Return Home

The New ‘Elephant in the Living Room’ :

Effects of Compulsive Cybersex Behaviors on the Spouse

By Jennifer P. Schneider

In addiction treatment, the ‘elephant is the living room’ refers to a situation in which the addictive use of alcohol (or other drug) by a family member significantly impacts the remainder of the family, yet no one talks about it. The apparent blindness to the presence of a behavior which adversely affects the user and the family results from a variable combination of true unawareness by the spouse and/or children, along with some element of denial, disbelief, and/or covering up by the family. Effective family treatment of addictive disorders includes bringing to light the dysfunctional behaviors of both the addict and family members, addressing the associated shame, and developing strategies (1) for the addict to stop addictive use of the substance (alcohol, cocaine, etc.) or behavior (gambling, sex, risk-taking, etc.), and (2) for spouses or partners to focus on their own needs rather than on the addict’s behavior and to become empowered to set boundaries for what is acceptable in the home and in the relationship.

With the increasing presence of computers in the home, a growing number of users neglect family, social, and work obligations, as well as their own health and wellbeing, in order to spend many hours per week viewing the computer screen in search of sexual gratification. As Cooper and his colleagues (Cooper et al, 1999; Cooper, Delmonico, & Burg, 2000) have shown, most people who access the Internet for sex are "recreational users," analogous to recreational drinkers or gamblers, yet at the same time a significant proportion have pre-existing sexual compulsions and addictions which are now finding a new outlet. For others, with no such history, cybersex is the first expression of an addictive sexual disorder, one that lends itself to rapid progression, similar to the effect of crack cocaine on the previously occasional cocaine user. Regardless of the user’s diagnosis, when cybersex begins to take precedence over a committed relationship, the partner suffers.

The internet has several characteristics which make it the ideal medium for sexual involvement (Cooper, 1999). It is widely accessible, inexpensive, legal, available in the privacy of one's own home, anonymous, and does not put the user at direct risk of contracting a sexually-transmitted disease. It is also particularly suited for hiding the activities from others because it does not leave obvious evidence of the sexual encounter. It often takes some computer knowledge on the part of the spouse to retrace the user's online adventures.

There is still some disagreement in the fields of psychiatry and addiction medicine about appropriate terminology for this disorder. Carnes (1983) was the first to apply the addiction paradigm to out-of-control sexual disorders. In this chapter the terms sexual addiction and compulsive sexual behaviors will be used interchangeably. However, I prefer the term sexual addiction because compulsive cybersex use fits the criteria formulated by Schneider & Irons (1996) for all addictions: The compulsive cybersex user experiences (1) loss of control (2) continuation despite adverse consequences, and (3) preoccupation or obsession with obtaining and using the substance or behavior. These criteria were adapted from the Diagnostic and Statistical Manual of Mental Disorders , 4^th Edition (1996). Although some clients who are compulsively sexual have been successfully treated with a developmental and psychotherapeutic approach, in the author’s experience and research, many persons have not been able to stop their behaviors until they approached the problem from an addiction paradigm. Addiction-model treatment, which includes cognitive-behavioral relapse prevention strategies along with attendance at self-help groups modeled after AA and its offshoot, Al-Anon, is also helpful for cybersex addicts and their partners (Schneider, 2000a; Hecht-Orzack & Ross, 2000; Schneider & Weiss,2001; Carnes, Delmonico, & Griffin, 2001).

Compulsive cybersex use, like all addictive sexual disorders, significantly impacts the couple relationship (Schneider, 2000a; Schneider, 2000b). Children may also be adversely affected (Freeman-Longo, 2000). Early involvement of the family in treatment of compulsive sexual behavior is an important ingredient to a successful treatment outcome. (Carnes, personal communication). Unfortunately, in the treatment of cybersex-related problems, the effect on the spouse or partner is all too often ignored, as attention is focused solely on the user.

