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Disclosing Secrets: Guidelines for Therapists Working with Sex Addicts and Co-addicts

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Abstract

Therapists who treat clients with addictive or compulsive behaviors often are faced with the dilemma of whether a person should disclose secrets about the sexual behaviors to others. If a disclosure is determined, then when, what, and how to disclose are issues clients must face. This article discusses issues related to the therapist, including transference and countertransference, disclosure of the therapist's personal history, and the therapist's values regarding keeping secrets from one member of a couple. Practice guidelines outlined for clinicians include obtaining and gathering history, the importance of establishing goals with clients, timing of disclosure, how much to disclose, and how to disclose. Other ethical situations and steps to rebuild relationships are discussed.
Sexual Addiction & Compulsivity, 9:43–67, 2002
Copyright © 2002 Brunner-Routledge
1072-0162 /02 $12.00 + .00
43
Address correspondence to M. Deborah Corley, 10853 Rolling Hills Dr., Little Elm, TX
75068. E-mail: mdcorley@msn.com
Disclosing Secrets: Guidelines for Therapists
Working with Sex Addicts and Co-addicts
M. DEBORAH CORLEY
Sante Center for Healing, Argyle, Texas, USA
JENNIFER P. SCHNEIDER
Arizona Community Physicians, Tucson, Arizona, USA
Therapists who treat clients with addictive or compulsive behaviors
often are faced with the dilemma of whether a person should dis-
close secrets about the sexual behaviors to others. If a disclosure is
determined, then when, what, and how to disclose are issues cli-
ents must face. This article discusses issues related to the therapist,
including transference and countertransference, disclosure of the
therapist’s personal history, and the therapist’s values regarding
keeping secrets from one member of a couple. Practice guidelines
outlined for clinicia ns include obtaining and gathering history,
the importance of establishing goals with clients, timing of disclo-
sure, how much to disclose, and how to disclose. Other ethical situ-
ations and steps to rebuild relationships are discussed.
Psychologists, addiction counselors, and other mental health workers who
treat individuals diagnosed with addictive sexual disorders frequently are
told of sexual behaviors that the patient has not disclosed to the spouse or
partner. Often the spouse has been suspicious and, in some cases, has threat-
ened divorce or separation should certain behaviors
(
e.g., affairs, purchasing
sex, participation in cybersex, or sexual involvement by professionals with
patients or clients
)
be revealed. At other times the spouse is totally unaware
of the affair, cybersex involvement, or other sexual acting out behaviors.
Treating professionals often are unclear as to the importance of disclosure,
the timing of the disclosure, and its extent.
When a disclosure or discovery of extramarital behavior has already
happened, the resultant distress is frequently the catalyst that brings the
couple into therapy. At the time of the first visit, the unfaithful partner has
M. D. Corley and J. P. Schneider44
already given some information to the spouse. But, especially in the case of
sex addicts, the disclosure is usually incomplete
(
Schneider, Corley, & Irons,
1998
)
.
Each member of the couple has his or her own agenda for therapy. For
the addict or unfaithful person, items on the agenda may include maintain-
ing the ongoing problematic behavior, preventing the betrayed partner from
leaving, limiting further disclosure as “damage control” against multiple losses,
and assuaging guilt by revealing everything. The partner’s agenda typically
includes obtaining information to validate her or his fears and suspicions in
hopes of feeling sane again and getting the addict to stop the behavior.
Additionally, the partner is hoping to learn every single detail of the acting
out in hopes of figuring out why it happened and to preserve the relation-
ship or to gain ammunition for further retaliation. Finally, the partner wants
to assess the risk of having been exposed to a sexually transmitted disease
(
STD
)
or other health risks.
When dealing with the consequences of sexual betrayal, there are many
similarities between nonaddicted and addicted couples seeking help to work
through the labyrinth of emotions and decisions. However, in the context of
addictive sexual disorders, there are two unique factors that significantly
impact the disclosure process:
1. The sexual acting out has been repetitive and the betrayal and lying egre-
gious. Even when the presenting problem is a single affair, there gener-
ally is a hidden history of other affairs or additional sexual acting out.
2. The most widely used model of recovery from addiction, based on the
Twelve Steps of Alcoholics Anonymous, is often interpreted as confusing.
On one hand, the program requires “rigorous honesty.” Yet step nine
cautions against disclosure to those we have harmed “when doing so
would injure them or others.”
(
Alcoholics Anonymous, 1953
)
.
Consequently, sex addicted couples have many questions and uncer-
tainties regarding the process of disclosure. The therapist’s actions can be
instrumental in helping both the individual and the couple through a very
difficult and complex process.
LITERATURE REVIEW
Although the literature in the marriage and family therapy field was not
written specifically for couples dealing with sex addiction problems, it is
certainly relevant when the acting out has involved the other partners, lies,
and betrayal. Some authors stress the importance of honesty and disclosure
(
Brown, 1991; Pittman, 1989; Subotnik & Harris, 1994; Vaughan, 1989
)
. Ac-
cording to Pittman
(
1989
)
, for example, the dishonesty may be a greater
violation of the rules than the affair of misconduct. He acknowledges that
Disclosure for Therapists 45
more marriages end in an effort to maintain the secret than do in the wake of
telling. Pittman speculates that the partner may be angry about the affair, but
will be even angrier if the affair continues and she or he finds out later. Glass
(
1998
)
, writing about the posttraumatic reactions to the disclosure of infidel-
ity, lists factors that affect the level of traumatization. High on the list is “the
extent of the deception and how the infidelity was disclosed”
(
p. 31
)
. Brown
(
1991
)
points out that secrecy creates insiders and outsiders. The one who
doesn’t know the secret becomes the outsider. This person commonly reacts
by searching within for what is wrong and then attempting to correct it by
trying even harder to please. Learning the truth brings a great sense of relief
and brings sense to the person’s experience.
Some authors give general advice about what to tell and when to tell
(
Brown, 1991; Subotnik & Harris, 1994; Wallerstein & Blakeslee, 1989; Spring,
1996; Vaughan, 1989
)
. Pittman
(
1989
)
, for example, advises, “Couples need
not tell each other every detail of their activity and every thought that goes
through their heads, but they do have to tell each other the bad news. . . . The
things people must be sure to talk about are those things that are unsettling,
guilt-producing, or controversial”
(
p. 281
)
. Brown
(
1991
)
advises that in most
circumstances the unfaithful partner must disclose if healing is to occur. In
some cases, she notes, behaviors from previous relationships or long ago do
not always need to be revealed. She also observes that time and support for
the partner is necessary. It often takes longer sessions or more sessions of
therapy to help the partner express her or his anger and sadness about the
infidelity before actual rebuilding of the relationship can occur. However,
these authors’ advice is rarely informed by scholarly publications.
Unfortunately, very little has been written in this discipline about disclo-
sure. Specifically absent is information about ethical issues for therapists
regarding disclosure, how to effectively counsel clients about the timing, or
how to actually carry out the steps of disclosure.
