Sex addiction: Is it real?

Addicts call it a God-sized hole, a hollowness in the soul. It leaks no matter how much they try to fill it — and at what cost. For years, George filled his emptiness with pornography, erotic massage and, eventually, sex for hire. There was no tenderness. Even pleasure was rare because every time George engaged in his obsessive sexual behaviors, he felt dirty and even emptier than before.

Heavy with shame, he'd throw used magazines into Dumpsters only to swim through the trash days later to retrieve them. George reached his edge in 2000, when, after 100 one-night stands and losing $10,000 to sex, he was warned by an Oakland, Calif., prostitute that if he continued, he would wind up dead.

George is a fictitious name used to protect this Oakland graduate student's anonymity. The fortysomething has been a recovering sex addict for 12 years and is one of 12 million Americans who struggle with it, according to the American Association for Marriage and Family Therapists. His story is a critical one, and comes at a time when mental health experts are debating whether compulsive sexual behavior is a true addiction, and celebrities such as Tiger Woods and Jesse James are rumored to be in treatment for their serial affairs.

It is likely that the term hypersexual disorder — not sex addiction — will appear in the updated version of the Diagnostic and Statistical Manual of Mental Disorders, the psychiatric Bible, due out in 2013. According to Ken Zucker, a Toronto psychologist and chairman of the DSM subcommittee on hypersexuality, the proposed term is neutral enough to address all theoretic perspectives on compulsive sexual behavior, including addiction, and open doors for critical research.

The proposed diagnosis would apply to people who, for a period of six months or longer, meet at least four of five criteria, including engaging in repetitive, intense sexual fantasies, urges and behaviors in response to stress, anxiety or depression and without regard for physical or emotional harm to themselves or others. Also, they try to stop and are unsuccessful.

"I was a junkie," says George, who ended up in a 12-step program after he hit rock bottom: seven sexual encounters in seven days. His girlfriend of four years found out and left him. "I was using sex as a drug and couldn't stop."

Marriage and family therapist Don Mathews has been treating sex addicts at his Impulse Treatment Center in Walnut Creek, Calif., for 25 years. "I've had cocaine addicts tell me the drug high is very similar to the high they get from their sexual acts," says Mathews, whose treatment model is based on individual depth counseling and group therapy. All addiction, he says, is about escape from the pain and unmanageability of one's life.