ABSTRACT
Therapists face the ongoing challenge of being alert to the presence of other significant diagnoses in addition to the patient's presenting complaint. For example, it is common for several addictions to exist concurrently, even though the patient is focusing on only one. Irons and Schneider state that addictive disorders tend to coexist, the presence of sexual compulsivity is a comorbid marker for chemical dependency, and addictive sexual disorders are frequently found during assessment for chemical dependence. Schneider and Schneider (1991), in an anonymous survey of recovering sex addicts, found that 39% were also recovering from chemical dependence, 32% had an eating disorder, 13% described themselves as compulsive spenders, and 5% were compulsive gamblers. Carnes (1991) had slightly higher percentages in his survey and included compulsive working at 28%. Washton (1989) reported that 50% of cocaine addicts in an outpatient setting were engaging in compulsive sex. Gordon, Fargason, and Kramer (1995) reported from their chemical dependency treatment program that over 4 years approximately 33% of patients were also sexually compulsive. There are varied interactions between substance abuse and compulsive behaviors (see table 14.1), but what is becoming clear is that sustained recovery in one addiction is only as successful as the least treated co-addiction. In other words, addicts often tend to become caught between several addictive behaviors that ultimately lead to relapse in one addiction because others remain untreated.
