Treatment for compulsive sexual behavior typically involves psychotherapy, self-help groups, and medication.

Certain psychiatrists hold that sexual compulsion is maintained by mood-dependent motives, and that pharmacological treatment of the underlying mood disorder can diminish the urges and cravings associated with addiction. Interventions that enhance mood/feelings regulation and behavioral inhibition also have positive effects on the ability to control impulses.

The Erotic Haze

That there are chemical changes in the brain when the sex addict enters “the erotic haze” cannot be disputed. Sexual arousal is a stimulated neuro-chemical state, induced by the release of adrenaline, serotonin, dopamine, and endorphins that occurs when the sex addict engages in intense sexual fantasy, ritual, and behaviors.

Sex addicts are high on their own neurochemistry long before actually having sex. In fact, most sex addicts try to stay in the “erotic haze” as long as they can, putting off any actual sexual release. The “erotic haze” is a somewhat euphoric state, not dissimilar to the inner state of an opiate user.

Medications for Sex Addiction

Although not a necessity, certain medications can often help alleviate some clients’ compulsivity, anxiety, and depression. Some medications act on brain chemicals linked to obsessive thoughts and behaviors and reduce the chemical “rewards” these behaviors provide. Which medication is best for you depends on your overall situation and other mental health conditions or addictions you may have.

You may have to try several medications, or a combination of medications, to find what works best for you with the fewest side effects. Medications used to treat compulsive sexual behavior are often used primarily for other conditions, including:

• Antidepressants. The antidepressants most commonly used to treat compulsive sexual behavior are selective serotonin reuptake inhibitors (SSRIs), such as Prozac, Paxil, Zoloft, and others. SSRIs often have a side effect of a reduction in libido and sexual functioning, which is sometimes useful in decreasing sexual activity.
• Mood stabilizers. These medications are usually used to treat mania, but research suggests that they also reduce uncontrollable sexual urges.
• Naltrexone. This medication is generally used to treat alcoholism and blocks the part of your brain that feels pleasure with certain addictive behaviors.
• Anti-androgens. These medications reduce the biological effects of sex hormones in men. Because they reduce sexual urges, anti-androgens are often used in men whose sexual behavior is dangerous to others, such as pedophilia.
• Luteinizing hormone-releasing hormone (LHRH). This medication may reduce obsessive sexual thoughts by reducing the production of testosterone.
• Anti-anxiety medications. Examples include Klonopin, Ativan, Librium, Valium, and Xanax. These medications are used to reduce serious anxiety and aggression in emergency situations, but are generally avoided, as they may worsen compulsive behavior in the long run.

Dorothy Hayden, LCSW has been specializing in treating sex addiction and chemical dependency for 15 years. She has training in sex addiction therapy, psychoanalysis, hypnosis and cognitive behavioral therapy. The full text of her writings on sex addiction can be found at www.sextreatment.com.

References
Goodman, A. (1998) Sexual Addiction: An Integrated Approach; International Universities Press, Inc.

Weiss, R. (1992) When Too Much Sex is a Problem…Understanding and Treating Sex Addiction. www.clinicalsocialworksociety.org/

As addressed in a recent Zee News article, for most people with sexual addiction, the behavior is not actually about the sex itself – but rather the way the behavior allows them to escape emotional pain or helps them escape an inability to form close personal bonds with others.

As a result of misconceptions about sexual addiction or feelings of shame, many people may not look for help from experts and treatment professionals. As the condition progresses, the person will need more intense forms of the behavior to get the same "rush" and remain powerless over their urges, despite the consequences.

Like other addictions, sexual addiction is linked with a person’s inability to experience and cope with negative emotions. Similar to people who abuse drugs or alcohol, a person may abuse sexual activity, masturbation, pornography or other sexual outlets to escape stressful emotions. The sexual activity may bring a temporary sense of control over these feelings, but in reality, each behavior associated with the addiction only worsens feelings of shame, guilt and isolation.