Situations in which there is a significant need to know are when the
partner is at risk of acquiring or has been exposed to a sexually transmitted
disease. Even in such a well-defined situation, in which life-and-death health
issues are involved, disclosure is not consistent. In a study of 203 consecu-
tive patients presenting for primary care for HIV at two urban hospitals
(
Stein
et al., 1998
)
, 129 reported having sexual partners during the previous six
months. Sixty percent of this group had disclosed their positive HIV status to
all sexual partners. Of the 40% who had not disclosed, half had kept the
information from their one and only partner. To make matters worse, 57% of
the nondisclosers used condoms less than all the time. The odds that an
individual with one sexual partner disclosed were 3.2 times the odds that a
person with multiple sexual partners disclosed. The odds that an individual
with high spousal support disclosed were 2.8 times the odds of individuals
without high support.
The authors call for guidelines for clinicians who wish to help HIV-
infected patients disclose their serostatus and protect partners through be-
M. D. Corley and J. P. Schneider46
havior change and advise clinicians to take a thorough sexual history that
includes questions regarding both current and past sexual partners.
When a client is HIV-positive or has AIDS, and has not disclosed to
sexual partners, the therapist may face a difficult ethical dilemma about his
or her priority—to maintain client confidentiality or to warn the partner
(
s
)
at
risk. The Tarasoff v. Regents of the University of California case
(
1976
)
man-
dated therapists to disclose client confidences to prevent clear and immedi-
ate danger to a person or persons,” but did not operationally define what
constitutes danger. A national survey of marriage and family therapists
(
Pais
et al., 1990
)
examined what therapists do when their HIV-positive clients
disclose that they are engaging in high-risk sexual behaviors. Among 309
respondents to a hypothetical vignette, 59.2% claimed they would report to
the client’s sexual partners. Interestingly, the likelihood of reporting depended
both on the client’s and the therapist’s background. Disclosure to partners
was more likely when the client was male, young, gay, or African American,
and when the therapist was older, female, had less experience with gay and
lesbian populations, Catholic, very religious, or was practicing in an urban
area. The authors conclude, “It appears that when there are no clear guide-
lines, bias and prejudice may determine decision making”
(
p. 469
)
, and the
call for more research and training in the area of duty-to-warn with HIV-
positive clients.
Persons with addictive sexual disorders are at an increased risk of ac-
quiring STD’s compared with nonsex addicts. At this time, there is not a
uniform legal standard regarding the therapist’s responsibility when clients
are HIV-positive. Guidelines for dealing with such clients were described by
Herring
(
2001
)
in an article on ethical issues in treating sexual addicts: “Cli-
nicians should discuss the exact nature of their HIV-related confidentiality
policies with clients at the onset of treatment, remain current with state laws,
educate clients about the seroconversion risks of their specific sex and drug
practices, be prepared to speak directly about any concerns that arise during
the course of treatment, offer to help communicate information to partners
and consult with colleagues as appropriate.
(
A recent special issue of the
journal Sexual Addiction & Compulsivity
(
2001, no. 2
)
is dedicated to help-
ing clinicians who work with HIV-infected sex addicts.
)
Within the addiction field, Schneider
(
1998
)
interviewed several part-
ners of sex addicts and concluded they have a high need to know. Based on
a subsequent larger study of couples in recovery from sex addiction and
coaddiction
(
Schneider & Schneider, 1990
)
, the authors advised couples to
be honest about the extramarital sexual behaviors. Their findings confirmed
that honesty is considered significant to recovery for both the individual and
for the couple relationship.
A more recent study specifically explored couples’ perceptions of their
disclosure experience. Based on anonymous surveys distributed to recover-
ing sex addicts and partners or former partners of sex addicts, the present
authors obtained information on the needs of such clients from therapy
Disclosure for Therapists 47
(
Schneider, Corley, & Irons. 1998; Schneider, Irons, & Corley, 1999
)
. Most
respondents emphasized that honesty was the foundation for an improved
relationship. Based on their experience, the majority of both sexually com-
pulsive persons
(
68.3%
)
and partners
(
81.4%
)
recommended disclosure. In
this population, over half of the partners threatened to leave
(
60.2%
)
but less
than one-quarter of those that threatened to leave actually left. Threats to
leave were seen as part of a process of coping with disclosure by partners
rather than a realistic outcome for most couples.
Also noted in the study cited above, some partners complained that in
therapy their needs were considered subservient to those of the addict. What
they wished for was validation of their feelings and perceptions, respect for
their need to have more information, and more assistance in making appro-
priate choices for themselves. Several reported traumatic experiences of re-
ceiving devastating disclosures by telephone when the addict was away in
treatment, or during intense family therapy at treatment centers which made
no follow-up arrangements for the partner to process the disclosure with
assistance.
In this article, we describe some specific issues that are relevant to
therapists who counsel sex addicts and their partners regarding disclosure.
Our views are based on several anonymous surveys done over the past 10
years which included questions about experiences with therapy
(
Schneider,
2000a, 2000b; Schneider & Schneider, 1990; Schneider et al., 1998
)
, and our
clinical experience and personal knowledge of hundreds of couples who
have experienced disclosure as part of their recovery from sex addiction
problems. The areas to be discussed are Therapist-specific issues including
(
1
)
transference and countertransference,
(
2
)
sharing personal experiences,
(
3
)
the therapist and secret keeping: ethical considerations,
(
4
)
the therapist
with limited knowledge of sex addition, and
(
5
)
the role of the therapist, and
Practice guidelines for the therapist including
(
1
)
crisis intervention and
early therapy,
(
2
)
helping the addict decide about full disclosure,
(
3
)
timing
of disclosure,
(
4
)
disclosure and safety issues,
(
5
)
how much to disclose,
(
6
)
the formal disclosure, and
(
7
)
on-going discussions of the impact of addic-
tion and establishing a process for future disclosures.
THERAPIST-SPECIFIC ISSUES
Transference and Countertransference
In his therapy work, Sigmund Freud thought of himself as a neutral observer,
who could reflect back to and interpret his patient’s words and emotions.
This perspective has been replaced by an understanding that not only does
the client project onto the therapist feelings that are based on earlier relation-
ships
(
transference
)
, but that the therapist’s own emotions and experiences
inevitably color his or her feelings about the client
(
countertransference
)
.
M. D. Corley and J. P. Schneider48
Given the high percent of primary relationships that have at some point
in their history involved affairs, there exists a significant likelihood that the
therapist has either had an affair himself or herself, has been the betrayed
partner, or has had a close friend or family member who has been affected
by an affair and its disclosure. The strong emotions the therapist may have
experienced are likely to influence his approach to the client’s affairs and the
need to disclose. The therapist who has been unfaithful may tend to identify
with the addict and to minimize the damage to the partner; the therapist who
has been betrayed might overly identify with the coaddict, views the addict
as the “bad guy,” and push for premature disclosure.
A therapist who is currently involved in an extramarital affair should
probably not be working with clients with this issue. Therapists who have
had personal experience with affairs need to obtain supervision about this to
clarify its effects on their values, beliefs, and their feelings about disclosing
affairs and about keeping secrets. Understanding one’s own feelings about
disclosure will allow the therapist to counsel the client more objectively and
more effectively.
Sharing Personal Experiences
There is a tradition in addiction counseling of sharing some of the counselor’s
own story. We agree with Herring
(
2001
)
in his article on ethical guidelines
for counselors treating sexual compulsion, “although a counselor who dis-
closes a personal recovery experience may offer clients hope and under-
standing and help reduce shame by modeling an authentic self, unrestrained
disclosure has clear risks, if used indiscriminately, such counselor transpar-
ency may be too intrusive, distracting, or unexpected for the client to inte-
grate, and may generate unrealistic expectations or a sense of inadequacy”
(
p. 19
)
.
