SEX ADDICTION AND DIVORCE Cynthia L. Ciancio, Esq., and David A. Lamb, Esq. August 2015 – Family Law Institute 1. Sex Addiction, What is it? Is it Even Real? While there still does not appear to be an official diagnoses of “sex addiction,” it certainly is real, and it is a growing prevalent problem in society. As divorce practitioners, we are experiencing more and more cases driven by an underlying sex addiction by one or both spouses. The degree and severity of the addiction vary widely from case to case. The DSM-IV and V refer to sex addiction as “Hypersexuality” and/or “Sexual Disorders Not Otherwise Specified.” Web MD uses the term “hypersexual disorder (HD).” Other experts have referred to it simply as an “addiction disorder” or a “behavior disorder,” and others refer to sex addiction as being associated with “obsessive compulsive disorder.” One treatment oriented website, The Recovery Ranch, had a concise definition followed by a criteria list as follows1: DSM 5 PROPOSED DIAGNOSTIC CRITERIA FOR HYPERSEXUAL DISORDER Over a period of at least 6 months, recurrent and intense sexual fantasies, sexual urges, or sexual behaviors in association with 3 or more of the following 5 criteria: 1 Should Sexual Addiction Be In the DSM-V, http://www.recoveryranch.com/articles/sexual-addiction-hypersexuality-dsm-v/ 1 1. Time consumed by sexual fantasies, urges or behaviors repetitively interferes with other important (non-sexual) goals, activities and obligations. 2. Repetitively engaging in sexual fantasies, urges or behaviors in response to dysphoric mood states (e.g., anxiety, depression, boredom, irritability). 3. Repetitively engaging in sexual fantasies, urges or behaviors in response to stressful life events. 4. Repetitive but unsuccessful efforts to control or significantly reduce these sexual fantasies, urges or behaviors. 5. Repetitively engaging in sexual behaviors while disregarding the risk for physical or emotional harm to self or others. o Provided A: That 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 or behaviors. o Provided B: That these sexual fantasies, urges or behaviors are not due to the direct physiological effect of an exogenous substance (e.g., a drug of abuse or a medication) Specify if: Masturbation, Pornography, Sexual Behavior with Consenting Adults, Cybersex, Telephone Sex, Strip Clubs, Other 2 2. Statistics / Introduction An estimated 17 to 37 million Americans struggle with this addictive disorder according to Patrick Carnes, 1994b; Cooper, Delmonico, & Burg, 2000; Morris, 1999; Wolfe, 2000. These figures are greater than the combined number of Americans who are addicted to gambling or have eating disorders according to National Center on Addiction and Substance Abuse at Columbia University, 2003; Potenza, Fiellin, Heninger, Rounsaville, & Mazure, 2002; Shaffer & Korn, 2002; Tenore, 2001. In addition to the prevalence, the incidence of sexual addiction is rising, due in part to the affordability, accessibility, and anonymity of sexually explicit material available on the Internet (Cooper et al., 2000). Based on current trends, the prevalence of sexual addiction is predicted to continue rising at a rapid rate (Cooper, 2004). 2 We expect to see more and more divorce and custody cases involving sex addictions of varying degrees. As such, it is important, as practitioners, that we begin to educate ourselves on the addiction and the effects it has on each family member, as well as the impact it has on the pending divorce case. There are special considerations to be made when dealing with these cases and it is important to have a higher level of understanding, especially if you are interested 2Treating the Sexually Addicted Client: Establishing a Need for Increased Counselor Awareness W. Bryce Hagedorn (Journal of Addictions & Offender Counseling •April 2005 •Volume 25; http://pegasus.cc.ucf.edu/~drbryce/Treating_the_Sexually_Addicted_Client.pdf 3 in bringing the case to a close with the least amount of acrimony and damage. The practitioner is better equipped to deal with the parties if he or she has a better understanding of the addiction, the pain and trauma it may cause each person and child, as well as the impact it may have on all aspects of the case. 3. Sex Addiction and Acting Out Further Defined The National Council on Sexual Addiction and Compulsivity has defined sexual addiction as “engaging in persistent and escalating patterns of sexual behavior acted out despite increasing negative consequences to self and others.” In other words, a sex addict will continue to engage in certain sexual behaviors despite facing potential health risks, financial problems, shattered relationships or even arrest. The Diagnostic and Statistical Manual of Psychiatric Disorders, Volume Four describes sex addiction, under the category “Sexual Disorders Not Otherwise Specified,” as “distress about a pattern of repeated sexual relationships involving a succession of lovers who are experienced by the individual only as things to be used.” 3 According to the DSM-IV, sex addiction also involves “compulsive searching for multiple partners, compulsive fixation on an unattainable partner, compulsive masturbation, compulsive love relationships and compulsive sexuality in a relationship.” 