For people with sexual addiction, sexual behaviors may bring a sense of release or a short-term high, but the consequences are devastating to their spouse, children and careers. Research involving the causes and treatments for sexual addiction is rapidly increasing across the globe, and hypersexuality is under consideration for formal inclusion in the next version of the Diagnostic and Statistical Manual of Mental Disorders.

As stated in the Zee News article and many professional sources, people living with sexual addiction are living with deep levels of pain and need the help of experts to reach recovery.

Sexual addictions and pornography addictions remain a private matter for most people who are enduring them, or are only shared within a spouse or intimate relationship – which further complicates their chances for recovery, says a recent news article about sex addiction in the Kansas State Collegian.

Dennis Detweiler, a Lawrence, Kan., based sex therapist, explains that when one partner is willing to talk about their pornography or sexual addiction, the chances for recovery are much greater. Many times, the spouse who is involved with someone addicted to sex or pornography feels they may be able to change the person’s behavior. They also experience feelings of inadequacy, says Detweiler, and may feel that they cannot live up to the fantasies of their partner.

Additionally, people suffering from sexual addictions are also living with deep fears and anxieties about emotional closeness, which can be another roadblock as couples try to pursue recovery. Many times, says Detweiler, a person with a sexual addiction will not reveal their true feelings or emotions. Sex becomes a place to hide.

A spouse can be a tremendous resource in encouraging someone to get treatment for sexual addiction, says Detweiler, even if the conversation isn’t easy. For Detweiler and other sexual addiction specialists, the problem is addressed as a relationship problem, instead of a problem of one individual – because the root cause is typically related to an inability to form close emotional bonds, which affects both partners.

Support groups for spouses of sexual addicts can be very powerful resources as couples seek treatment, and experts also encourage couples to adopt the idea that sexual addiction can happen to both genders and that many other couples are also working through the condition.

Even though addictions to sex, hypersexuality and sexual compulsivity have been the source of debate over official diagnoses, addiction experts say the numbers of people seeking treatment for the conditions continues to grow, as noted in an April 2011 article on the Online Journal.

Sexual therapists who began treating people with sexual addictions in the late 1990s banded together to share information and expertise, being only a few in the area of specialty. Today, centers are being established worldwide as are group-based therapy programs and new Internet resources for recovering from sexual addiction.

Alexandra Katehakis, founder of the Center for Healthy Sex, believes celebrity announcements of sexual addictions and sexually compulsive behaviors have helped ignite the progress toward recognition of the problem. Without celebrities addressing their sexual addictions, Katehakis doesn’t believe as many treatment centers would be available.

Because federal regulations to determine exactly how many people are receiving professional assistance for sexual addictions are not yet in place, it is unclear how widespread the problem may be. Further complicating the issue is the reality that while people with sexual addictions may neglect their families and jobs, see financial ruin and the destruction of their families, scientific research to demonstrate withdrawal symptoms has not yet been officially documented.

Experts expect scientific studies addressing sexual addiction withdrawal symptoms and tolerance issues to emerge soon, with potential to place the field of sexual addiction into a similar field as alcohol or drug addiction.

1. Difficulty Dealing With Emotions
Ultimately sex addiction is an intimacy disorder where sex is substituted for human connection. The addicted person has difficulty regulating their feelings and uses sex to feel better. They are often disconnected and closed off, unable to show the necessary openness and vulnerability for intimacy to develop.

2. Changes in Libido
Libido can increase or decrease. The addict may demand sex all the time yet never seem satisfied, and not just early on in a relationship. On the flipside, avoidance of sex and physical contact can also occur, signaling the person is finding sex elsewhere.

3. Excessive Time Online
Viewing online pornography and spending excessive time in chat rooms focused on sexual or romantic intrigue allows the person to check out and disassociate. To review a computer’s online history for pornography sites, press the control and H buttons, or hit the drop-down arrow on the address bar.