A young clergyman, who only days before had come to the realization
that his three years of compulsive cybersex activities represented an addic-
tion, immediately went to see a sex addiction counselor, and reported on his
first visit:
I saw a counselor yesterday. It turns out that he is a sex addict in recovery.
He gave me some different perspectives on it to think about. He told me
about group meetings that I can go to. But he talked too much, and at
times wondered whether it was me or him who was the counselor. From
my training, I know how it should be done. I think it is good for the
counselor to share information about himself into the session, but this guy
did it a bit too much. There were things I wanted to talk about, but I
couldn’t get a word in edgewise.
Intimate personal information should be shared only when it is directly
relevant to the treatment goals. Although many therapists in recovery dis-
close in session some information about their addiction history, it is not
Disclosure for Therapists 49
advisable for a therapist to share information about his or her own affair or
sexual acting out history. This type of personal information is private; unless
the therapist and his or her spouse
(
or former spouse
)
has gone public with
this experience, the professional is betraying the confidentiality of his or her
mate. Additionally, some therapists have had unfortunate consequences of
such personal disclosures. A client who has had a less than favorable out-
come may seek revenge by making public personal information about the
therapist. A client with dependent personality disorder may believe that she
or he is the therapist’s best friend because the therapist shared such intimate
information. Our recommendation is that although it may be helpful to share
less intimate stories that teach skills or demonstrate techniques for resolving
problems, it is more appropriate to use case examples or metaphors than the
therapist’s personal story.
The Therapist and Secret Keeping: Ethical Considerations
Whether or not to disclose a secret is a decision clients need to make. The
therapist’s discussions with the client around the decision can significantly
impact the effectiveness of the therapy. The following case is illustrative:
Martin, a 40-year-old radio announcer, had a history of affairs in his first
marriage and was now in the midst of the second affair of his second
marriage. His wife, Marla, knew about the problems in his previous mar-
riage, but believed that this behavior was ancient history and that Martin
was as committed to monogamy as she was. Martin’s increasing guilt over
this latest affair led him to therapy with Dr. Jim. When Martin had trouble
resolving his ambivalence over ending the affair, and with his desire to
come clean with Marla about it, Dr. Jim suggested including Marla in a
couple of therapy sessions.
In session, Dr. Jim explained to Marla that her presence might help
Martin as well as their relationship, without specifying exactly how. In-
stead he asked Marla how she would feel if she learned that Martin was
having an affair. Marla replied
(
as do many partners asked about such a
hypothetical situation
)
, “I’d leave him.” Based on this, Dr. Jim counseled
Martin not to disclose his affair to Marla. Shortly thereafter Marla became
suspicious and Martin ended the affair and told Marla about it.
Marla recalls:
“In addition to feeling betrayed by Martin and angry with him, I felt
betrayed by and angry at Dr. Jim. Dr. Jim got me into therapy under false
pretences, in order to dishonestly obtain information for Martin about the
likely consequences of disclosing the affair to me, then colluded with
Martin in keeping the affair secret from me. He acted like he was trying to
help me, but instead he hurt both Martin and me. I would never go back
to him again, and Martin now feels the same way.”
When a couple seeks conjoint counseling and one of them reveals pri-
vately to the therapist a concealed affair or other secret the situation repre-
M. D. Corley and J. P. Schneider50
sents an ethical dilemma for the therapist. Should she or he keep the secret
and see the couple? Is it ethical for the therapist to counsel a man who
suspects his wife is having an affair, a suspicion that she knows is justified,
but not say anything to the man about the affair?
Unlike Dr. Jim, most therapists are uncomfortable holding a secret for
one partner that significantly affects the relationship. The reasons they give
include “I’m not comfortable with being an accomplice to deceiving one of
my clients.” “I want to avoid a situation where one partner states she sus-
pects an affair, the other denies it, and I have to act ignorant although I know
the affair is indeed going on.” “If it ultimately comes out that I knew about
the affair, I would feel inhibited in the session because I’d have to hold back
speaking spontaneously.”
Glass and Wright
(
1992, p. 327
)
believe “it is inappropriate to conduct
conjoint marital therapy when there is a secret alliance between one spouse
and an extramarital partner that is being supported by another secret alliance
between the involved spouse and the therapist.” However, they are willing
to see the couple without addressing the affair if the affair is first terminated.
Brown
(
1991, p. 56
)
writes “I believe that the integrity of the therapeutic
process with couples depends on open and honest communication. No-
where is this truer than with affairs. The therapist cannot be effective while
colluding with one spouse to hide the truth from the other.” Instead of get-
ting stuck in the dilemma, Brown proposes referring the couple to separate
therapists. She does list a few exceptions in which maintaining the secret
with the client is the wiser choice:
(
1
)
when there is the potential for physical
violence or for destructive litigation in divorce courts, or
(
2
)
if the unfaithful
client is remaining in the marriage to care for a permanently incapacitated
spouse.
Possible solutions proposed by several therapists include:
1. Continuing to see both members of the couple, but setting a deadline for
the secret to be disclosed in therapy—for example, three sessions—and
in the meantime working individually with the secret holder on reduction
of fear and developing a respectful strategy for how to disclose.
2. Discontinuing couple counseling but working individually with the secret
holder to explore his commitment to the primary relationship and moti-
vation for being in counseling.
Some clinicians are less insistent on disclosure and would continue
working with the couple while keeping the secret, hoping that they could
still assist the couple to improve their relationship. Regarding a request by a
client that the therapist not reveal and ongoing affair, Moultrup
(
1990
)
ar-
gues that if the request comes before the therapist begins couple work and
the therapist insists on disclosure and discontinuation of the affair, “it is
unlikely that the client will agree to begin therapy. If the demand comes
shortly after the treatment has commenced, the probability that the client
Disclosure for Therapists 51
will bolt from treatment is great”
(
p. 123
)
. In the interest of not losing the
client altogether, Moultrup would keep the secret from the spouse. More-
over, Moultrup suggests that a therapist who insists on disclosure may be
promoting his own emotional agenda: “If a demand for certain action pre-
cedes the treatment, it clearly signals the need to re-evaluate the motivation
for that action.” He writes that his therapeutic strategy clearly anticipates the
probability that the therapy will be involved in keeping a secret from one
member of some couples. Moultrup’s view represents a minority position
among therapists who counsel couples.
Although many therapists believe that there is no need
(
for nonsex
addicts, that is
)
to disclose a long-past affair which has no bearing on the
present relationship, most therapists feel strongly that on-going affairs need
to be disclosed. Karpel
(
1980, quoted in Brown, 1991, p. 58
)
notes that “a
current secret extra-marital affair by one spouse is, in most cases, highly
relevant to the other spouse, because it involves major issues of trust and
trustworthiness, deception, and a violation of reciprocity.”
The therapist has a duty to protect the confidentiality of the client, and
as much as the therapist may think the partner needs to know, it is the
responsibility of the client to decide if he or she will tell. Just because a
therapist may think it is morally wrong for a client to be engaging in a
particular behavior does not give the therapist the right to disclose for the
client. Unless the partner’s life is in danger, the therapist cannot disclose
information for the client. If you feel that the partner’s life is at imminent risk,
contact a supervisor and obtain legal council before taking any steps to
disclose information to a partner.