To summarize the types of behaviors involved, the viewing of pornography while masturbating is nearly universal among male cybersex addicts, and also found among some female cybersex users, although women often prefer relational activities such as chat rooms to strictly visual activities (Schneider, 2000b, Cooper et al., 2000). Other behaviors are reading and writing sexually explicit letters and stories, e-mailing to set up personal meetings with someone, placing ads to meet sexual partners, visiting sexually oriented chat rooms, and engaging in interactive online affairs with same- or opposite-sex people, which may include real-time viewing of each other's bodies using electronic cameras connected to the computer. Related activities include phone-sex with people met online, and online affairs that progress to skin-to-skin sex.. A preliminary study suggests that a higher percentage of women cybersex addicts (80%, versus 30% of men) progress to offline sexual encounters (Schneider, 2000b). Some cybersex users participate in illegal or paraphilic online activities such as sadomasochism and domination/bondage, bestiality, viewing child pornography and pornographic pictures of teenagers , and having sex with underage persons.

To assist the clinician in formulating a treatment approach that includes the significant other, this chapter will describe the reactions of the partner to discovery of the compulsive cybersex use, the stages of “pre-recovery” of the partner, and elements of an effective therapeutic plan.

When no offline sexual interactions have occurred, therapists may underestimate the impact on the partner, likening it to having a spouse who enjoys perusing “Playboy” or “Penthouse.” The following description may make the distinction clearer. A 38-year old woman, now in the process of ending her 15-year marriage , wrote,

A 44 year old man had been married for 24 years when his wife became hooked on the Internet (Schneider, 2001). He explained that she wrote and read erotic stories and e-mails, participated in sexually-oriented chat rooms, became involved in a dominance/submission, sadomasochism (BDSM) online community, and participated in both online and real-life sexual encounters with various men. She spent thousands of dollars on airplane tickets and phone calls, and eventually lost her job because of her online activities. She stopped paying bills or doing housework. She stopped going on family outings, locked the kids out of her room, and ignored them.

With this introduction to the feelings of the partner, we will turn to a broad overview of the stages partners go through when living with ‘the elephant in the living room.’ This will be followed by discussion of specific aspects of the relationship which are of interest to therapists: the effects of cybersex on the partner and the relationship –and specifically on the couple’s sexual relationship; partners’ perceptions of what constitutes ‘adultery’; specific issues for male partners of female cybersex addicts; gay relationships; and finally, various implications for therapists.

Addictionists speak of ‘recovery’ as the process of healing from addictive disorders, both for users and for family members. Recovery begins with recognition that one needs help for oneself. Partners of cybersex addicts go through a sequence of responses to the user’s ongoing involvement with online sex (Schneider, 2000a)

In contrast to the more traditional forms of sexual acting out, cybersex use happens in the user’s own home. Paradoxically, it is therefore easier to conceal. There are no telltale receipts, lipstick stains, or unaccounted-for absences. Instead , the user is simply “working at the computer” in the home office or study. When the user withdraws emotionally and/or physically from the marriage, the partner recognizes there is a problem in the relationship, but is unaware of the contribution of cybersex to the problem. The partner believes the user's denials, explanations, and promises. She (or he –we will use the female pronoun for simplicity) tends to ignore and explain away her own concerns, and may blame herself for sexual problems that are commonly present. The compulsive cybersex user is often uninterested in marital sex; in response the partner may try to enhance her own attractiveness to him/her.

At some point the partner learns of the cybersex user's activities, either accidentally (because the partner comes upon the activities in progress, or turns on the computer and discovers a cache of pornographic pictures), or as a result of deliberate investigations. In either case, the partner's ignorance and denial are over.

Discovery often results in shock, betrayal, anger, pain, hopelessness, confusion, and shame. Because the pull of the computer is so strong and its availability in the home and at work is so great, there is a great tendency for the user to return to cybersex activities even after discovery by the spouse, no matter how sincere the initial intention to quit. A common result is a cycle of discoveries, promises made and broken, and additional discoveries and promises.

