The pain in the man's voice is controlled, but it takes on a sharper edge when he begins to talk about his wrecked marriage, his secret behavior, his lack of control. Bob is an engineer who lives in Orange County. His tone lowers when he talks about the helplessness, the loneliness, the fear and guilt.
One word, though, seems to recur in his conversation and appears to rankle more than any other. Shame.
"I couldn't believe it applied to me: sexual addict. Talk about offensive terms. It was like I was a baby killer. I thought of guys wandering around in parks in trench coats. I told myself I was never going to put that millstone around my neck. Yeah, there's an enormous amount of shame."
The words--sexual addiction--are charged with dark implications, misunderstanding and age-old taboos. They seem to suggest--and many people believe--that the person afflicted is a kind of subhuman, a predator, a freak possessed by uncontrollable lust, a villain out of a psychological horror story.
Many people, say psychologists and researchers, can't believe such a condition exists at all and think the term was invented simply to describe those with more active libidos.
"Some people's first reaction is to think it sounds funny," said Carl, an Orange County bank executive who admits he has suffered from sexual addiction for "a number of years."
" 'Sexual addict?' they say. 'Hey, how can I be one?' But it's no joke. It's real. The guilt can be overwhelming. And you don't feel that you can talk to anyone about it, because you'll be suddenly exposed. You can't talk about it the same way you can talk about compulsive gambling or drinking.
"I used sex just like alcohol sometimes. If I had a bad day, I'd use it to make myself feel better. I'd use other people the way an alcoholic uses a drink."
True sexual addiction, for all its seeming implausibility, is real, say sex therapists and psychologists. The term has been in use for perhaps 10 years. But, said Tyrone Westlie, senior chief manager of the sexual dependency unit of the Golden Valley Health Center in Minneapolis, the term did not become widely known until psychologist Patrick Carnes established an outpatient treatment center for the disorder in 1978 at Fairview Hospital in suburban Minneapolis.
In the last decade, support groups for sexually dependent people have sprung up throughout the country. The three best-known of those groups--Sexual Addicts Anonymous (SAA), Sexaholics Anonymous (SA) and Sex and Love Addicts Anonymous (SLAA)--use as their model the Alcoholics Anonymous "12-Step" program.
Sexual addiction also is finding wider recognition in the established psychiatric community, said a UC Irvine psychiatrist.
'The New Frontier'
"It's the new frontier in sex therapy," said Dr. Paul Blair, a clinical professor of psychiatry and director of emergency psychiatry at UC Irvine Medical Center in Orange. "It's a relatively newly recognized phenomenon, but I would guess it's been around for quite a while."
And Blair said he agrees with therapists who estimate that the number of sexual addicts in the American population probably is at least as high as the number of alcoholics--around 10%.
A spokesman for Sexual Addicts Anonymous in Minneapolis estimated that sexual addiction is almost equally divided between men and women. The norm is to have single-sex groups, but occasionally, the spokesman said, you'll find mixed groups.
While sexual addiction is not listed under that name in the diagnostic manual of the American Psychiatric Assn., a spokesman for the association said a body of professional papers on the subject has been published. The Kinsey Institute for Research in Sex, Gender and Reproduction at the University of Indiana, on the other hand, recognizes sexually compulsive behavior. The institute defines it as "hypersexuality--excessive, uncontrollable or compulsive sexual desire."
"It's a strange term, and it really means nothing until you know the 'why' behind it," said Ruth Weg, a professor of gerontology at USC who teaches several classes in human sexuality. "And that 'why' will vary with each individual. It's usually much more deep-seated than a simple need for sexual expression of one kind or another. It isn't an addiction in the same way people can be addicted to drugs. It's a symptom of something else underneath. It can relate to one's self-esteem, to alienation or loneliness, and that's what you have to treat. We can't separate our sexuality from the rest of our being. And there is no single formula. We all bring different emotional baggage with us."