As a therapist, the most important factor to keep in mind is the context
of the case. Each case is individual. However, with addicts, our clinical expe-
rience reveals that addicts do get better after disclosure to someone in addi-
tion to the therapist. Sometimes this is a sponsor or other group members.
Sometimes it is done in the context of 12-step work where an addict reflects
on his character flaws and admits this to his or her Higher Power and one
other. With this work comes a reduction in shame and often the addict is the
willing to disclose to partner. Disclosure is a process rather than a single
event.
Therapists with Limited Knowledge of Sex Addiction
In our research with couples dealing with sexual addiction, the primary
complaint was that the therapist was unfamiliar with sex addiction and that
the therapist’s approach prolonged the addict’s denial about the extent of
the problem. A therapist who has little or no experience with sex addiction
needs to let the couple know this. Express a willingness to refer the couple
to a therapist who is familiar with these issues. Some therapists continue
working with the couple but find it useful to get peer supervision from
someone familiar with sex addiction diagnosis and treatment.
M. D. Corley and J. P. Schneider52
Therapists with inadequate knowledge of sex addiction may fall prey to
the error of premature diagnosis. When a client presents with a sexual prob-
lem, ferreting out its cause may require some detective work. An all-too-
common therapist mistake is to diagnose without obtaining an adequate
sexual history of both the addict and the partner. For example, a client who
complains that her husband is not interested in sex with her may indeed be
married to someone who has a sexual desire disorder or sexual dysphoric
disorder, but alternatively, he may be an active sex addict who is spending
hours every night downloading pornography and masturbating. If a client
describes her own loss of interest in sex with her husband, she may have
sexual anorexia, but alternatively she may be reacting appropriately to living
with a spouse who has disclosed that he spends hours masturbating on the
computer, and who after 10 years of marriage suddenly wants her to partici-
pate in unusual sexual practices with which she is uncomfortable. Therapists
need to take the time to ask enough questions to get a full understanding of
what is happening in the relationship.
Another type of premature diagnosis is to attribute the cause of any
sexual problem to the partner. For example, years ago a woman wrote to Dr.
Ruth Westheimer
(
1987
)
, who had a sex therapy newspaper column, com-
plaining that her husband could hardly wait for her to leave the house so
that he could begin watching pornographic videos, and that several times
she had returned home early and found him masturbating to a porn movie.
Meanwhile, her husband was rarely interested in sex with her. Dr. Ruth’s
diagnosis was that the wife was sexually boring, and she recommended the
wife work on becoming more exciting sexually by dressing more provoca-
tively and increasing her sexual repertoire and her sexual availability. An-
other therapist, upon hearing a woman’s complaints about her husband’s
interest in pornography, told her that all she needed was a more enlightened
attitude about pornography, including joining her husband in viewing the
pictures and films. Meanwhile, her husband’s preferred sexual outlet, one he
spent engaged in for may hours a week, was masturbating to pornography,
The wife had, in the past, agreed to experiment with various sexual activities
with her husband, but he was not particularly interested in relational sex
(
Schneider et al., 1998
)
.
In both of the cases, the underlying problem may have been a compul-
sive or addictive sexual disorder involving pornography and masturbation.
Rather than looking to the partner to change, it is better to obtain a thorough
history about addictive or compulsive patterns.
In other cases, the diagnosis may be correct, but the labeling may be
premature. Partners are very sensitive to being labeled along with the addict.
Labels such as “coaddict” or “codependent,” while they may appropriately
describe the partner, rarely are the best path for helping the partner begin to
see her part in the couple’s relational dance. After the chaos begins to sub-
side, it is easier for the partner to see that some of her behaviors have
contributed to the situation with the couple. Early on, it is preferable that the
Disclosure for Therapists 53
partner hear those labels at support group meetings from other partners in
similar situations.
The Role of the Therapist
The role of the therapist is not to side with either the partner or the addict. It
is tempting to side with the partner because the addict has done the betray-
ing. However, this puts the therapist in a triangulated position and allows the
couple to focus on blaming or proving their point through the therapist
rather than dealing with their own issues within the context of the relation-
ship. Early in therapy, the couple looks to the therapist as all knowing and
the expert. Sharing information about what the counselor has learned through
the literature, research, and his or her own clinical experience with couples
dealing with sex addiction can be useful to give the couple hope and help
them be realistic about what to expect.
When concealed affairs of other problematic sexual behaviors are present,
the therapist needs to take into consideration the couple’s agenda and their
commitment to the recovery process. Brown
(
1991
)
advises not opening the
issue unless the therapist is available to help the couple resolve it, and un-
less the couple has the commitment to work through the consequences of
disclosure.
The therapist helps to interpret what is happening and discuss the dif-
ferences between how genders view and interpret situations. She or he vali-
dates each partner’s reality and the intensity of their emotional feelings. As a
coach, the therapist offers strategies to help the couple communicate more
effectively
(
especially the listening and reflecting part of communication
)
.
Another strategy we find useful for addicted couples is the incorporation of
cognitive behavioral exercises to correct the thinking errors and to develop
skills to help build emotional competence. Personal responsibility can be
enhanced by teaching skills for holding self and other accountable.
As the couple progresses the therapist will see them able to move from
the attack-defend mode of interacting, to productively handling disagree-
ments or difficult issues on a regular basis. Gradually, the problems are
addressed without blaming or bringing up past betrayals. Having moved
from interventionist in the early crisis phase, to educator, and then coach
during the rebuilding stage, near the end of therapy the therapist’s role changes
to cheerleader, letting the couple practice what they have learned.
CLINICAL GUIDELINES FOR THE THERAPIST
(
While the authors are aware that sex addiction is common among males
and females, the majority of addicts in our research have been males and the
partners have been females. For ease of reading, the following guidelines
refer to addicts as “he” and partners [representing coaddicts and codependents]
M. D. Corley and J. P. Schneider54
as “she.” Please take into consideration, the disorder has no preference for
gender.
)
Crisis Intervention and Early Therapy
A therapist’s introduction to a couple often begins with a telephone call from
the partner, who reports a crisis—the spouse’s infidelity. Ask if the betrayal
was just discovered and how it was found out, or if there has been an
ongoing problem regarding sex in the marriage. If the addict calls, it is usu-
ally because the partner has discovered something about his sexual activi-
ties, and a major disruption of the marriage has resulted. Ask if the addict
thinks he has a serious problem, if he has sought help for the problem, and
if so, if he is still in therapy. Determine if he is still acting out. If still acting
out , an individual session is appropriate to assess the commitment to getting
into recovery.
The partner is usually in a state of shock, either full of rage and anger or
devastated and hopeless. She may vacillate between both emotional states.
She may become anxious and seek relief through several phone calls to you
day or night, weekends, and holidays. While listening to her is vital to the
process, your ability to model some healthy boundary setting is equally as
important. Assure her that some feelings of depression and chaos are normal
for this period and help her develop a plan of coping. Encourage her to
postpone calling you until a designated check-in time. Help her identify a
support system by recommending S-Anon or Al-anon meetings and clarify-
ing with her who may be safe to share this information with. Encourage her
to journal what she wants to cover with you in the check-in sessions.
