The first question, are you willing to get well?, reveals if the addict wants to be free of the addiction and is willing to surrender to a higher power. When couples seek counseling the questions are the same, do you want to heal your relationship?, are you willing to do the hard work?, are you willing to stop blaming each other and take your own inventory? The partners need to stop being enemies and begin being companions in the journey toward recovery.
The second question, what are you thirsty for?, deals with seven universal desires. They are the desire to be heard and understood, affirmed, blessed, safe, touched in non-sexual ways, chosen and passionately desired, and be included in fellowship with God and with others. If these desires are not met in healthy ways, expectations are developed of others to give them to us. This can cause problems in relationships. The solution is not for couples to strive to serves each other's desires better, it is to find the desires of our heart in our relationship with God and our community of family and friends.
The third question is, are you willing to die to yourself and, therefore, what are you willing to die for? Addiction is selfish and during recovery the addict needs to die in their arrogance and sense of control. During the recovery process the non-addicted partner is encouraged to establish healthy boundaries, but there can be a danger that if carried too far this can also lead to selfishness. Laaser (2005) counsels that it is through selflessness, putting your partner first, and a sense of spirituality, that people become willing to die to yourself and for your partner. He asserts that when this attitude is adopted in a marriage arguments are virtually non-existent.
Successful couple's counseling can only proceed where both partners are willing to seek individual healing for their trauma. Laaser (2005) says couples must find meaning in suffering and pain. By this he means that couples who have suffered a trauma together have an opportunity to for greater insight, healing and empathy for and with each other. When this takes place partners become companions.
Helping couples rebuild trust is a vital part of repairing the relationship after the sexual addiction has been disclosed. Laaser (2005) believes the spiritual tradition encourages couples to find forgiveness in their hearts. "Christian tradition tells us that we must forgive others as God has forgiven us."
Vision determines what we see and is based on what we desire. For instance, sexual fantasy leads to the belief that the love can be found in sexual activity. Any fantasy according to Laaser (2005) can be a false solution to desires that only God or deeper spiritual understanding can provide. The trouble for some couples is that each partner may have a vision, but they don't match up or complement each other. The couple that has two different visions really experiences division. Couple's counseling must facilitate the development of a vision that both partners can embrace and pursue.
Couples who don't have a vision, will do only what they think they have to in order to survive, while couples who do have a vision will do whatever it takes to fulfill that vision.
Sexual addicts and their partners may be reluctant to delve further into this area due to the potential negative consequences, trauma for the partner and the loss of the relationship for the addict according to Bird (2006). Nevertheless, research indicates that discloser is necessary and helpful in the long run in improving the relationship and recovering from the addiction. It is important to keep in mind that partners who are further along in therapy report that learning more about the addict's behavior does not give them the power to control the addict or the situation. In fact, too much detail can be more traumatic the helpful. The revelation of certain details may possibly cause, or enhance, PTSD symptoms; therefore the therapist must consider the potential negative consequences of collecting too much information.
If disclosure of inappropriate sexual behavior is prior to therapy most spouses have already dealt with threats to leave and other ineffective and often harmful problem-solving behaviors. Bird (July, 2006) states that research indicates such behavior does not preclude relapse and often induces the addicted partner to withhold important information for fear of losing the relationship. At this juncture the role of the therapist is to assist partners in setting appropriate boundaries, up to and including separation, which will allow the addict to feel more open. It is further noted the trust in the relationship will increase over time and consistency in the addict's behavior. By helping couples become more aware of their own feelings, learn to share these feeling with each other, set boundaries and manage future disclosures, the therapist can support them while they work at redeveloping lost confidence in each other.
In terms of general treatment approaches therapists recommend contracting, anger management, cognitive restructuring, confrontation, defining sexual sobriety, defining behavioral boundaries, empathy, and grief counseling as treatments. Prayer and scripture study are also useful.
Balswick, J.O., & Balswick, J.K. (2006). A model for marriage: Covenant, grace empowerment and intimacy. InterVarsity Press, Downers Grove, IL.
Bird, M.H., ( July, 2006). Sexual addiction and marriage and family therapy: Facilitating individual and relationship healing through couple therapy. Journal of Marital and Family Therapy, Vol. 32, No. 3, 297-311. Retrieved June 16, 2010, from, http://findarticles.com/p/articles/mi_qa3658/is_200607/ai_nl6692836/
Carnes, P., (2001) Out of the shadows: Understanding sexual addiction. Hazelden Information and Educational Services, Center City, MN.
Doss, B.D., Thum, Y.M., Sevier, M., Atkins, D.C. & Christensen, a., (2005). Improving relationships: Mechanisms of change in couple therapy. Journal of Consulting and Clinical Psychology, Vol. 73, No. 4, 624 -- 633. American Psychological Association, Retrieved June 16, 2010, from, http://ibct.psych.ucla.edu/articles/Doss%20et%20al%202005pdf
Frank, D. & Frank, J., (2003). Unclaimed baggage: Dealing with the past on your way to a stronger marriage. Navpress, Colorado Springs, CO.
Hanson, R.R. & Woodside, S.J., (2009). Optimizing marital success: The conscious couple uniting process. Humboldt Journal of Social Relations, Vol. 32 (1), pp. 158-183. Humboldt State University, Eureka, CA. Retrieved June 16, 2010, from, http://www.humboldt.edu/~hjsr/current.html
Hertlein, K. & Viers, D. (Eds) (2005). The couple and family therapist's notebook: Homework, handouts, and activities for use in marital and family theropy. The Haworth Clinical Practice Press, New York.
Laaser, M.R., (2006). Working with couples from a spiritual perspective. Sexual Addiction & Compulsivity, 13:209 -- 217. Taylor & Francis Group, LLC. Retrieved June 16, 2010, from, http://www.informaworld.com
Murray, C.E. & Murray T.L. Jr., (January, 2007). The family pharm: An ethical consideration of psychophamacology in couple and family counciling. The Family Jounal, Vol. 15 (1), pp. 65-71. Sage Journals Online, Retrieved June 16, 2010, from, http://tfj.sagepub.com
Smith, R.L. & Southern, S., (October, 2005). Integrative confusion: An examination of integrative models in couple and family therapy. The Family Journal, Vol. 13 (4), pp. 392-399. Sage Journals Online, Retrieved June 16, 2010, from, http://tfj.sagepub.com
Zalter, B. & Fiske, H., (2005). Scaling in action.…