From Tiger Woods to Lifetime movies, there has been no small amount of conjecture about the slippery concept known as ‘sex addiction." 
But does such a condition really exist?

Finding out requires sweeping aside the presumption,
dismissiveness, and shame that clouds the subject.

The phenomenon didn’t have a name until 1983 when
psychologist Patrick Carnes published the influential book, Out of the Shadows: Understanding Sexual
Addiction. Prior to that, the behavior was described as “hyper-sexual
arousal.” In short, the term “sex addiction” is used to describe a pattern of
frequent, progressive, and often secret sexual behavior, even when the behavior
jeopardizes a person’s time, employment, financial stability, relationships,
and reputation. While often conflated with adultery, sex addiction does not
necessarily mean cheating—or even intercourse. Rather, it can manifest as a
dependency on pornography, masturbation, phone or Internet sex, and other
related behavior.

People who struggle with sex addictions are of varying ages,
genders, and sexual orientations. The Society for the Advancement of Sexual
Health estimates that 3 to 5 percent of the American population wrestles with
addictive or compulsive sexual activity.

Re-framing compulsive sexual behavior has led the
therapeutic community to look at it through the lens of addiction for the last
twenty years, noting how the behavior activates the same pleasure centers of
the brain, releasing the same chemicals as drug use does, and providing the
addict with the same kind of euphoric high, and numbed escapism that addictive
substances cause.

Maureen Canning treats sex addiction both in her private
practice and as a consultant at The Meadows, a recovery center in Arizona.
She said the therapeutic response to sexual addiction parallels that of
chemical addiction. Its diagnosis uses the same assessment tool, gauging, for
example, whether the behavior progresses over time and has negative
consequences on the person’s life.

If an addiction is assessed, Canning said, the treatment she
provides hinges on listening.

“We listen to what they’ve been doing, how they’ve been
doing it,” Canning said. “We listen for the story around their childhood, how
they were influenced sexually, both overtly and covertly. Sometimes they were
abused, or exposed to something traumatic.”

She added that treatment guides people into stabilizing
their lives—they often begin recovery while in chaotic circumstances—and then
helping the individual learn to manage their feelings, set boundaries, and find
healthy coping mechanism. The process can be painful.

“For many sex addicts, they’ve been acting out for most of
their lives and (treatment) is like a death—this was the one thing they could
count on to make them feel good,” Canning said.

She also noted that there is an anorexic cycle to sex
addiction, where an individual compulsively avoids sexuality. Others, she said,
especially women, can become addicted to the process of seduction rather than
the sex per se.

Especially with the advent of the Internet, there have been
more and more diagnoses of sex addiction.

“We called (the internet) the crack cocaine of sex
addiction,” Canning said. “It’s affordable, accessible, and anonymous. People
who have addictions are likely to experience them more intensely, and those who
might not have had them (without the internet) develop them.”

Dean W., who asked that only his first name and last initial
be used in this story, said that he was addicted to pornography and phone sex
for more than ten years; he continues to be actively engaged in therapy. While
he spent 30 to 40 hours a week acting out, he said, sex addiction is “much,
much easier to conceal” than other addictions—which is why very successful
people, such as CEOS, can find themselves struggling with it, and why he
believes the disease is still not well known.

“When I’ve told
people, they think it’s funny, not true, or that I’m a pervert,” Dean said.
“The biggest thing that hurts as a person is that (sex addiction) is so
misunderstood.”

To underscore the reality of his situation, Dean points out
to the addictive patterns that played out in his life—twelve to fourteen hours
of looking at pornography at a time, he said, and extended phone sex binges.
One of his phone sex binges lasted 36 hours, in which Dean neither ate nor
slept, and which cost him $2000. In all, Dean estimates that he spent more than
$150,000 on phone sex over the course of his addiction.

The addictive pattern, Dean said, was a way to escape
feelings of low self worth and loneliness. These deep feelings had roots in
both his parents and his grandfather being alcoholics; his brother has a
gambling problem. Dean said that he was emotionally, physically, and sexually
abused as a child. His steep investment in his therapy—he has been through many
intensive programs and has been in a weekly program for more than two years,
most of which is not covered by his health insurance—is in part an effort to
ensure that his own child is not affected by his addiction.

Elle can attest to the pain that sexual addiction can cause
a family. The Canadian mother, who asked that her real name not be used, never
heard of sex addiction until her husband confessed to her that he was seeking
recovery from it.

“I was floored. (Sex addiction) …  what the hell was that?” Elle said. “I worried that it meant
he was a pervert. The very next morning (after he told me about it), we had a
conference call with his counselor who helps set up treatment programs for sex
addiction. Thankfully he laid out the facts, assured me it was treatable,
explained to me that my husband was doing very well and desperately wanted to
put his past behind him.”

That past involved betrayal that Elle said nearly destroyed
her. What she initially thought was one affair turned out to be a pattern of
secrecy that was difficult for her to accept.

“I had a very hard time with it. Felt very, very lonely.
Felt duped. Ripped off,” Elle said. “My perfect world wasn’t so perfect after
all.”

Elle and her husband didn’t discuss the details of the sex
addiction with their young kids, but Elle said that the process of recovery has
made it possible for her husband to reconnect with his whole family by spending
more time together; his addiction had led him to detach from the family.
Recovery, she said, “involves a lot of soul-searching, a lot of reparations,
total disclosure, total transparency.”