In the first few sessions
(
or in those frantic phone calls
)
it is helpful to
reduce her fear by validating her experience and reassuring her that she is
not crazy and that self-care is of the utmost importance. Help her establish
obtainable goals in these areas.
In our study, most respondents did see a therapist. In fact, most saw
more than one. The partners reported that the most important and useful
part of seeing a therapist was being supported and feeling heard. The sec-
ond most valuable type of advice was to take care of themselves and to
recognize that the addict’s behavior was not the partner’s fault.
In contrast, addicts reported that the most useful early advice was in the
area of what and how to tell. Some
(
60%
)
thought the advice to be honest
and tell everything was the most useful. Rather than demand the addict
disclose, a persistent, gentle coaching to share information with the partner
was seen as the most motivating. The therapists discouraged keeping se-
crets, warning that secrets are destructive and severely damage trust. Thera-
pists also helped addicts make better choices by considering many options.
Most often, the respondents reported that the most useful advice was hon-
esty is the best way to rebuild the relationship.
Help the addict identify his values and formulate ideas about how hon-
Disclosure for Therapists 55
esty can be helpful to the relationship with his partner and his recovery.
Have the addicts be specific about setting goals for honesty.
While most people in our study reported their experience with advice
from therapists to be satisfactory, those who responded to the question about
least helpful advice spoke to the impact and seriousness of disclosure for
both the addict and the partner. The primary theme identified for both addict
and partner was lack of knowledge and skill by the therapist. This included
lack of responsiveness to the emotional condition of the partner. Below are
some comments by partners that illustrate the serious situation that exists for
the partner.
Another therapist counseled my husband and myself but she didn’t know
that it was an addiction. Instead she encouraged me to be a better sexual
partner and support his habits.
When I found out my husband prefers men or children, I was really
devastated. My self-esteem was shaky and that finished it off. I was afraid
for my children. I don’t think my husband would stay in our home. Months
later my psychiatrist told me he was a pedophile—by then I was so de-
pressed I was planning to kill myself and my children.
I was so angry but isolated. I needed to talk about my feelings, but his
behavior was all we could see. Maybe disclosure should follow prepara-
tion. This was such a dangerous time for me.
The first two therapists did not address my need to ask more. I was a
psychologist for a period of time. He was ill prepared to help me. He
questioned my aversion to knowing the details. It confused me.
I felt I let my children down enormously by dragging them through all the
sordid details. Early, I should have been cautioned about who I disclosed
to along with connecting up with S-Anon groups. I acted inappropriately
by making several phone calls to those two women he’d been with.
Obviously from these comments, the serious nature of the emotional
state of the partners was not enough of a concern for the therapists. Thera-
pists need to assess the emotional state of the partner before moving forward
with further disclosure or before letting the partner leave after a difficult
session. Establish a firm goal with her about safety and check for suicidal
ideation.
After trust has been broken, couples often struggle with what to do
about the marriage. It is common to see the partner beset with fear that she
will be hurt again or will not be able to heal from the betrayal. The partner
is likely to threaten to leave, want the addict out of the house, actually leave,
or become so hypervigilant she becomes obsessed by the addict’s every
move. Reassure couples that their ambivalence and fear about the future of
the relationship is normal at this stage. Early on, establish an agreement to
M. D. Corley and J. P. Schneider56
not do anything for 90 days about leaving. We recommend waiting a year,
but most couples have a difficult time postponing this decision for what
seems like such a lengthy time period, not to mention recognizing that the
real recovery takes between two and five years. Couples in early recovery
are usually more comfortable agreeing to sit tight for three to six months,
and then reassess where they are. At that time, they can recommit to con-
tinuing to work on marriage and perhaps increase their level of commitment
to each other.
Helping the Addict Decide about Full Disclosure
Addicts who ask the therapist, “Should I disclose” are expressing ambiva-
lence about keeping the secret either because he wants to tell his partner, or
someone is pressuring him to tell and he is not sure. The therapist’s role,
then, is to help the addict resolve this ambivalence and prepare him for
telling. The following are useful questions to consider during and individual
session:
1. Is the affair over? Is the client still acting out? Does he want to stop?
2. Does the client still have any contact with the affair partner, or does his
or her spouse?
3. Does the client still have strong emotions about the affair partner? What
has been the attempt to resolve those feelings?
4. How did the affair impact the couple’s relationship?
5. What did the affair solve or seem to make better
6. What lies where used to cover up the affair?
7. Did the partner suspect, and if so, how much energy and additional
lying was necessary to disarm the partner’s suspicions?
(
For example,
was the partner accused of imagining things, paranoia, etc. that perhaps
contributed to the partner’s loss of self-esteem?
)
8. Is this the only affair or behavior the client had, or has this been a
recurrent pattern?
9. Does a past affair or problematic behavior still have an impact on the
couple’s current relationship?
10. How comfortable does the client feel about continuing to conceal the
affair or behavior?
11. What is the meaning for the client of continuing not to disclose, and of
disclosing?
12. What does the client believe will be the positive as well as negative
consequences of disclosing the affair or problematic behavior
(
on him-
self, or on the spouse, on the relationship
)
?
13. What does the client believe will be the positive and negative conse-
quences of continuing, not to disclose
(
on himself, on the spouse, on
the relationship
)
?
Disclosure for Therapists 57
By clarifying the reasons for the addicts consideration of disclosure, the
therapist can help him decide if it would be the right thing to do. By allow-
ing the addict to talk about the positive and negative reasons for disclosing,
the addict’s motivation for disclosing may increase. However, sometimes the
addict may determine disclosure is not right at this time. Determine what he
will need to change in order for the time to be right for disclosure.
Timing of Disclosure
When there is a need for disclosure, it is best done early, as explained by
Brown
(
1991
)
,
The earlier in marital therapy that the revelation of an affair occurs, the
better once a relationship has been established between couple and the
therapist. Otherwise, any work that has been done is jeopardized, as is
the therapy itself, by the fact that it occurred under false pretenses. The
spouse’s sense of betrayal and outrage is greater and trust is much more
difficult to rebuild than when the affair is revealed at the beginning of
marital therapy
(
p. 60
)
.
Often some type of disclosure has already taken place before the couple
shows up for the first therapy session. The addict’s initial disclosure most
frequently occurs when the partner is about to learn the truth anyway, or
when the partner has some incriminating information. Other addicts, how-
ever, develop so much guilt that they feel a huge buildup of pressure to
disclose. At some point they may disclose everything precipitously, without
considering the consequences for the partner. In both of these cases, the
couple typically consults the therapist only after the initial disclosure, in
which case the therapist must then support and validate the partner and
process the disclosure with the couple. If, however, there is additional
material to disclose, doing so in session with a therapist is likely to be most
helpful for the partner. If the addict has written a disclosure letter to the
partner, process that letter in the session. Discourage the addict from giving
a letter to the partner outside the session or without first being reviewed
by the therapist, and without responding to the therapist’s recommenda-
tions.
If, however, the therapist has the luxury of planning the disclosure, it is
best to prepare first. The counselor needs to talk with the partner, be sure
she has a support system in place, and determine when she is ready. Simi-
larly, the addict needs preparation to be able to receive the partner’s anger,
grief, and other emotions without either becoming defensive or fleeing from
his discomfort into a relapse of the addictive behaviors.