4. Mood Swings Before or After Sex
Avoidance or agitated behavior before or after sex can be another sign that the person is disconnected rather than connected to intimate experience.

5. Inability to Socialize Well
Besides isolating themselves, a classic sign of addiction, the person may also socialize in unusual settings or with unusual people. The sex addict displays trouble reading emotions and connecting with others.

Sex Addiction Treatment
Sex addiction treatment is often in-patient and includes individual and group therapy, lectures on the disease and other therapeutic models designed to help sex addicts come to terms with the issues behind their fear of intimacy.

Elizabeth Cohen of CNN writes that Jack Rogers (that’s not his real name) knows a little something about body count because he has one of his own: In the first 20 years of his marriage, he slept with some 50 women. Roger says he views Woods as a sex addict, not just someone looking for a good time.

The 49-year-old Rogers, who works in the high-tech industry in Washington and has two children, says his whole life was geared around how he would have his next orgasm, in the same way a methamphetamine addict is constantly trying to find his next drug hit.

Between women and pornography, he was having three to five orgasms a day, he says. "As soon as I was done with one I was thinking about how I was going to get the next one. Sex was controlling my life, and I was miserable."

Rogers says his addiction began at age 16. "I would have sex for hours and hours at a time, and then go look at pornography," he remembers. "Sex was my all-consuming endpoint."

While some young men might brag about their sexual conquests, Rogers was the opposite. He kept his sex life a secret, seeking out girls who didn’t attend his high school. He says no one suspected.

"I was elected all-school president," he says. "I was well thought of. I earned a full scholarship to the University of Washington. If you’d met me, you’d think, ‘Wow, I want to give that kid a scholarship.’ "

He continued to be obsessed with sex in college. "The day Mount Saint Helens blew up, everyone was talking about it. But I didn’t even know it happened because I was having sex all that day," he remembers.

He was never faithful to a girlfriend, and although he married at age 25, he was never at any point faithful to his wife. "I was having affairs while we were engaged," he says.

His quest for sex started at 4 in the morning, when he would wake up to get in touch with the women he was seeing on the East Coast. The rest of the day was spent mapping out his sexual activities. Some of the women he had sex with were colleagues. Others were prostitutes. Some were women he met by chance.

"I could meet a woman on the elevator and be having sex in her apartment two days later," he says. "I would just get a feeling, from the amount of eye contact or the type of eye contact, that a person would be open to the idea."
He says he usually had two or three affairs going on at one time, but didn’t actually derive pleasure from them. "I wanted to stop and I couldn’t," he says. "I was miserable. It was a horrible way to live."

Jay Parker, a dependency counselor who runs a program for sex addicts in Redmond, Washington, called "No More Secrets," says an intense interest in sex doesn’t mean someone is a sex addict.

"It’s like with alcohol—everyone who gets a DUI isn’t an alcoholic," he says. "There are people who have errors in judgment—they’re not addicts."

According to the Society for the Advancement of Sexual Health, an estimated 3 to 5 percent of Americans could fall in the category of having an addiction to sex.

However, it’s important to note that the official handbook of psychiatric diagnoses, The Diagnostic and Statistical Manual of Mental Disorders, doesn’t include a diagnosis for sexual addiction. Some therapists, like Craig Fabrikant, a clinical psychologist at the Hackensack University Medical Center, doubts such a thing even exists.

"I think it’s more of a habit than an addiction," he says. "I would classify it as OCD–more of an obsession or compulsion than an addiction."

But professional arguments aside, Fabrikant agrees that people like Rogers who are miserable or dysfunctional because their sex lives are out of control need professional help–and that the first step is to recognize when they have a problem.

Click here to see checklists devised by the Sexual Recovery Institute and the Society for the Advancement of Sexual Health to help you determine whether you have a sexual addiction. If you answer yes to a high number of questions on any checklist, you may have a problem.

