Abstract
Frequently couples seek marital therapy for the painful impact of one partner's “sex addiction.” Disagreement abounds in both the clinical world and the larger society, about what the designation “sex addiction” actually means. A variety of diagnostic categories are subsumed under it, creating confusion about both its causes and effective treatments. The current paper proposes precise definition and diagnostic language regarding a range of compulsive sexual behaviors. It maps a model for understanding and treating compulsive sexual activity in marital therapy in a stepwise sequence, beginning with careful history taking and diagnostics of both partners, identification of the mutually reinforcing relationship dynamics keeping destructive behaviors in play, processing of underlying psychological and developmental roots of such behaviors, cultivation of empathy and trust, and revitalizing of the couple's sexual relationship. The method is illustrated with a case history.
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