On the other hand, the process should not be prolonged beyond a few
sessions. If there is repeated postponement, then the addict is stuck in fear
and it is unfair to keep the partner uninformed. When she eventually learns
M. D. Corley and J. P. Schneider58
both the facts and the delay in disclosing them, she will be even more angry
with both the addict and the therapist.
Timing of Disclosure when There is High-Risk Acting Out
Sex addicts engage in a variety of behaviors that the partner may or may not
view as extramarital—for example, collecting pornography, telephone sex,
viewing nude dancers, masturbation while chatting with another person on
the computer, and sexual massage. Most sex addicts, however, do engage in
behaviors that involve sexual contact with another person, often without
protection from sexually transmitted diseases. This was evident in the results
of our survey, which found of that of the 100 sex addict responses, 91%
reported engaging in unprotected sexual behavior that included another
person.
Involvement with another person presents a different threat or cost to
the relationship than solitary sexual activities. For one, it increases the risk
that the partner will want to leave the relationship, and therefor makes it
more difficult for the addict to disclose the behaviors. For anther, involve-
ment with another person risks exposure of the addict—and by extension
the partner—to sexually transmitted diseases, financial liabilities, and some-
times legal consequences. The risk of infection with a sexually transmitted
disease, especially HIV, presents an ethical dilemma for the therapist who
learns about a concealed affair. Given the ethical stipulation that therapists
report to authorities when a person’s life is in danger, an addict might be
asked by his therapist to disclose to the partner if he was HIV positive. If the
addict has not yet been tested, it is appropriate for the therapist to suggest
this to him.
Timing of Disclosure: Long-Distance or Unprepared Disclosure
As reported in our earlier publications
(
Schneider et al., 1998, 1999
)
, inpa-
tient treatment programs sometimes fail to take into account the needs of
family members. In several cases, sex addicts revealed devastating informa-
tion over long-distance telephone calls to unsuspecting spouses, who were
then left to deal with their overwhelming emotions without any support
system. Adverse experiences also were reported by partners who received
disclosures of significant sexual activities during a therapy session at the
inpatient facility and were then left to process the news alone, and were not
provided with referrals for follow-up back home. We recommend that inpa-
tients be counseled against precipitous long-distance disclosure. If the addict
is in treatment elsewhere and if the partner is not able to be present at the
center for the initial or further disclosure, it is best to arrange with the treat-
ment center to have the addict disclose any further information only when
the partner is in a therapy session.
Disclosure for Therapists 59
Additionally, disclosure during “Family Week” should be planned with
careful attention to providing the recipient with onsite support, an opportu-
nity to process the information and her feelings with a counselor, and refer-
ral for ongoing counseling and self-help groups in the community.
Disclosure and Safety Issues
If the addict or the partner fears for their physical safety, appropriate steps
should be taken to get the couple to separate for a short period of time. If
domestic violence has been part of the couple’s history, the victim needs to
have a back-up plan for leaving if the situation increases in volatility. Espe-
cially when it is the woman who has acted out sexually outside the marriage,
the therapist needs to assess the risk of violence to her before recommend-
ing disclosure.
Another area of safety concerns potential victims of sexual offenders.
When sex behaviors include victimizing others, the therapist’s first priority
needs to be to get the client to stop the behaviors. A significant therapist
mistake is to focus on getting the addict to understand the sources of the
behavior, resolve childhood trauma, and so forth, without directly address-
ing the behavior itself. For example in his book Therapists Who Have Sex
with their Patients, Dr. Herbert Strean describes his treatment of a male thera-
pist who over time had sexual relations with several female clients. He re-
lates how over a 4-year period, using psychoanalytical psychotherapy, he
was finally able to bring the patient to sufficient mental health that he no
longer felt compelled to get his emotional needs met through sexual contact
with clients. However, the issue of the trauma done to the clients and the
need to immediately stop the behavior was reportedly never directly ad-
dressed, and the patient apparently continued the behavior for an extended
time period while undergoing therapy.
(
Sexual relations with a therapy cli-
ent or patient are so potentially damaging to the patient that it is prohibited
by professional associations and licensing bodies throughout the United States
and Canada, and is a felony in several states.
)
Similarly, when a client relates to a helping professional that her partner
disclosed to her some potentially victimizing sexual activities, it is a mistake
to underestimate the gravity of the situation. For example, in a survey of
partners of cybersex addicts
(
Schneider, 2000a
)
, a young woman related that
when she was engaged to be married, her fiance’ admitted he was down-
loading pornographic images of underage girls from the computer. She went
to her minister for counseling and to discuss her options. She reported that
the minister dismissed her concern, stating that her fiancé was probably “just
curious,” and that after they were married, his curiosity would undoubtedly
be satisfied by having sex with his wife. Unfortunately the husband’s behav-
ior continued long past the marriage, and the wife was now worried about
his risk of arrest.
M. D. Corley and J. P. Schneider60
The bottom line is, when disclosure reveals behaviors that are illegal,
dangerous, or involve victimizing others, therapists must make it their prior-
ity to assure the safety of the addict, spouse, and potential victims.
How Much to Tell: “I am Afraid to Tell” versus “I Want to Know
Everything”
Because disclosure brings shame to the addict and pain to spouse and risks
the end of the relationship, addicts initially tend to avoid complete disclo-
sure. In contrast, partners often demand complete disclosure, which is a way
for them to make sense of the past, validate their suspicions and the reality
they had experienced
(
which had often been denied by the addict
)
, have a
sense of control of the situation, assess their risk of having been exposed to
STDs, and establish some hope for the future.
Unfortunately, the belief that knowing “everything” will provide control
is an illusion, and the partner who has all the details in her head may rumi-
nate and obsess over them and cause herself endless pain. Disclosure of
various details can leave partners with unpleasant memories and associa-
tions that are difficult to ignore, serving as triggers for intrusive thoughts and
negative feelings. If the partner does not begin a personal recovery program,
this information can become the source of pathological obsessing that can
result in the partner’s own acting out behaviors.
For partners who begin a recovery program, later they come to recog-
nize that knowledge is not necessarily power, that no matter how much
information they have they are still unable to control the addict. Instead,
they develop guidelines for themselves about what information they want
(
typically, general information such as their risk of STDs and the addict’s
commitment to recovery and the relationship
)
and what they do not want
(
details of sexual activities, locations, and numbers
)
.
The therapist can encourage the partner to consider carefully what in-
formation she wants rather than asking for “everything.” One helpful therapy
technique is to have the client write down every question to which she
wants an answer, then give the list to the therapist for safekeeping and for an
agreed-upon time period, say two months. At the end of that time the thera-
pist and partner review the list and decide which questions to ask. Fre-
quently, after such a cooling-off period, the partner is no longer interested in
painful details.
The therapist also can monitor the intent of the disclosure: moving to-
wards greater intimacy is a positive intent; to obtain ammunition to punish,
control, or manipulate the addict is a poor intent.
PARTIAL OR SEQUENTIAL DISCLOSURE
It is tempting for the addict to attempt damage control by initially disclosing
only some of the sexual acting out. The adverse effects of staggered disclo-
Disclosure for Therapists 61
sure have been described
(
Schneider et al., 1998
)
. A recurrent theme among
partners was the damage of staggered disclosure by the addict. When the
addict claimed at the time to reveal all the relevant facts but actually with-
held the most difficult information for later disclosure, partners reported
great difficulty in restoring trust. One recipient described it by saying, “His
revelations continued to dribble out over weeks as I continued to ask for
information. Each new piece of information felt like a scab being ripped off.”