4. Understanding The Addiction 3 Treating the Sexually Addicted Client: Establishing a Need for Increased Counselor Awareness W. Bryce Hagedorn (Journal of Addictions & Offender Counseling •April 2005 •Volume 25; http://pegasus.cc.ucf.edu/~drbryce/Treating_the_Sexually_Addicted_Client.pdf 4 In preparing our materials, we relied heavily on a number of resources, but in particular, found an excellent and informative article by Michael Herkov, Ph.D. http://psychcentral.com/lib/author/michael-h/. While it is an older publication, Dr. Herkov’s article is very helpful in understanding sexual addictions and disorders, and it gives guidance about the addiction and information related to the cause and effects (on the addict and the partner/non-addict spouse). There were several sections in Dr. Herkov’s article that we felt worth repeating in our materials: Sexual addiction is best described as a progressive intimacy disorder characterized by compulsive sexual thoughts and acts. Like all addictions, its negative impact on the addict and on family members increases as the disorder progresses. Over time, the addict usually has to intensify the addictive behavior to achieve the same results. For some sex addicts, behavior does not progress beyond compulsive masturbation or the extensive use of pornography or phone or computer sex services. For others, addiction can involve illegal activities such as exhibitionism, voyeurism, obscene phone calls, child molestation or rape. Sex addicts do not necessarily become sex offenders. Moreover, not all sex offenders are sex addicts. Roughly 55 percent of convicted sex offenders can be considered sex addicts. About 71 percent of child molesters are sex addicts. 5 For many, their problems are so severe that imprisonment is the only way to ensure society’s safety against them. Society has accepted that sex offenders act not for sexual gratification, but rather out of a disturbed need for power, dominance, control or revenge, or a perverted expression of anger. More recently, however, an awareness of brain changes and brain reward associated with sexual behavior has led us to understand that there are also powerful sexual drives that motivate sex offenses. Increasing sexual provocation in our society has spawned an increase in the number of individuals engaging in a variety of unusual or illicit sexual practices, such as phone sex, the use of escort services and computer pornography. More of these individuals and their partners are seeking help. The same compulsive behavior that characterizes other addictions also is typical of sex addiction. But these other addictions, including drug, alcohol and gambling dependency, involve substances or activities with no necessary relationship to our survival. For example, we can live normal and happy lives without ever gambling, taking illicit drugs or drinking alcohol. Even the most genetically vulnerable person will function well without ever being exposed to, or provoked by, these addictive activities. Sexual activity is different. Like eating, having sex is necessary for human survival. Although some people 6 are celibate — some not by choice, while others choose celibacy for cultural or religious reasons — healthy humans have a strong desire for sex. In fact, lack of interest or low interest in sex can indicate a medical problem or psychiatric illness. 5. Medical/Psychological Recognition, Discussion and Recommendations There is a journal called the Journal of Addictions & Offender Counseling, April 2005, Volume 25 in which Bruce Hagedorn and Gerald Juhnke, wrote an article titled Treating The Sexually Addicted Client: Establishing a Need for Increased Counselor Awareness. We have copied excerpts from their article as well, below. The entire article can be found at: http://pegasus.cc.ucf.edu/~drbryce/Treating_the_Sexually_Addi cted_Client.pdf Patrick Carnes (1994b), a pioneer in the sexual addiction field since 1976, noted that compulsive sexual behaviors resembled the progressive and chronic compulsive behaviors commonly found with other addictions. For this reason, Carnes chose to use the term sexual addiction to describe