Is It Cheating or Sex Addiction?

door with eye

By Lili Bee, CPC, OM, SEP, ACC
& Cassie Kingan,  MA, LPC, CCPS, CCTP

We get asked this question all the time. We think what partners really want to know is: If my mate is just a garden-variety cheater, that means he had a choice about whether to engage in infidelity or not. But- if he's an addict, doesn't that mean he has lost control over the behaviors he engages in?

We asked ourselves the same question years ago, but since then, we realize the real question that needs to be answered, one that will help a partner not get stuck waiting for changes endlessly, is:

How does he feel about stopping those behaviors immediately and permanently?  Because whether habituated to his behaviors or not, his own motivation to stop are what is essential.                

He may say he is willing to change. You may decide to float him a little time until you are able to discern if he is really willing to do "whatever it takes" to restore your trust. This should not become a battle, even if you believe he may have become habituated to his infidelity behaviors.

The truth is, if his behaviors have not negatively impacted his life in a significant-enough way (meaning they haven't cost him much; you already know they cost you) and he is not sufficiently remorseful, he will not change his ways, whether he is habituated to them or not.

And remember, while your distress is significant to you, it may not count as terribly significant to him. We know how upsetting that sounds, but think about it: if our mates were really so concerned about us, they wouldn't have cheated on us in the first place. They would not have been able to, knowing how much it would hurt us. But they weren't thinking about us and they never expected to get caught. Once caught, it is easier to blame externals (like us) than do the hard work of giving up entitlement behaviors. That is the harsh reality, almost without exception.

Therefore, if he isn't absolutely certain his infidelity behaviors are a serious problem for him, then you sending him into traditional recovery treatment to address his "sex addiction" will most likely fail, despite the optimistic language used by many who work in the lucrative recovery industry.               

Can partners help their mate quit his infidelity behaviors?

We do not believe that partners can motivate someone to quit their exploitative behaviors for a few different reasons:

1) It assumes that the Betraying Partner was not capable of thinking or that he was walking around in a "trance" with his brain completely unhooked when he engaged in the infidelity behaviors. We know that the recovery industry often portrays chronic cheaters this way, as "out of control addicts". We hear all kinds of overly-mystifying terms and concepts, such as: "he was compartmentalizing when he was engaging in his infidelity behaviors."

Please consider: if your mate is truly walking around in that much of an altered state, incapable of employing his logic or his conscience to not cheat on you, that should alarm you. Some might even use the term "sociopathic" to describe a mate capable of shutting you out that completely while he cheats. And what of the days after that when he wasn't cheating? Surely the "trance" was not in effect then. The lies he was holding onto never once exerted any kind of pressure on his conscience to tell you, to purge the deceptions that have poisoned the space between you?

We ourselves would consider there may be serious underlying psychopathology at work for that level of dissociation to occur. "Sex addiction recovery" won't fix that. Nor can it because it does not assess for the deeper pathologies that would allow someone to behave with no conscience on a regular basis.

More importantly for you, if you truly believe he can pop himself in and out of mental "compartments" long enough to cheat on you, forgetting that he is in a committed relationship, even putting your health at risk--and then be able to create and maintain complex deceptions while looking you in the eyes afterwards, ask yourself:  how safe or sane is this for you?

Although we partners may wish otherwise, the truth is we can't love them out of their darkness, cajole them into changing, threaten them with ultimatums or bring them brilliant insights about why changing is the right thing to do. Well, we can but it won't change things in the direction we were hoping for.

We like imagining we are that powerful or that our love can move mountains but the abysmal recovery rate from any addiction tells a very different story.

And since many of these compulsive behaviors are often motivated by significant co-occurring psychopathology (such as the personality disorders), we would hope you would want to know that. Management for these disorders goes well beyond traditional "recovery" approaches.

2) One important truth we concur with, dispensed at all 12-step programs for partners of any  kind of addict is: You can't change it, You can't cure it, You can't control it.

Our work as partners is in accepting that. We have no control over our partners' behaviors but we do have control over our own lives and our environments.  We know how easy this is to grasp intellectually, yet it is brutally difficult to truly accept that we cannot love our mate back into wellness.

We write about how you can have more control over your own relational environment and protect yourself from further damages in our new e-book called Boundaries.

Unless your mate has decided he can't live with who he has become, and he comes to you to confess his infidelity behaviors, is genuinely remorseful and willing to do whatever it takes to stay free of those behaviors and do whatever you need for your trust to be rebuilt, we would proceed very cautiously, if we proceeded at all.

If, however, it is you who discovered his secrets, we know the shock and cognitive dissonance that follows such discoveries can make it extremely difficult for you to figure out what to do next. Stay? Leave? Start spending exorbitant amounts of money on his "recovery" when deep down, you know your mate never expected to get caught? We know you aren't even sure of what the full extent of his behaviors is- or much more importantly, what may be driving those behaviors. However....

Calling his infidelity behaviors an addiction might be something you want to question closely.

Because we at PoSARC are committed to providing partners with accurate information, it is important to say that at this time, the DSM, or Diagnostic and Statistical Manual of Mental Disorders, considered to be the "bible" or gold standard of the psychiatry and psychology professions for diagnosing and treating mental disorders does not identify sex addiction as a disorder.