Feelings of shame, self-blame, and embarrassment often accompany the early days of dealing with a partner's cybersex addiction. The cybersex user often minimizes the significance of the behavior (“What’s the big deal –I’m not cheating after all”) and may even suggest that the real problem is the partner’s anti-pornography attitude (“All men like to look at pictures -- you’re just too uptight about these things.”) The partner may wonder if indeed she might be the only problem. These feelings may prevent the partner from talking with others and appealing for help, and the resultant isolation worsens the situation.

Covering up for the user is part of this stage:

The partner now begins to take action to resolve the problem, which is perceived as the cybersex behaviors. If real-life sexual activities have in fact occurred in addition to online sex, then the spouse’s feelings and behaviors will be familiar to therapists who have counseled couples regarding a traditional affair. However, when the behaviors have been limited to the computer, the reaction is likely to be somewhat different: The computer has become such a staple in many homes that the partner is more likely to try to control the addict’s use rather than eliminate it. This would be analogous to the alcoholic’s wife who believes that if the alcoholic drinks only under her direct supervision at home, the problem would disappear.

At this stage behaviors typical of “codependency” peak -- snooping, bargaining, controlling access to the computer, giving ultimatums, asking for full disclosure after every episode, obtaining information for the user on sex addiction and addiction recovery, and (early in this stage) increasing the frequency and repertory of sexual activities with the user in hopes of decreasing his desire for cybersex.

A sexual solution to the sexual problem seems to make sense in this stage. Partners may agree to sexual practices with which they are not comfortable, have sex even when tired, and think about improving their appearance by undergoing breast enhancement surgery or liposuction. For the cybersex user, none of these methods are likely to diminish the lure of the internet.

The partner at this stage believes that additional information will enhance her or his ability to manage the situation. This leads to snooping or "detective" behaviors. Partners who are computer-savvy learn how to trace the user's activities, and in some cases may even try to entice him by logging on into the same chat rooms themselves under false names.

The couple often comes to some agreement to try to limit the addict's use of the computer. This may consist simply of promises not to use it, or to restrict usage to legitimate needs. The partner or the couple may purchase filtering software (e.g. CyberPatrol or Net Nanny) which prevents access to sexually-oriented sites. Often, the partner, with the user's agreement or at least knowledge, assumes control of the access. This type of agreement rarely works for long. It provides a measure of comfort for the wife to know what is going on and gives her the illusion of control. But the result is to establish a parent-child dynamic between the couple and engenders resentment in the cybersex user The user will begin or increase cybersex activities on the work computer, or find ways to defeat blocking software at home, and will simply become more skilled at deception. Until the user is motivated to stop the cybersex activities, relying on external controls via the spouse or partner is effective at best temporarily.

In describing the phases of prerecovery of partners of sex addicts (coaddicts) in the pre-cybersex era, Milrad (1999) found the end of the prerecovery phase and the beginning of recovery to be an awareness that they are in crisis and need help. Similarly, partners of cybersex addicts enter the crisis stage when they realize that their problem-solving efforts have been unsuccessful and when the costs of remaining in the status quo become intolerable - depressive symptoms, isolation, loss of libido, a "dead" marriage, their own dysfunctional behaviors in some cases (affairs, excessive drinking, violence), as well as awareness of the effects on the children of the family dysfunction. This is the stage when the partner seeks help for herself/himself rather than in order to “fix” the cybersex user. Once the partner is in therapy and getting help, the equilibrium of the system is disrupted, forcing some type of real change. Either the problematic behavior will change as the cybersex user too becomes engaged in treatment , or the relationship will end.

Effect of cybersex on the partner and the relationship

Some of the most troubling effects of a person's compulsive cybersex involvement result from the large amount of time spent on the computer. Cooper et al (1999) reported that compulsive sex use on the internet occupies an average of 11 hours/week, time which clearly decreases the user's availability to the family. Partners of compulsive cybersex users feel lonely, ignored, unimportant, neglected, or angry as a result of the user’s spending so much time on the net.