A man who was sent to prison as a consequence of his sexual behavior
disclosed to his wife only some of his activities. She wrote, “Some of his past
was reported to the presentence investigator, and I received the report only
after he’d been in prison for 3 months. When I read it, I felt immense pain
and anger. Part of that was not having been told. I felt lied to and I didn’t
trust any of the relationship.”
Despite the potential adverse consequences of disclosure, most respon-
dents in our surveys recommended disclosure. We advise that the initial
disclosure include the broad outlines of all the behaviors, while not spelling
out the details.
Recipients of disclosure need to be informed by the therapist, however,
that disclosure is always a process, and not a one-time event. The reason for
staggered disclosure is not always that the addict is deliberately holding
back some damaging facts to protect himself or avoid unpleasant conse-
quences. Other reasons
(
Corley & Schneider, 2002
)
for not having immedi-
ately disclosed “everything” include:
1. The addict has acted out in so many different ways or with so many
different people or has told so many lies that he genuinely does not recall
some of them until a later time.
2. The addict was in such an altered state at the time of the episodes of
acting out—for example, he may have been drinking or using drugs—
that he simply does not remember particular events.
3. The addict, although remembering all the details of his acting out, does
not initially consider particular events or actions significant enough to
bother disclosing. With increased recovery, the addict realizes the need
for disclosing additional history.
4. Disclosure of certain actions may be so damaging to the partner or to
family relations
(
for example, an affair with the wife’s sister
)
, that a thera-
pist recommends not disclosing these facts initially, until the partner has
received counseling and preparation.
5. Certain episodes of acting out occurred only after the initial disclosure.
That is, they represented slips or relapses of the addiction.
(
This is the
most problematic situation, in that it is likely to cause the most damage
to the process of rebuilding trust.
)
6. The addict may be so frightened that what he has disclosed may truly be
all he was capable of at the time.
M. D. Corley and J. P. Schneider62
A Formal Disclosure
A formal or healing disclosure is appropriate when some disclosure has
occurred but the partner continues to voice concern that she does not be-
lieve the addict has been honest—that she believes he is still withholding
information—and she remains stuck in her fear and anger. The couple seems
stuck in gridlock and neither can make movement beyond this stage. The
therapist should encourage the couple to have a formal disclosure session—
with the goal that this session symbolically stand for beginning the rebuild-
ing process for the couple. It is useful to set aside a two or three hour session
for this process. This process is most useful after the addict and partner have
had some experience with a 12-step recovery process so each has support
and some understanding of unhealthy but common addict and codependent
styles of responding during highly emotional times.
The partner is invited to write a letter to the addict, outlining how she
feels and the impact his behavior and the addiction has had, and is having,
on her life and to include all of her unanswered questions. The therapist
may want to meet separately with the partner to review her letter and coach
her to have personal integrity in her approach, while helping her express
emotions that she may be mismanaging. She
(
the partner
)
will bring this
letter to the session.
The addict is invited to write an amends letter disclosing what he has
done in his addiction that has been hurtful and harmful to his partner. The
therapist also may want to have an individual session with the addict to
review this assignment, and prepare the addict for the presentation of the
letter. If he has an opportunity to practice reading the letter to a select group
of his peers or in group therapy, he often gains further insight into how he
could improve the letter or his presentation. Groups often remind the addict
if he is continuing to try to minimize his behavior or blame others. He should
read the letter aloud to gain the full benefit of the process. If the addict does
not have a group in which to process this, then the therapist should serve
this purpose. He is cautioned not blame her or others for his behavior, but to
take full responsibility for his actions. He should also be advised to give
general details rather than all the particulars of acting out but to state he is
willing to answer any questions she may have.
It is important to remind the addict that partial disclosures usually result
in further harm to the relationship. Informing him that the research clearly
states that over half of the partners threaten to leave, but of that number,
fewer that a quarter actually leave. It can be useful to ask the addict if he
wants the partner to stay because she has the information and is informed or
stays based on a set of lies.
Sometimes if the addict has been doing individual work on why he
turned to addictive behavior, he may want to share what he has learned
about himself in the recovery process. It is here that he may chose to talk
about the impact of the addiction on his life and futility of his actions if the
Disclosure for Therapists 63
addict is cognizant of that at this juncture. Be careful to remind the addict not
to use this section of the letter to blame others for his behavior.
It is particularly useful for the addict to admit how he has manipulated
the partner to think she was in some way to blame for his behavior or that
she was imagining things. He should also admit how he was been dishonest
about his emotional state. If he has been dishonest about other aspects of
their life together, such as putting the children at risk, putting job at risk,
spending money on himself when the partner or children did without, for
that the addict should take full responsibility. He should state he was wrong
and that he is sorry. Once his letter has been reviewed, and often rewritten,
the couple should have the formal disclosure session.
The therapist should have both the addict and partner state their goals
for the disclosure. If neither has mentioned “to start the healing process” as
a goal, then the therapist should ask if they are ready to make that step for
themselves individually, if not for the relationship.
The partner is asked to read her letter first. The addict, who is encour-
aged to be attentive and responsive to the partner’s emotional state, might
also ask for permission to take notes if the addict is prone to forgetting or
discounting important points made by the partner. The addict should be
instructed to add to his letter any items the partner has brought up that the
addict has yet to address.
After the partner has read her letter, the therapist might ask the addict to
describe the emotions he has seen and heard from the partner and to ac-
knowledge those. Although this may seem to directive for some therapists,
at this stage the emotional states are so intense that the addict and partner
can easily become trapped in anger or fear. The therapist can be instrumen-
tal in helping the couple make the most of this session, especially if prior
motivational work has occurred in which either client has been able to gen-
erate ideas on his or her own or make healthy selections of choices from a
menu of solution options. The addict should thank the partner for courage
to present her letter and indicate that he hopes his letter will respond to
some of her questions and concerns. This a good place for the therapist to
suggest a restroom or stretch break and for the addict to make any changes
he thinks are needed in his original letter.
The therapist then asks if the partner is ready to hear the addict’s re-
sponse. It is often helpful for the therapist to remark about the level of work
the addict has put into the letter writing and how seriously he has taken the
process
(
unless he has not, and in that case the therapist would not be
suggesting this type of process
)
. The therapist should have coached the
addict about the strength it takes to do this, that the process represents him
being an authentic person and taking the first steps toward regaining his life,
and that he should come to the session willing to let his emotional self be
vulnerable.
The addict is invited to read his letter to the partner. He is to turn to face
her and read the letter to her. Generally, if the addict has any sincerity in his
M. D. Corley and J. P. Schneider64
efforts to complete the letter, both the addict and partner are tearful. It is
common for the partner to begin to respond to the addict’s emotional dis-
tress by reaching out to him if he has become tearful in the process. How-
ever, if information comes out that the partner has had no idea about
(
i.e.,
exposure to sexually transmitted disease, the existence of another family and
child
(
ren
)
, involvement of a best friend of the partner
)
the partner may have
difficulty completing the process. However, it has been our experience that
the partner wants all of the information contained in the letter to be in the
open, so she is able to tolerate her feelings until the end or the letter. The
key to the success of this process is the addict’s ability to take full responsi-
bility for his behavior, acknowledge that the partner has every right to be
angry, and say he was wrong and that he is sorry. In some cases the addict
will ask for forgiveness, but most often the addict does not feel he deserves
forgiveness at this stage. When he has finished, a meaningful period of si-
lence for people to gather their thoughts is in order. Often couples will hug
and there will be a sense of relief that important progress has been made.
