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By Sex therapist and relationship counselor
TODAY contributor
updated 9/4/2008 2:41:46 PM ET 2008-09-04T18:41:46

For years David Duchovny, in the form of FBI agent Fox Mulder, chased down aliens and told us that we’re not alone.

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So what should he be told now, after publicly admitting that he doesn't just play a sex addict on TV, but also struggles with the issue in real life ? He’s not alone either.

His recent entry into rehab for a self-described obsession with Internet porn has cast a national spotlight on a widely misunderstood issue that affects millions of Americans: sex addiction, specifically compulsive use of Internet-based pornography.

In talking about sex addiction, it’s important to note that even though the term is commonly used in popular culture, the APA (the American Psychiatric Association) does not currently recognize sex addiction as a condition, nor is it listed in their widely used clinical bible, the Diagnostic and Statistical Manual of Mental Disorders. But while the concept of sex addiction, as well as its diagnostic criteria, may still be a matter of debate, most experts nonetheless agree that there are growing numbers of people who find themselves in the grip of compulsive sexual behaviors that are beyond their control — behaviors that seriously damage their lives as well as those of their loved ones.

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While sex addiction was once viewed as being rare and obscure, the rapid proliferation of Internet porn has brought the issue very much into the mainstream, affecting men and women alike. Porn addiction and sex addiction have become synonymous; a “quick click” of self-gratification can escalate into a self-destructive pattern of behavior (Christie Brinkley’s former husband, Peter Cook, is alleged to have spent more than $3,000 per month on his porn habit). Like any substance of abuse, porn becomes a form of escape — from depression, anger, stress, boredom, intimacy, as well as an array of other issues. Self-gratification becomes a way of self-medicating.

  • Do you or your partner have a porn problem?
  • Do you always masturbate via porn? Have you become reliant on external visual stimulation as opposed to your own imagination or memories?
  • Do you use porn because you're sexually frustrated in your relationship?
  • Is your use of porn tapping you out erotically, leaving little to nothing for your partner?
  • Are you spending too much money on porn sites?
  • Is your use of porn getting in the way of work or other day-to-day responsibilities?
  • Do you think about pornographic images/scenes when you're actually having sex?
  • Do you feel a pressure to perform like a porn star?
  • Do you judge your partner's sexual performance based on images from porn?
  • Is your use of porn an entirely solo activity, or do you share it with your partner?
  • Are you hiding your use of porn from your partner?

If you or someone you know has developed a dependency on Internet porn, it's important to unplug the computer and go cold turkey. Some professionals recommend an extended period of total abstinence from all sexual activity. But unlike alcohol or drug dependency, from which a person can strive to permanently abstain, one should ultimately be able to express and enjoy his or her sexuality as part of a healthy intimate relationship.

Whether a person seeks in-patient treatment or, more commonly, outpatient counseling, it’s crucial to develop an awareness of the triggers that lead to sexually compulsive behaviors, as well as explore their psychological roots. During this process of self-examination, some prescription drugs may be useful as part of an overall biopsychosocial approach: For example, a well-known sexual side effect of common antidepressants is a dampening of sexual desire, which is why SSRIs may be helpful to an individual in managing sexually compulsive behaviors.

Fox Mulder may have led us into the shadows, but David Duchovny deserves our support for stepping out of them.

Ian Kerner is a sex therapist, relationship counselor and New York Times best-selling author of numerous books, including the recently published “Sex Detox: A Program to Detoxify and Rejuvenate Your Love Life.” He was born and raised in New York City, where he lives with his wife, two young sons and plump Jack Russell terrier.

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