Here are some general ways to know you might have crossed the line from healthy sexual interest to sexual addiction or compulsion:

1. You lie
For Parker, the sex addiction counselor, this is the No. 1 way you know you’ve crossed the line: when you make up stories to get sex. "If you lie with women to get them to have sex with you, you’re a predator and an addict," he says.

2. Sex consumes you
If your interest in sex runs your life, you have a problem, says Robert Weiss, a social worker and founder of the Sexual Recovery Institute. He says addicts "are always preoccupied with hitting on someone, or picking someone up, or getting home to look at porn before their spouse comes home."

3. You’re "divorced, dead, fired, or arrested"
If you continue your sexual activities even under threat of being "divorced, dead, fired or arrested," you’re an addict, Parker says. "They ignore the consequences," Weiss adds. "They say, ‘I could really screw up myself here, but I’m going to continue to do it.’"

4. You have an intense interest in pornography
"The pornography piece of this cannot be overstated," Parker says. "Show me a guy who’s having sex with three women in one week, and I promise you he has a relationship with pornography."

5. You want to stop and you can’t
Sexual addiction is defined by a loss of control, Weiss says. "I was totally out of control. I tried to stop and I couldn’t," Rogers says.

Five years ago, when the misery got to be too much, Rogers confessed his addiction to his wife and checked himself into an inpatient treatment program for a month, which included not having orgasms alone or with anyone else. After leaving the treatment center, he continued on outpatient treatment, and has not cheated on his wife again.

In treatment, Rogers was not allowed to engage in any type of sexual activity or look at pornography. He also did what he called "psychodrama," looking at situations from his past that might have led to his addiction, including being sexually abused repeatedly at age 7 by an older boy in his neighborhood. In other sessions, counselors helped him understand the effect he’d had on his wife and children, the women he’d slept with, and their families.

His wife joined him for two days at the program. He read her his "disclosure letter" describing his sexual activities over the past 20 years.

"She knew about the pornography and masturbation, but she didn’t know about the affairs or the prostitutes," he says. "So it was very difficult to her to receive this information, just in terms of the sheer numbers of women."

In the last week of treatment, he and his doctors mapped out what his life would look like back home after recovery. He sees a counselor and goes to a 12-step recovery program. "In my first 365 days after treatment, I went to 523 meetings," he says.

Early on in his recovery he did sometimes look at Internet pornography, but a software program he installed on his computer alerted his wife and sponsor in his support group, and he stopped looking at porn.

Gradually, Rogers says, he learned how to have a healthy sex life with his wife. "That’s what we aim for," Parker says. "We’re not trying to turn someone into a monk. He needs to learn how to have sex like a gentleman."

“People look at sex addiction as an excuse; it’s not an excuse. I’m fully responsible for everything that I did and accept responsibility for that,” Phillips said in his first interview since leaving the Gentle Path sex addiction program at the same Mississippi treatment center that is said to have just finished treating Tiger Woods.

“I’ve broken my wife’s heart,” Phillips said. “I’ve damaged her and our relationship in a terrible way.”

Mike Celizic of TODAYshow.com writes that last August, Brooke Hundley, a 22-year-old production assistant at ESPN, told Phillips’ wife Marni that she had had an affair with him. Hundley, who also contacted Phillips’ 16-year-old son through the Internet, posing as a classmate, confronted Marni in front of her home. Terrified, Marni called the police.

This wasn’t the first time Phillips’ sex addiction got him in trouble. In 1998, while he was the general manager of the New York Mets, a co-worker filed a sexual harassment suit against him that forced him to take a brief leave of absence from his job. The case was settled out of court.

Phillips told Lauer that he knew he had a problem back then, but he didn’t look at it as an addiction. “I didn’t go to a clinic; I just got some local therapy,” he said. “I tried to manage everything on my own. I didn’t get the appropriate help that I needed.”

Celizic writes that everything finally came crashing down when he had three sexual adventures with Hundley last summer. After the affair ended, Hundley contacted Marni and then the eldest of the Phillips’ four sons. When Marni made her 911 call after Hundley confronted her in her own driveway, the story hit the New York tabloids.

