London - Eight years into her marriage, Rachel started to wonder if her husband had lost interest in sex.
“He'd always go to bed later than me and often made excuses when I brought it up,” explains the 41-year-old. “So when he sat me down one day to tell me he was a sex addict, I actually laughed - although I soon stopped when he disclosed night upon night of watching pornography for hours on end and numerous short-lived affairs. My life fell apart.”
Sex addiction hurts partners in a way that no other addiction can, says Paula Hall, who has written a book on the subject.
Sex Addiction: The Partner's Perspective is overdue, Hall believes, with thousands of partners across the UK struggling with something that evokes all the most destructive ingredients of personal pain - betrayal, infidelity, deceit and shame.
“Sex addiction feels extremely personal when you're the partner because it affects the most intimate part of your relationship in a way that, say, alcohol or drugs just don't,” she explains.
“I could have dealt with a gambling addiction or alcoholism - anything but this,” Rachel confirms. Like most partners, she initially didn't buy into the concept of sex addiction (“it sounded like a pretty weak excuse for an affair”) and even when she did start to believe that her husband's behaviour was compulsive, her friends didn't (“they'd look at me in despair, asking since when had sexual desire became a monster that can't be controlled”), leaving her feeling isolated.
To be fair on Rachel's friends, there is some debate about whether the term sex addiction is scientifically accurate, but the field of addiction is changing fast and emphasis is shifting from the substance to the psychological symptoms of addiction.
The NHS has a website page dedicated to sex addiction. “It could involve sex with a partner, but it may also mean activities such as viewing pornography, masturbation, visiting prostitutes or using sex chat lines,” it explains, claiming that while for most people such habits don't cause problems, sex addicts are unable to control these urges and actions.
Causes can of course be more complex, while for some - a fast-growing number, according to Hall - it's simply opportunity-induced. “The reality of the Western world today means you can find anything you desire easily and anonymously. Indeed, you can find a whole load of stuff you don't desire, but get hooked nonetheless,” she says.
Traditionally, most partners of sex addicts have been treated as co-dependents, says Hall.
“The presumption is that the partner knew at some level what was going on and was 'enabling' it, which is frankly an insult. The reality for most partners I see is that they experience phenomenal shock.”
The damage to self-esteem, she continues, isn't just about the sexualised behaviour, such as visits to prostitutes that partners never knew about. It's the fact that they've lived with someone so long and had no idea. “These guys, and it is mostly guys, are on the whole loving husbands, yet they did this right under your nose, leaving you unable to trust your partner, or even your own judgements,” she explains.
No wonder many partners suffer trauma, which can lead to depression, anxiety and panic attacks, rage or utter dissociation. “One confident businesswoman recently told me that the discovery that her husband is a sex addict turned her into a 'screaming banshee - I've become a stranger to myself',” Hall tells me.
Hall believes these partners need help of their own - hence her book, which is essentially a self-help guide, covering three broad areas: understanding sex addiction and why it hurts partners so much; repairing the damage it has caused to the partner; and finally, helping the partner to work out whether the relationship can survive and, either way, how to move forward.
“Ideally, partners get their own therapy,” says Hall. “The problem is that all the assumptions made by well-meaning friends about sex addiction are also shared by many therapists who are untrained in this area. Some relationship therapists work with the partner's pain by treating it as an infidelity, for example, but it's so much more than that - and sometimes it isn't even that at all, with some people not actually having sex elsewhere, but using porn instead.”
No wonder Hall's therapeutic practice, which recognises the uniqueness of the partner's pain, has gone from strength to strength.
Also providing a haven of hope is the small, but growing, number of support groups. Joy Rosendale, a sex-addiction therapist specialising in partner work, instigated the first one in the UK back in 2005, following her own experiences.
“Although there is usually huge reluctance for partners to seek help, let alone come into a group, because of the privacy and shame, something happens in these groups that liberates these women - and I say women because in my experience, it is usually women who access them,” says Rosendale, who still runs the group at the Marylebone Centre, London.
Rosendale starts each 12-week support group by educating the women about sex addiction. “One of the points of this group is to depersonalise it. Sex addiction for a partner brings up feelings of 'I'm not good enough' and 'He doesn't want me', but it's not about the sex, it's about the dopamine fix. Once they understand the nature of the addictive drive, sometimes they're able to move into self-care.”
Rosendale's anecdotal research reveals that a third of those partners seeking help decide to stay in the relationship, while a further third leave and the final third “remain stuck”.
Couples who make it work generally take a three-pronged approach, says Hall. “First, the addict goes into recovery on their own to work out causes and develop relapse prevention strategies. Second, the partner has to feel stable again, as well as understanding the addiction and working out what they want the relationship to look like in the future. Third, the couple works together on the renegotiation of the boundaries in the relationship.”
While some sex addicts move on, other partners must recognise that they'll be living with someone in recovery for the rest of their life, says Hall. Nobody is suggesting partners should stay, she stresses. “For some partners, leaving is the right decision. But even then, they need support with rebuilding trust and reclaiming their sexuality.”
Rachel agrees. “Much as my husband tried to stop his behaviours by understanding the nature of sex addiction, he wasn't willing to delve into the cause. I felt that meant the risk of relapse was too great, so I left. But without help of my own, I wouldn't have been able to let go and move on with my life.”
* Sex Addiction: The Partner's Perspective by Paula Hall (Routledge) is out now
The Independent