There remains, however, a strong segment of the population
that believes that sex addiction is merely a manufactured phenomenon. John
Wilder is one of them. A retired Baptist minister from Newcastle, Indiana who
serves as a marriage and relationship coach, Wilder contends that sex addiction
is so much “pop psychology.” A true addiction is distinguished by a chemical
dependence, resulting in painful physical withdrawal, he argues. While many
people have obsessive-compulsive patterns of sexuality, often out of a need to
be soothed, Wilder said, it is misleading to call it an addiction.

“There’s simply no physical (withdrawal) component with
so-called sex addiction,” Wilder said.

In the most recent version of the American Psychiatric
Association’s Diagnostic and Statistical
Manual of Mental Disorders (DSM-IV), published in 2000, “sex addiction” is
not listed as a diagnosis

Nonetheless, Canning said that in the last ten years, public
awareness about sex addiction has developed—though it has a long way to go. In
no small part, this is because American culture itself is sex-addicted, she
said.

“As a sex-addicted culture, we carry a lot of sexual shame,”
Canning said. “We haven’t really been able to accept it, we like to act out, and
we objectify people sexually. This all reinforces the belief that sex is the
most powerful thing.”

It is a point where she and Wilder actually seem to agree.

“This society teaches people, especially girls, that sex is
a nasty, dirty thing,” Wilder said. “Sex is a great gift from God, but you
never see that taught in churches or Sunday school. … Most of us get stuck in
an adolescent mode: ‘Hurry up, get it
over with before someone catches us.’ … There’s very poor communication
about sex.”

Canning added that, “oftentimes as a culture, we confuse
intimacy for intensity.

“We think the goal is to have the most intense kind of
experience—that’s where the high is, the power, the excitement. We need to
shift our paradigm of what healthy sexual experience is. When we make someone
an object, we depersonalize him or her. When we depersonalize them, there can’t
be intimacy.”

Both Dean and Elle were able to relate to the idea of objectification.

“I learned (in therapy), even though its still difficult,
not to objectify women,” Dean said. “Objectification in our culture is just
rampant.”

Elle said that she was particularly surprised about one
woman her husband had an affair with because she was someone he typically would
find unappealing. But as she learned about addictive behavior, she realized
that this woman was ‘safe’ because her husband knew he’d never have an
emotional connection with her.

“Sex addicts usually—not always but usually—seek out
partners they can objectify. That are really nothing more than sexual
partners,” Elle said. “My husband feels a lot of shame that he treated people
that way—that he didn’t even really see them as human beings, but as objects.”

Elle added: “Believe me, there’s nothing sexy or passionate
or exciting about (sex addiction). It’s generally two sick people feeding off
each other.” 

The public reaction to Tiger Woods’ personal struggles has
ignited this sex-addicted culture. The top athlete is reported to have sought
treatment for sex addiction at a recovery center in Arizona.

Canning said that while the publicity of his treatment
provides an opportunity for discussion, which can ultimately normalize struggles
with sex addiction, she’d like to see the conversation about it be more
educated—and less joking.

“I think if we are more educated about it, there’s less
shame for an individual to reach out for resources and help when they need it,”
she said.

In his support communities, where he connects with about forty
people each week who are seeking treatment for sex addiction, Dean said that
there is almost unanimous hope that Woods will speak out about his experience.

“There’s a glimmer of hope (in the therapy groups) and a
sense of understanding,” Dean said. 
“I hope he gets the help he needs.”

Dean said one of the most important things that could happen
for sex addiction would be the emergence of a spokesperson like Tiger Woods, as
well as active support from the National Institute of Health and coverage from health
insurance companies. He added, though, that he knows that recovery takes many
years of reducing shame and guilt—and he suspects that Woods will probably not
go beyond making a public statement indicating, “everything’s taken care of.”

Elle too hopes that the conversation about Woods leads to
more public understanding. While emphasizing that there’s no clear confirmation
that Woods is indeed receiving treatment for sex addiction, she admits that the
signs seem to indicate that it’s so.

“I would hope that (the Woods story) might bring sex
addiction to the public arena and perhaps educate more people, particularly
those who know their sexual behavior is causing them pain, but don’t have a
name or understanding of it,” Elle said. “And I would hope that maybe, just
maybe, we might become more compassionate about it.”

Elle added, “My husband isn’t the least surprised that his
background is similar to Tiger Woods. The domineering father who demanded
perfection, the high pressure career… the false sense of invincibility. … I
ache for (Woods’) wife, who has to be witness to her pain being played out on
the world stage.”

Resources:

• Sexual Addicts Anonymous, which models the
  Twelve Steps principles of recovery from Alcoholics Anonymous, offers a network
  of in-person meetings around the world—single gender or mixed, open or
  closed—as well as tele-meetings and online meetings.
• The Society for the Advancement of Sexual Health is
  a membership organization founded in 1987 “dedicated specifically to helping those who suffer from out of control
  sexual behavior.”
• Dean uses
  Safe Eyes for Internet access. Costing $40-50 a year, Safe Eyes is one among
  several tools that blocks sexually explicit websites. Dean, who struggled
  particularly with pornography, said it has “helped a lot.” He added that he
  looks forward to the day when sex addiction is no longer so taboo that people
  feel like they can’t have it installed on their work computers.