“I think of all that my family’s gone through,” Phillips said. “People choose to participate in a relationship, but my wife and kids didn’t. With what my wife and kids have gone through, the trauma that they’ve faced, not only from having a father and a husband that’s a sex addict, but the trauma of the media attention, they’ve been through a lot.”

Phillips told Lauer that he realized he was out of control after he broke off the affair with Hundley. “I started calling facilities in August, well before everything blew up, and before there really was a problem where I ended up losing my job,” he said. “I knew I had a problem; I needed to get help.”

By the time he entered treatment in October, both Phillips and Hundley had been fired by ESPN. Now living in California, Hundley told NBC News that she regrets what happened.
“I’m sorry for him and his family. I’m sorry for my family. I was 22; I made some mistakes. If I could take them back, I would, OK?” she said.

The program Phillips completed is a 12-step program similar to Alcoholics Anonymous, whose first step calls on members to recognize that they are powerless over their addictions and their lives have become unmanageable.

“People who go there are broken people,” Phillips explained. “That’s really the essence of the addiction, that you’re broken inside. You’ve got a hole that you’ve tried to fill, whether it was with alcohol or drugs or sex or gambling, with whatever. You go there and try to get the basics of why did you do what you did,” he added. “For most addicts, whether it’s alcohol or sex or whatever, it is that you have that hole inside based upon shame and trauma that occurred from childhood.”

"Whether it’s drug, alcohol, or sex addiction they’re coming in for, it’s usually because of family or the courts or massive outside pressure forcing this person to change,” he continued.

"The chemicals that are released in the brain when people are acting out with sex dependency are every bit as powerful as any substance they could be putting into their body," says Dr. Shari Corbitt, senior executive director at Promises Treatment Centers in West Los Angeles, which also treats sex addiction when paired with substance abuse.

Reports have indicated that Woods’ wife Elin Nordegren has been visiting him in sex rehab at a program called "Gentle Path" at the Pine Grove Behavioral Health & Addiction Services treatment center in Hattiesburg, Mississippi. Addiction experts say that spouses are usually very involved in an addiction recovery process.

"Couples therapy is a huge part of the treatment," says Corbitt. "It would actually be odd if she weren’t visiting."

Addiction experts say it’s likely that the Woods’ sessions are going for anywhere from 90 minutes apiece to two and a half hours or even longer. Tiger may be asked to spill exactly how many affairs he’s had so that the healing process can begin.

Several people claim to have spotted Woods around Cape Town, and he is said to be undergoing treatment for sexual addiction at the Montrose Place facility in the upmarket suburb of Bishopscourt/

Elin, who has two children with Woods, reportedly told friends she was "100 percent" determined to end their marriage because Tiger had refused to attend a clinic for his sex addiction.

Staff at Montrose Place would not comment on whether Woods was at the facility, saying only: "Montrose Place is a reputable treatment facility and no matter what the circumstances, no patient names would ever be revealed."

Since news of his affairs broke, Tiger’s involvement with major sponsors Accenture, Gillette, Gatorade, and Tag Heuer have been scaled back, potentially costing him millions if deals aren’t renewed in the future.

"I always ran around extra wildly, so that she had to catch and grab me,” he told German TV channel Tele 5.

Duchovny believes his sexual appetite grew to such extreme levels because sex is a form of escapism for him.

"Sex, to me, means I can forget myself. It’s just the moment. I heard that skiing is even better than sex. It could be possible—but I’m not a skier."

However, the 49-year-old star is fully aware that his addiction to sex almost destroyed his marriage to wife Tea Leoni, the mother of his children Madelaine, 10, and Kyd, 7.

"My family and I have had a very hard year. Today I’m as happy as ever. I’m ultimately grateful for all the difficulties. My wife and I have gone through that together and now we are even stronger,” he said.