However, there are additional consequences for the partner which result specifically from the sexual content of the user's internet addiction. When the partner perceives that the user prefers a computer construct to the real-life committed partner, her self-esteem often suffers and she feels she cannot compete with the fantasy person on the computer. Most partners experience some combination of devastation, hurt, betrayal, loss of self-esteem, abandonment, mistrust, suspicion, fear, and a decreased level of intimacy in their primary relationship. Some partners, including females, become physically abusive to their spouses. Some men and women engage in extramarital affairs or encounters, either to shore up their own self-esteem or else to get revenge on their cybersex-using spouses. Other reactions include feeling sexually inadequate, unattractive; doubting one's judgment and even sanity; severe depression, and in extreme cases attempting suicide. The loss of trust felt by most partners is at least as harmful to the relationship as the sexual activities themselves. Despite the user's promises, the behaviors and the lies often continue, which leads to further erosion of trust.

Compulsive cybersex use elicits partners' deepest insecurities about their ability to measure up to the fantasy online men and women. The need to compete with interactive sex online pressures them into unwanted sexual activities. A 34 year old woman, married 14 years to a minister, said,

On the internet it is possible to find groups of people who are interested in all kinds of unusual, paraphilic, and/or degrading sexual practices. Interacting with these people online desensitizes the cybersex user to such activities and "normalizes" them. Some cybersex users eventually come to blame their partners for being unwilling to engage in these behaviors.

The therapist who treats a cybersex user’s spouse can validate the client’s sense of betrayal resulting from her spouse’s cybersex activities and can support her feelings as typical of others who have had similar experiences. In working with such couples, the therapist can help cybersex users become more empathetic to their spouse’s feelings by reviewing with the users how they felt about the same activities before beginning to view them online. Another useful approach is to consider unusual or deviant sexual practices which the cybersex user has not viewed and normalized to himself, and ask him to imagine his reaction if his spouse were to pressure him to engage in these activities.

The significant consequences of cybersex on the partner and the relationship can be summarized as follows:

Compulsive cybersex use by one member of a couple usually has significant adverse effects on the conjugal sexual relationship. Sexual and other energies taken away from the relationship cheat both partners of addressing issues of self-development and deepening their sexual and relational connection. In the author’s study of partners of cybersex addicts (Schneider, 2000a), two-thirds of the 94 respondents (68%) described sexual problems in the couple relationship, usually coinciding with the beginning of the cybersex activities. Fifty-two percent of the cybersex users had decreased interest in relational sex, as had one-third of the spouses. In some of these cases (18%), both partners had a decreased interest. In only 32 percent of the couples were both partners still interested in sex with each other.

Spouses who lose interest in sex with the cybersex user report being repulsed by the user’s sexual activities with cybersex, phone sex, live encounters, etc.. This generally does not cause a problem for the cybersex user, who has already substituted cybersex for sex with spouse. On the other hand, when it is the user who loses interest in sex with spouse, this is definitely a problem for the spouse, who feels angry, hurt, rejected, and often sexually unfulfilled.

Recurrent themes among such couples are:

A 33-year man, partner of a male cybersex user wrote,

In a small minority of cases (16% in Schneider’s [2000a] study), the cybersex user maintains his/her desire for sex with the partner, but the partner is less interested. In some cases the partner refuses to have sex; in others, the partner doesn't want to, but continues out of fear of driving the user further into online activities. Major themes in such relationships are:

The knowledge that the addict's head is full of cybersex images inevitably produces in the partner a comparison between the spouse and the fantasy woman in terms of appearance, desirability, and repertory of sexual behaviors. The partner feels she/he is competing with the computer images and people. ("If only I was perfect like his porn, then he would want the real thing and love me.") The result is often confusion -- on the one hand, desire to emulate and better the computer woman (or man), on the other revulsion at the lack of intimacy and mechanical nature of the sex. Some people vacillate between these two polarities:

When one partner has some sexual involvement outside the marriage, there is often disagreement by the couple on what constitutes adultery. The reason is that there is still disagreement about what constitutes sexual relations. For example, in a study reported in 1999 [Sanders & Reinisch, 1999], 59 percent of college students surveyed believed that oral sex does not constitute “having sex,” and 19 percent believed that even penile penetration of the anus did not constitutes “having sex.” There is now a similar disagreement about the meaning of the varieties of computer sex. When the cybersex user engages in real-time online sex with another person, most partners react as though skin-to-skin adultery has taken place. According to one distraught woman,

To effectively counsel partners of cybersex addicts, therapists must understand and be able to validate the intensity of their feelings that this is indeed a significant betrayal of the relationship. The main reasons reported by partners include:

Although some of the most troubling effects of a person's compulsive cybersex involvement result from the large amount of time spent on the computer, the sexual content of the material can have an huge impact on the person and the partner. Accordingly, it would be a mistake to focus in therapy primarily on the

time element of computer use without specifically considering the sexual content of the activities. It is crucial to spend enough time getting a thorough sexual history of the client and of the couple’s sexual relationship, as well as details of the computer user’s activities online (and by extension, offline).

Some compulsive cybersex users and/or their partners have erroneously been labeled by their therapists as suffering “ sexual anorexia” or a sexual aversion disorder (DSMIV, 1994, p. 499). It is a mistake to apply this label to person simply because he or she is uninterested in sex in one particular context (e.g. within the couple relationship). Cybersex addicts do not avoid sex; on the contrary, they engage in sex compulsively. However, they often redirect their sexual interest away from the spouse and towards the computer. It is crucial for the therapist to get a thorough sexual history, and, especially, to inquire at length about the presence of online sexual activity in the life of a client who appears not to be interested in sex with the partner. Similarly, the cybersex user’s partner who feels unconnected, ignored, and betrayed and who therefore loses sexual interest in the cybersex addict, is not suffering from sexual anorexia, but rather may be reacting with integrity and autonomy to a situation in which (s)he does not feel valued. As Schnarch, (1997, p. 127) wrote, “Healthy people don’t want sex when it’s not worth wanting.”

Schneider (2000a and 2000b) reported that several people in her study consulted counselors or psychotherapists who apparently failed to obtain an adequate history and therefore missed the diagnosis of sexual compulsivity. Some counselors urged the partner to initiate sex more frequently. Some had never heard of sexual addiction/compulsivity, or failed to understand how a person could be threatened by the use of a computer or other inanimate object. Others were so committed to being nonjudgmental that they missed the big picture: One young woman reported that her pastor had dismissed her concerns about her fiance’s online preference for young girls, telling her that “once we were married, my husband's curiosity would be filled by me. Now that we are married, and I find that he has continued his acting out, and lied to me so much, I am afraid of what could happen if we have children and one is a girl.”

A client's complaints about her spouse's cybersex use may simply reflect her own discomfort with pornography, but it also may be a sign of a significant cybersex problem in the family; each of these requires a different treatment approach. Therapists who wish to treat cybersex problems effectively need a basic understanding of addictive sexual disorders so that they can determine if this problem exists in the client and, if so, institute appropriate treatment or refer out. Compulsive behavior is by definition out of control. Suggesting to the client that he access cybersex only 1 hour per day instead of 4 is likely to be as effective as suggesting to an alcoholic to cut down his consumption of alcoholic beverages from 15 to 4 per day.

Where compulsive cybersex use is in fact present, potential mistakes by the uninformed counselor are:

The first step for the counselor is to gather information, preferably from both partners. Ask specific questions -- what is a typical day in the life of each partner, hour by hour? Are there large chunks of time that are unaccounted for? Have there been changes in the couple's sexual relationship? In the amount of time the family spends together? In the time spent with children? Is there evidence of cybersex involvement? Is there a history of other compulsive sexual behaviors? Ask about the partner’s beliefs regarding sex, pornography, and masturbation. Obtain a thorough sexual history from both partners, and a history of their sexual relationship with each other.