Each disorder listed in the manual features a specific set of diagnostic criteria that must be adhered to when diagnosing a mental disorder.

Since there are no publishable research results accepted by the DSM that demonstrate the "sex addiction model" is a competent model of diagnosis, how can it possibly diagnose correctly? By extension, it therefore cannot treat correctly. If it did, there would be credible research verifying these treatment results.

You may or may not care about this, or you may be wondering about the relevancy of this to your mate's infidelity behaviors, but keep in mind this vital fact:

It is critically important in the field of psychology, just as in the field of medicine- that any and all treatment begins with accurate diagnosis.

Because partners' worlds have been turned upside down from Discovery, they need and deserve solid, DSM-validated testing for their mates, not just because they want him to have every possible chance to get the most effective treatment he can, but because partners will be basing their decisions to stay with him (or not) based on results they see from that therapy/ treatment.

The AMA (American Medical Association) does not allow doctors to administer medical treatments that the AMA has not first approved; it is considered unethical. Similarly, as no valid "disorder" diagnosis can be made for "sex addiction" according to the DSM, we would seriously question the ethics of a treatment provider who decides that doesn't matter.  

Are we saying it's impossible to get habituated to problematic sexual behaviors?

What many psychologists and psychiatrists outside the sex addiction recovery industry understand is this:

The behaviors of those who engage in compulsive sexuality are but symptoms of deeper, underlying pathology. But these symptoms do not constitute a disorder in and of themselves. So, shouldn't we be extremely curious about what lies underneath the infidelity behaviors?

(The one possible exception to this may be when a compulsion is limited to internet pornography use which can alter the brain's reward circuitry, especially in very young users. Again, more research is needed. But we still would want to see a full psycho-sexual evaluation, even for pornography-only addicts).  

Our view

We have spent considerable time learning directly from the doctor who co-pioneered the Trauma Model for Partners, Dr. Omar Minwalla of The Institute for Sexual Health, (himself a clinical psychologist and sexologist). Possibly the most important thing we have learned from him is the value of testing those who exhibit problematic sexual behaviors via a full psycho-sexual evaluation.

This extensive, multi-day testing is designed to assess those with problematic sexual behaviors for underlying pathology that exists on a spectrum, such as: Narcissistic Personality Disorder, Borderline Personality Disorder, Obsessive Compulsive Disorder, (to name just a few of the personality disorders in the DSM), depression, anxiety, and more. The co-occurrence rates for these disorders in those who engage in "problematic sexual behaviors" is high. Research shows there is also a significant co-occurrence rate of ADD/ ADHD within this same population. While all these disorders ought to be routinely tested for in sexual compulsives (given the high co-occurrence rate), they rarely are, partly because:

Administering this testing and providing comprehensive diagnoses is available only  to doctors / PhD-level clinical psychologists who have undertaken specific training to conduct these batteries of tests. Fortunately, if your mate signs a release form, the testing psychologist or psychiatrist may share the testing results and any diagnostically-based treatment recommendations with a local-area therapist your mate may be working with.

Dr. Minwalla believes what is vital is the proper conceptualization of the problematic sexual behaviors and the context in which they occur. Based on his field research working with thousands of men with problematic sexual behaviors over many years, Dr. Minwalla believes that since these behaviors are only the outermost (visible) symptoms of deeper, underlying pathology which drives the sexual behaviors in the first place, this pathology must be thoroughly assessed in order to arrive at the correct, diagnosis-specific treatment plans for sexual compulsives.                                                                          

Without this, Dr. Minwalla asserts, treating clients without a proper diagnosis is clinically unsound and unethical.

This makes complete, logical sense to us. You will recognize this rational approach from the medical field where a valid diagnosis comes first, treatment follows from that. Formulaic approaches do not work well, which also helps explain why recovery meetings are filled with so many men who do not move past their infidelity behaviors for very long before re-engaging in them. And if you attend any partners meetings, you will notice they are filled with women who are constantly being re-traumatized as they stay connected to these men who either cannot or will not cease their infidelity behaviors.

We at PoSARC believe, along with Dr. Minwalla, that partners deserve as comprehensive a diagnostic report as possible of what they are being asked to live with, support, and be affected by in every aspect of their life with a sexual compulsive.

We encourage partners to request their mates go for comprehensive psycho-sexual testing, so partners can know what and who they are really dealing with, and so that their mate's treatment recommendations are informed by a full diagnosis that includes the sexual behaviors but also takes into account any underlying pathology that is so commonly co-occurring.

**Please note: We do not benefit in any way from recommending Dr. Minwalla for psycho-sexual evaluations, or from his Intensives for men, though we highly value both services for Betraying Partners interested in saving their relationships. To learn more:

Our goal at PoSARC is to allow our readers to learn from the circuitous and costly mistakes thousands of other partners have made in the quest to save their relationships.

We are happy to provide our readers with the resources we have used and found incredibly helpful, however we cannot offer guarantees of any kind. Every case and client is unique.

All information and resources on this site reflect our opinions, are for educational and informational purposes only and should not take the place of consulting a doctor or mental health professional. None of the information provided is meant to treat or diagnose any (mental) health condition nor is any information provided on this site a substitute for medical, psychological diagnosis or treatment.


Related Topics

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infidelity When the Sex Addiction Model Doesn't Fit

infidelity Is It Sex Addiction or Narcissism?

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