The therapist can ask the partner if she has any questions or anything
she wants to say. To close the session, the therapist should go back to the
original goals to see what now needs to happen to complete them and
determine where to from here.
Discussing the Impact of Addiction and
Establishing a Process for Further Disclosures
Addiction is a chronic, relapsing condition that takes time for the addict to
learn to manage. The partner needs to understand this, and proactively cre-
ate a plan for self-care should a setback take place. If the addict has a slip or
relapse, new disclosures should be done as soon as possible. Holding on to
the information will only make the partner trust the addict less. Recognize
that despite preparation, any further disclosure is a setback for the partner.
None the less, if she can avoid punishing the addict for being honest, this
will increase his level of emotional confidence and be empowering for her.
If he continues to relapse, she may have to re-evalauate her desire to stay in
a marriage in which the person will not use the tools he has been taught to
keep himself healthy.
Depending on the outcome of the formal disclosure, in the follow-up
session the therapist encourages the couple to talk about what positive things
have come from the disclosure work they have done thus far. Mention that if
the partner wants to disclose any information about her own acting out
behaviors
(
coaddict/codependent
)
that should also happen, reiterating that
this disorder is systemic and everyone needs to do their own work. Point out
that the addict may remember more information as his head clears during
the recovery process or think of things he had not previously thought impor-
tant to share and want to share them. There should be an agreed upon
process to complete with a therapist in session, once per month or on a
Disclosure for Therapists 65
mutually agreed upon time frame for the first several months of recovery.
Then the process can be shifted to support group peers such as another
couple from Recovering Couples Anonymous. There needs to be an agree-
ment about what information the partner wants to have now or what infor-
mation the addict would find helpful to share if the addict
(
or partner
)
has a
slip or relapse. The therapist then helps the couple determine how that will
happen. In this session, any new disclosure of old information remembered
or new slips or relapses should be discussed. More importantly, the addict
and partner should discuss the impact, both positive and negative, the addic-
tion has had on their lives individually and as a couple. This process sched-
ules those difficult conversations that often get postponed. Some couples
may want to do this more often.
Most partners want to know why the sex addict did what he did. Rather
than focus on the why, it is more beneficial for the couple to talk about the
meaning of the addictive behavior to each of them. Once the anger and fear
have subsided, discuss what aspects of the relationship are sources of emo-
tional distress for the partner or addict. Explore with the couple alternative
ways of viewing those situations or other ways to interact during those times.
Also make plans for dealing with other high risk times such as work difficul-
ties, financial hardships, accidents, or illnesses. Be certain that couple recog-
nizes that anniversary dates of the disclosure or discovery or other particu-
larly painful events can be difficult occasions. Their anniversaries tend to
reignite the partner’s anger and the addict’s shame and need to be planned
for appropriately. The couple needs to increase their ability to cope with
emotional distress.
More intense flashbacks and other posttraumatic symptoms in the part-
ner can throw the couple into another crisis. Intrusions by a former affair
partner, anniversary date, discovery of old acting out paraphernalia, or the
exposure of a lie about an important event to the partner can trigger obses-
sive thoughts for the partner. The addict’s best defense is to agree his past
behavior was wrong, express sorrow, ant then ask if there is anything he can
do now to remedy the situation. It is the therapist’s task in session to help the
partner get unstuck. Ask her to identify any additional unanswered ques-
tions and to recognize if she is mismanaging an emotional state. Encourage
her to express pain without blaming. Advise her to set aside specific times
for obsessing, to use a thoughts / feelings journal to help her identify think-
ing errors, and develop plans of action. Meditation and prayers also are
helpful for most people. Some therapists have found it helpful to use eye
movement desensitization and reprocessing
(
EMDR
)
to reprocess and extin-
guish the power of traumatic memories of the betrayal.
It is common for one or both of the parties to have other addictions,
depression, or anxiety. Both partners need to address and begin treatment of
any other addictive behavior. If severe depression and anxiety are present,
consider referral to a psychiatrist for prescription medication. However, re-
member that some depression and anxiety is normal; it is important for the
M. D. Corley and J. P. Schneider66
client to learn to manage those emotional states rather than medicate them
away.
If the couple determines that the marriage is to end, then the goal of
therapy is to gain closure and determine what, if any, relationship they want
to have with each other. If they share children, help them to negotiate how
to manage the responsibilities of coparenting.
CONCLUSIONS
Disclosure is the cornerstone of healing and is often what gives the couple
hope. Most couples who have experienced disclosure agree with this state-
ment, and recommend the process to other recovering couples. Disclosure
brings relief, an end to denial and secrecy, and the gateway to recovery.
Disclosure also brings validation to the partner, and hope for a better rela-
tionship. Yet disclosure also brings shame to the addict, pain to the partner,
and fears to both about the loss of the relationship.
Disclosure is a process rather than a one-time event. The initial disclo-
sure is better done early than late, and should include the broad outline of
all the sexual acting out behaviors, while avoiding painful details. The out-
line can be filled in later, with the help of the therapist in deciding what to
detail. Multiple disclosures are unavoidable when due to relapses or forgot-
ten behaviors which are later remembered, but staggered disclosures result-
ing form efforts to avoid unpleasant consequences are very destructive to
the partner and to the relationship.
Therapists who counsel couples about issues of secrets and disclosure
need to first examine their own biases and beliefs. A therapist who does
couple counseling with sex addicts needs some understanding of addictive
sexual disorders, and needs to understand that honesty is vital to addiction
recovery, that recovering sex addicts need to disclose affairs and other sexual
acting out to their partners, that it is unethical for a couple therapist to
collude with one member of the couple in keeping secrets, and that the
partner needs validation of her reality, which can only come from knowing
the truth.
Therapists are in a unique position to facilitate disclosure for clients, to
answer for them questions about the timing of disclosure, and about how
much to disclose and to whom, about situations when it might be better not
to disclose, and about the difference between secrecy and privacy. Thera-
pists need to be educated about disclosure, about its benefits and risks for
couples, and about how to best facilitate .
Disclosure for Therapists 67
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Just as antisocial patients who hurt others and themselves need thorough understanding and skilled therapy, the recalcitrant therapist needs a similar response. Therefore [the author has] decided to write this book, which [he believes] will be the first major work to thoroughly, objectively, and compassionately study the mental health professional who has had sexual contact with his or her patients. Through intensive case studies that will describe in detail their therapeutic encounters with [the author], the motives, dynamics, life-styles, and psychopathology of these psychotherapists will be revealed. In addition, [the author] will also try to demonstrate how [he] used [himself] in the therapeutic situation with these clinicians so that their psychological difficulties could be resolved and their sexual acting out with patients [countertransference] could be given up. (PsycINFO Database Record (c) 2012 APA, all rights reserved)