Lucy Atkins: Is sex addiction a genuine disorder?

Does your partner spend an inordinate amount of time thinking about sex? Has your relationship been damaged by his sexual activities? Are there times when his sexual urges, thoughts or images seem to control him? If so, he - or she - may not be merely an untrustworthy cad but an addict in need of psychiatric help.

You may be familiar with the term "sexual addiction" from a few years ago when Michael Douglas in his pre-Zeta-Jones days ran out of control in the bedroom department. Douglas, of course, is now a reformed character. And none of us believe a word of the addiction story. The problem is that sexaholism sounds more like the brainchild of Californian therapists than a bona fide disorder.

The latest high-profile case does little to dispel this image. Eric Benet, husband of the actor Halle Berry, was recently treated for sexual addiction (to women other than his wife) in the exclusive Meadows rehabilitation centre in Wickenburg, Arizona. The fact that Benet, a rock star, was merely doing what generations of self-respecting idols have done before him was not an argument his wife would accept. "I've been through it with my husband," she tells this month's Elle magazine. "If everybody lived by the principles of 12 Steps, there would be a lot more healthy people walking around."

Berry, of course, is not the only woman to have been put through the mill by a husband who cannot keep his pants on. But does Benet's behaviour really warrant expensive psychiatric treatment? Can sexual addiction be a real psychiatric disorder? Or has Halle been had?

Sexual addiction, says Robert Brown, senior lecturer in psychology at Glasgow University, "is not a clinically defined disorder". The American Society of Addiction Medicine refused to accept it. But there is, says Brown, "a considerable body of medical opinion in the US that thinks otherwise."

According to Sex Addicts Anonymous, 6% of British people are sexually addicted. But in the UK, there are few treatment programmes and therapists who know anything about the subject. Thaddeus Birchard, a registered psychotherapist, runs a treatment programme. Sexual addiction "is not a new phenomenon. It is just a new way of conceptualising an age-old behaviour," he says, "it is more like an eating disorder than, say, alcoholism." A "binge phase" of destructive self-indulgence is followed by an "anorexic phase" where you promise you will be good and faithful. Now, surely, unlike anorexia, the actual physical danger of sexual addiction is minimal (if you don't count your spouse threatening you with a cleaver). Not so, says Birchard. Sex addicts can face considerable danger, including HIV, sexually transmitted diseases and any number of physical threats, particularly if they are female. They also, of course, routinely put their family, reputation, career and friendships on the line.

This all sounds very distressing, but surely most unfaithful partners feel guilt after the event, so at what point does the average swine become a helpless sufferer? Sexual addiction, says Birchard, is "a pattern of sexual behaviour characterised by three things: a difficulty in stopping and staying stopped; harmful consequences, and preoccupation or obsession". This can involve anything from compulsive flirting and masturbating, to escorts, cybersex and serial infidelity. In pursuit of these pleasures, the sexaholic will take huge risks.

Sexaholism, says Brown, follows similar patterns to other addictions, such as alcoholism or gambling. Such compulsions tend to go in cycles. In a sexual addict, a cycle starts with a trigger, usually some kind of fantasy where the addict achieves a state of sexual arousal that "relieves a previously negative mood state". This may sound like an attempt to quell the pain of his team's relegation with some hanky panky, but there the similarity ends. In an addict, arousal leads to a prolonged state of erotic chase, which "only needs to be physically consummated occasionally". After consummation, he or she is left feeling revulsion, guilt and despair. It is perhaps no surprise that such emotions are particularly strong in women, and that the only way to relieve these feelings is to start the cycle again.

This destructive behaviour does not spring from simple lack of self-control, morals or good sense. Research in the US shows that a high proportion of sexaholics report being abused, either sexually or emotionally, as a child. Treatment usually focuses on the "restoration of connections" with other people. (The addict is often lonely or isolated). The 12-step programme that so delighted Berry is often the basis of this treatment. But the problem with an addiction to sex is that fantasy plays such a large part. While it is not easy to conceal the fact that you have downed a bottle of whisky, who is going to know if you are repeatedly having naughty thoughts about Britney Spears?

Clearly, sexual addiction is a complex syndrome and, as such, may be hard to cure. "With other addictions you withdraw the substance from the body and the body adjusts," says Birchard. "But with this one you carry your own supply. It is a bit like giving up heroin and still having a shot every now and then." However, he says, with help and ongoing support, "these patterns can be left behind and new patterns of healthy sexuality established". Groups such as Sex Addicts Anonymous who meet regularly can help, though how successful this is in the long term varies widely. We can but hope that all sufferers and their spouses have as much to celebrate as Berry and Benet.

· Further information: For Sex Addicts Anonymous see www.sexaa.org; for the National Council on Sexual Addiction and Compulsivity, www.ncsac.org and for Thaddeus Birchard's sexual addiction treatment programme call 020-7372 3155.

Thanks to guardian.co.uk who have provided this article. View the original here.