David Duchovny plays sex addict Hank Moody in Californication.

A few months before their wedding, David Prior (not his real name) told his fiancée Sue his biggest secret. Although the couple had a good sex life, and were committed to a future together, he was addicted to visiting prostitutes.



Perhaps surprisingly, the wedding went ahead. “I was horribly shocked, but I thought that with some therapy he’d get over it,” says Sue, 42. Fifteen years and two children later, the couple are still together – but Prior’s sex addiction is still with him. “I don’t think we could possibly have imagined that it would be as long-term, or as difficult as it has been,” says Sue.



David and Sue are clients of a sex psychotherapist, Paula Hall, who last month published the UK’s first comprehensive guide to sex addiction – she defines it as “a pattern of out-of-control sexual behaviour that causes problems in someone’s life”.



“I run training sessions on understanding sex addiction, and four years ago I might have been training six therapists a year,” she says. “Now I’m doing 20 sessions annually, with an average of 30 therapists at each. And when you ask them why they’re here, they all give the same answer: more and more clients are presenting with sex addiction.”



No one understands what the rise in sex addiction is entirely about, but internet porn, Hall says, has got to be part of it. “Porn is like the gateway drug. Just as with cannabis and cocaine, many people will use the gateway drug and never become addicted; but others most definitely will. And unlike drugs or alcohol, users don’t even realise they’re dealing with something that might prove to be addictive.”



In researching her book, Hall surveyed 350 people who described themselves as addicted to sex, 25 percent of whom were women.



The biggest problem for sex addicts, Hall says, is that it’s seen as a moral deficiency rather than a mental illness. “In my survey I asked people what the worst consequence of their addiction was, and the answers were truly terrible.



“People had lost their families, they’d lost their homes and gone bankrupt, they were depressed, even suicidal, and they felt unable to embark on a proper relationship.”



Of the people Hall surveyed, 40 percent were under 16 and nearly 10 percent were under 10 when their problems started.



For Prior, though, the problem started later: he was in his mid-twenties when he started to visit prostitutes. “I was in a very unhappy relationship, and I now realise that was echoing the difficult relationship I’d had with my mother,” he says. “Seeing a prostitute became a way of escape; and even when I met Sue and started what became a good relationship with her, I still needed the fix of seeing sex workers.



“The strange thing was, and is, that it’s never been about fun or enjoyment: the thing I craved, and still do crave, is the feeling of shame. One of the biggest ironies about sex addiction is that it’s only marginally about sex; like all addicts, what it’s really about is being unable to process or deal with something difficult in your life, whether it’s unhappiness, boredom or frustration.”



A big breakthrough for many, says Hall – who chairs the Association for the Treatment of Sex Addiction and Compulsivity – is realising they’re not alone. “Many people with this problem believe they’re the only one with it – so finding out that there are good people out there struggling in exactly the same way really boosts their self-esteem,” she says.



Therapy focuses on understanding what addicts are anaesthetising themselves against, and finding healthy ways to meet their needs.



“I advise clients to block adult content on the internet, and to avoid people or places that trigger their need for sex,” Hall says. – Foreign Service



l Understanding and Treating Sex Addiction by Paula Hall is published by Routledge