work to have sex with her.


While disagreeing with my methods, Maria asked another good question: “How do I know he won’t do it again?”

If you’re a sex addict, the answer is “I’ll always be tempted. But I have ways to deal with that—contacting my sponsor, going to meetings, thinking about my wife’s pain or the possibility of contracting a disease or the humiliation if everyone found out.”

At the end of successful psychotherapy, the answer to Maria’s question “How do I know…” is much different. It’s “I won’t do it again because I’ve changed. And the marriage has changed—or least, the way I deal with the marriage has changed.”

Sooner or later, he’ll be trustworthy—if he does the psychological work. Will she do the emotional work enabling her to trust him, or will she never trust him again? The sex addiction model says he’ll never be cured, in which case she’d be a fool to ever trust him again. How awful.

All of this said, one week Maria looked at me and simply said “You’re not helping. You’re confusing us, you’re telling me I’m wrong to be hurt and angry [of course I wasn’t], you’re telling him everything he’s done is fine [of course I didn’t] and you think anything goes [of course I don’t].”

And at that moment Xavier had to make a choice: is he just a selfish bastard who didn’t care how much he hurt Maria? “No,” Xavier replied. “I’m a sex addict, and will get treatment for my addiction. Now will you stay with me?”

“Yes,” she said. “As long as you’re being treated for your addiction.” And so Xavier was welcomed into the fellowship of Lifelong Recovery.

And Maria never trusted him again. And so she never welcomed him back into her life sexually. Their marriage never recovered from his infidelity. And they never agreed on why.


Whether the subject is sex or not, rational people often behave irrationally, hurting themselves or those they love.

When people are dissatisfied with their seemingly irrational behavior, they need to understand the emotional deficits they’re trying to fill with various sexual behaviors; and they need to understand the desperation to be liked or the terror of being rejected that leads them to lie and deceive. And when intimacy breaks down between two people, they need new ways to negotiate sexual relationships, boundaries, and expression.

Therapy is a powerful tool for exploring the huge range of non-sexual aspects of sexual feelings, decisions, and behavior.

But sex addiction treatment? When all you have is a hammer, all your problems look like nails.

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