Sex addiction is highly treatable but he must do the work.
I have some experience in dealing with people battling addictions, and I won’t argue over if SA is "highly treatable" or not because I actually think the treatment works, so in that sense it’s highly treatable.
However - the relapse rate for addicts indicates that the treatment is seriously dependent on the work the addict puts into it, and in consistency. Don’t know about SA, but alcoholics, coke- and meth addicts tend to go through 3-5 cycles of relapses before (and if) they find their path out.
Possibly because unlike a disease you can treat with pills or an injection, addiction can require a life-long change in attitude, behaviors and lifestyle. An alcoholic never get’s cured – he always has his addiction in him – but a successful non-active alcoholic is maintaining his treatment/sobriety for all his life.
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Short history lesson to explain my POV on this matter:
SA is going through a lot of the same issues as good-old school alcoholism had to go through before being recognized as an illness. Before that the "just say no" line of thought was prevalent, with many seeing alcoholism as a lack of will, self-control and/or a moral weakness. There was a major breakthrough in the early 1980’s when it was acknowledged that it was more complex and a combination of psychological and physiological factors that needed to be addressed.
When society acknowledged alcoholism as an illness there was a surge of people seeking treatment. Many were alcoholics, others had bad drinking habits. However – after losing your family and kids through drinking, losing your job, going bankrupt… then for many it was "easier" to go into rehab, do AA for some months and come back claiming to be healed – and therefore deserving a second chance. After all – it was the illness that made you do it.
This is also where AA’s success rate started dropping. AA is like a cast on your foot for a broken bone: It’s excellent treatment for a broken bone but won’t help an ulcerated stomach. Different problems -> different treatment.
What might muddy the field is how hard it has been for SA to become acknowledged as a real issue. I venture that the majority of therapists see it as a real issue. The APA does not yet list sexual addiction as an illness, but talk about Compulsive Sexual Behavior Disorder. That makes me – a layman – question how far we can go comparing SA and "normal" addictions.
In one way this can be good. I know that an addiction never goes. Like my friend who is a recovering alcoholic for over 30 years still goes to his monthly AA meeting, and if he gets into certain emotional conditions, 2-3 extra meetings. He’s applying "dosage" of the treatment that works for him. An addiction is lifetime, and the only question is if it’s active or under control. Possibly a Compulsive Sexual Behavior Disorder can be "treated" – as in permanently dealt with. But I honestly think this is all so new that we simply don’t know.
In your instance you mention he used to do drugs, and that he might have transitioned from drugs to SA.
I have often stated on this site that when a spouse has addictions then the first step – even before contemplating dealing with the effects of infidelity – is to get some clarity on if the addiction is being treated or still ongoing.
While the addiction is in control then NOTHING can prevent the addict from getting their fix. This is why we see parents reeking of booze or sluggish on sedatives go pick up their kids from daycare and drive away. Why families sit in the dark with no utilities, but the father still has a bottle of Jacks. The priority is the fix.
I’m not too optimistic on your behalf, but I can be realistic:
Maybe the best you can do right now is agree with him that he has a period of "sobriety" where he commits to NOT actively feed his addiction. Be that porn, sex-workers, old copies of Playboy or even the swimsuit issue of Sports Illustrated. That he seeks treatment – therapy, SA, sponsor, 12-step – and that during that time there is total financial transparency, as well as access to his agenda, plans etc. That he doesn’t transpose his addiction back to drugs or booze. Doesn’t replace one unhealthy habit for another.
This period is six months. Six months of NO relapse.
During that period you can cohabit. Date. Spend time together. But it’s basically like back to the dating period. No plans beyond those six months.
If he reaches that stage… then and only then can you start talking of some sort of future.
PS: Often recovering addicts will replace one addiction with other addict-like activities. This doesn’t have to be bad; my above friend has a golf-handicap of 3, some go into running, some find God… As a rule they beat snorting stuff or doing sex-workers.
Final PS: The most interesting developments in addiction are medical treatments that impact certain brain-areas and/or hormonal adjustments that seem to remove the strong need to get a fix that addicts talk about. Supporting the theory that it’s a combination of physiological and psychological issue.