If cybersex addiction is indeed present, some psychotherapists report success using cognitive-behavioral and developmental approaches. Many patients are best helped using the same principles of treatment of any other form of sex addiction or compulsivity: Initially, the user needs to be helped to break through the denial that a problem exists and to recognize the impact of the behaviors on the partner and family; to stop the behaviors and associated lying; to stop blaming the partner; to learn problem-solving in ways other than escape through cybersex activities; to develop strategies for dealing with sexual urges, Support through membership in 12-step programs such as Sex Addicts Anonymous (SAA), Sexaholics Anonymous (SA), or Sex and Love Addicts Anonymous (SLAA) is as useful as with any other addiction. Strategies specific to the computer are discussed in other chapters in this book and include limitations on use of the computer, acquisition of blocking software, and avoidance of the internet.

For the spouse or partner, the negative consequences detailed in this chapter constitute a lengthy list of issues to explore in therapy. Early on, partners need validation of their belief that a real problem does exist, and of their perception that cybersex addiction can be as damaging to the relationship as more traditional sexual affairs. They need to feel "heard" by the counselor, and encouraged to state their needs. Other early goals of therapy are to help clients accept that they did not cause the problem, cannot control it, and cannot cure it, and that the belief that having enough information will allow control of the situation is an illusion. The focus needs to be moved from fixing the other person to working on oneself, especially one's damaged self-esteem, and learning to pay attention to one's own needs and desires. Education about appropriate boundaries is useful, along with development of appropriate boundaries regarding the presence of the computer in the home and conditions for its use. Except perhaps very temporarily, however, it is not useful to have the partner be the "keeper" of the computer or to control the cybersex user’s involvement with it; this is better left to the user's therapist or 12-step sponsor. Like the cybersex addict, the partner can be greatly helped and supported by membership in a 12-step program such as S-Anon, COSA, or Al-Anon.

There is very little written thus far in the professional literature about male partners of cybersex addicts. Gay men often have sexually inclusive relationships, and monogamy is less of an issue than in heterosexual relationships. However,

isolated first-person accounts (Schneider,2000a,2000b) suggest that themes of loss of esteem and feelings of abandonment and betrayal are common to both male and female partners. Like most women, one gay man felt very hurt by his partner’s loss of interest in relational sex with him, but unlike most women, he claimed not to be bothered by his partner’s involvement with other men online. Whether the relationship is heterosexual or homosexual, compulsive sexual energy takes away from one’s relationship with oneself and would be a relational problem as well.

An earlier study of husbands of women sex addicts, written before cybersex existed (Schneider & Schneider, 1990) found that husbands who were not themselves recovering from chemical or behavioral addictions had difficulty accepting that their wives’ behavior was an addiction, were more likely than women to react with rage and wishes to dispatch the “other man,” experienced more shame than did women, and were less willing to get involved in treatment or self-help groups which focused on themselves rather than on “fixing” their spouses. They tended to excuse the wife’s behavior as a symptom of illness or stress, and were very ready to believe that the problem had solved itself at the first sign of progress.

Research in the marriage and family therapy literature (Glass [need reference] about extramarital affairs shows that men are more upset than women when there has been actual sexual contact without loving feelings, whereas women are more upset than men when there has been a strong emotional connection but no sexual contact. One may hypothesize that in the case of cybersex activities where there has not been offline sexual contact, men would be more likely than women to minimize the significance of the activities. More research is clearly needed in this area.

When recreational cybersex use becomes compulsive, therapists need to consider the impact on the partner. Rather than simply encouraging the partner to be more understanding and more supportive of the user’s enjoyment of the internet, therapists need to understand and validate the partner’s distress and the impact of the compulsive cybersex use on the partner’s emotions and self-esteem, as well as on the couple’s sexual relationship, level of emotional intimacy, and family time together. Therapy with the partner includes

2) helping the partner understand that it is futile to try to compete with fantasy online sex partners,

3) empowering the partner so that (s)he is in a position to make real choices regarding the relationship,

4) helping the partner to set appropriate boundaries for herself or himself regarding the user’s sexual behavior online and off (for example, “I can’t control what you do all day, but is too painful for me to have this going on in my home; the computer has got to go,” or “I am not comfortable having sexual relations with you if you are having real-time sex with women online,”) and

5) informing the partner about the availability of support groups where (s)he can share experiences, feelings, and solutions with others who have lived through similar situations.

As with other issues affecting couples, the prognosis is better if both members of the couple recognize that there is a problem and are willing to work to resolve it.

American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th Edition . Washington, D.C.: American Psychiatric Association.

Carnes, P.J. Personal communication

Carnes, P. J. with Moriarity, J. M. (1997). Sexual Anorexia. Center City, MN: Hazelden.

Carnes, P. J. (1991). Don't Call it Love. New York: Bantam Books.

Carnes, P.J., Delmonico, D, & Griffin, E. (2001). In the Shadow of the Net. Center City, Minn.: Hazelden Education & Publishing.

Computerworld. (1998). Commerce by numbers -- Internet population [Online]. Available: http://www.computerworld.com/home/Emmerce.nsf/All/pop

Cooper, A., Putnam, D. A., Planchon, L.A., & Boies, S. C. (1999). Online sexual compulsivity: Getting tangled in the net. Sexual Addiction & Compulsivity , 6, 79-104.

Cooper, A. & L. Sportolari (1997). Romance in cyberspace: Understanding online attraction. Journal of Sex Education and Therapy , 22, 71-14.

Cooper, A., Delmonico, DL, & Burg, R. (2000). Cybersex users, abusers, and compulsives: New findings and implications. Sexual Addiction & Compulsivity , 7, 1-25.

Freeman-Longo, R. E. (2000) Children, teens, and sex on the Internet. Sexual Addiction & Compulsivity , 7,75-90.

Hecht-Orzack, M., & Ross, C.J. (2000) Should virtual sex be treated like other sex addictions? Sexual Addiction & Compulsivity , 7, 113-126.

Milrad, R., (1999). Coaddictive recovery: Early recovery issues for spouses of sex addicts. Sexual Addiction & Compulsivity , 6, 125-136.

Sanders, S.A. & Reinisch, J.M. (1999). Would you say you “had sex” if. . .? Journal of the American Medical Association 281:275-277.

Schnarch, D. (1996) Passionate Marriage. New York, Henry Holt & Co.

Schneider, J.P. (2000b) A qualitative study of cybersex participants, gender differences, recovery issues, and implications for therapists. Sexual Addiction and Compulsivity 7,250-278.

Schneider, J. P. (2000a) Effect of cybersex addiction on the family. Sexual Addiction and Compulsivity 7: 31-58, 2000.

Schneider, J.P. (1994). Sex addiction: Controversy within mainstream addiction medicine, dianosis based on the DSM-III-R and physician case histories. Sexual Addiction and Compulsivity 1, 19-44.

Schneider, J. P., Corley, M.D., & Irons, R. R. (1998). Surviving disclosure of infidelity: Results of an international survey of 164 recovering sex addicts and partners. Sexual Addiction & Compulsivity , 5, 189-218.

Schneider, J.P. & Irons, R.R. (1996). "Differential diagnosis of addictive sexual disorders using the DSM-IV." Sexual Addiction & Compulsivity 3:7-

Schneider, J. P. & Schneider, B. H. (1996). Couple recovery from sexual addiction/coaddiction: Results of a survey of 88 marriages. Sexual Addiction & Compulsivity , 3, 111-126.

Schneider, J. P. & Schneider, B. H. (1990). Sex, lies, and forgiveness: Couples speaking on healing from sex addiction. Center City, MN: Hazelden Educational Materials.

Schneider, J. P. & Weiss, R. (2001). Cybersex Exposed: From Fantasy to Obsession. Center City, Minn.: Hazelden Education & Publishing.

Young, K.S. (1998) Caught in the Net . New York: John Wiley & Sons

Young, K.S., Griffin-Shelley. E., Cooper, A., O’Mara, and Buchanan, J. (2000). Online infidelity: A new dimension in couple relationships with implications for evaluation and treatment. Sexual Addiction & Compulsivity , 7,59-74.