Sex addiction: The facts from the fruity fiction

Ah, sex. Our compulsion to reproduce, or to go through the motions of doing so, has a habit of getting people into trouble, especially if they are wealthy or powerful. The readiness with which men – it is usually men – with money or influence will turn aside from their business affairs to engage in extra-curricular dalliances is all too familiar. What we didn't know, until recently, is that it may qualify as a medical disorder.

Of all those whose sexual proclivities have been exposed down the years, Lord Irvine Laidlaw of Rothiemay surely broke new ground at the weekend with his remarkable apologia for his behaviour.

The wealthy peer, who was born a Scot but lives in Monaco, was alleged in Sunday's News of the World to have flown £3,000-a-night prostitutes from London to take part in orgies in the presidential suite of a hotel in the Mediterranean principality. The prostitutes are alleged to have drunk champagne and snorted drugs before participating in sex acts with each other and with Lord Laidlaw, 64, in what the paper described as "cocaine fuelled bondage romps".

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Once, the married peer would have been dismissed as a dirty old man; an ageing toff indulging in "depraved" activities long past his sell-by date. Now, however, we are invited to show sympathy for the son of a mill owner with the £760m fortune – because he's now the victim of a "disease".

In a letter to the News of the World, printed alongside the revelations, Lord Laidlaw said he was "deeply sorry" for the embarrassment caused to friends and colleagues.

"I apologise from the bottom of my heart," he said, begging forgiveness from his wife, Christine – whom he said was standing by him – and from the public. "I have been fighting sex addiction for my whole adult life. Sexual addiction is comparable to the other better known addictions, such as drugs, alcohol and gambling. There is no cure and self-help is rarely successful."

He'd had therapy "a number of times" for the condition but confessed he had not "worked hard enough or continuously enough" at it. He added: "With Christine's support and encouragement I am seeking long-term expert help, not to cure me, but to prevent any relapse into unacceptable behaviours."

The newspaper reported that he was due to check into a sex therapy clinic in South Africa yesterday for a six-week stay and had made a £1m donation to a UK charity to help other victims of the condition.

So should we feel sorry for Lord Laidlaw and applaud his decision to go into rehab? And what of Max Mosley, president of the Fédération Internationale de L'Automobile (FIA), exposed a few weeks ago in the same paper for his somewhat darker sexual tastes, involving sado-masochistic orgies with semi-naked prostitutes in uniform?

What, for that matter, should we think of Russell Brand, motor-mouthed presenter, actor and author with a penchant for nubile blondes and a bed post that has run out of notch space? He said on the Jonathan Ross show at the weekend that he quite fancied sex with a flamingo – an admission which, coupled with his comments on the opposite page – should guarantee him space on any therapist's couch.

As these topical points of conversation suggest, suddenly, sex addiction is fashionable. Everyone has it, or is at risk of developing it, or wonders if their friends may be afflicted by it – or dreams of meeting someone with it (teenage boys, mostly).

In the context of the nudge, nudge, wink, wink British attitude to sex – uptight, voyeuristic, titillating – it plays to our deepest fears of sex as an overwhelming, destructive force.

Mention the subject and it is certain to induce a knowing laugh, a ribald joke or haughty dismissal. The idea that sex could rank alongside heroin, alcohol or even gambling as an addiction seems inherently absurd. Yet therapists are reporting arise in cases as sufferers areincreasingly admitting they have a problem. The publicity given to Lord Laidlaw's antics will undoubtedly fuel that trend.

There is a proliferation of self-help books and websites on the disorder, as well as clinics, many based in America, where for years it has been a celebrity disease, suffered by such local A-listers as Michael Douglas, Woody Harrelson, and Rob Lowe.

But the diagnosis is catching on in Britain. What no one disputes is that an unhealthy obsession with sex damages relationships. Sally Brampton, Sunday Times agony aunt, says that, despite being shrouded in shame, pain and secrecy, the problem is becoming more common.

"People laugh at sex addiction, but I get increasing numbers of letters about it. Usually they are from women whose boyfriends are hooked on porn. The pain caused to those women, and the shame and guilt those men feel, are not the subjects of comedy."

While attending group therapy meetings with sex addicts, Brampton says she watched a man "cry helplessly as he described masturbating 20 times in one day" and had seen a woman "racked with terrifying shame as she described multiple sexual partners in one evening in a bar". Both sufferers were in relationships.

Brampton's account is backed up by Thaddeus Birchard, a London psychotherapist with a special interest in sex addiction. There is "increasing evidence" that eating, shopping and gambling can become the subjects of addictive behaviour, just as with drugs and alcohol. Sex is no different, he says: "These are processes, rather than substances, but they create a release of brain chemicals in the same way. Sex and love trigger the release of chemicals similar to heroin and cocaine. The purpose of the behaviour is to obtain that pay-off."

According to Dr Birchard, sex addiction affects 6 to 8 per cent of the population (the journal Postgraduate Medicine puts the incidence at 3 to 6 per cent) and is 10 times more common in men than women. It has four defining criteria. First, the obsession with sex feels preoccupying and out of control and is pursued in spite of the harm it causes. Second, all attempts to curb it fail. Third, it has a psychological function – "generally to anaesthetise something else that is going on in the addict's life". Fourth, it is miserable to be a sex addict.

"We are not talking about happy sex here," Dr Birchard says. "We are talking about something that leaves people feeling pretty wretched and distressed." So is a happy sex addict not an addict? "I am not distinguishing sex addicts from the highly promiscuous. It is only a problem if it's a problem. If you are happy sleeping around then that's fine," Dr Birchard adds.

And the monogamous sex addict – is that a contradiction in terms? No, says Dr Birchard. "I have had a case of a man who was sex addicted to his wife. It was a problem because it was depersonalising – he turned her into an object rather than treating her as his wife."

However, it is precisely these casual distinctions between happy and unhappy sex addicts that irritate the mainstream addiction lobby – those who deal with the heavy end of heroin and cocaine abuse and see its devastating consequences. To bracket sex with these all-consuming and life-destroying addictions seems both crass and irresponsible, they say.

Harry Shapiro, director of communications at Drugscope, the charity for drug abusers, says: "When you are using heroin or cocaine to the point where everything else becomes secondary and your work goes down the pan and your relationships go to pot and life collapses around you – there doesn't seem much comparison [with sex addiction].

"You wonder whether the self-destructive behaviour that is often rooted in childhood problems or mental or emotional poverty, can be transferred across to trying to have sex with as many people as you can stumble across. Overindulging a habit doesn't line up with the clinical or even common-sense definition of a genuine addiction. People say they are addicted to watching soaps. Does that qualify? I do have a cynical view of some of this."

As the drug and sex addiction lobbies have become polarised on the issue, mainstream psychiatry has taken up a middle position. Most psychiatrists acknowledge the existence of a medical problem affecting a very small group of sex-obsessed individuals, but they distinguish this from the much larger question of what makes for satisfying relationships.

Sexuality is inherently variable and there is a danger of people with average sex lives coming to think of themselves as abnormal. There is a question, too, of where ordinary sexual experimentation shades into selfish or hurtful behaviour and then into compulsive and destructive behaviour. Evidence suggests that up to half of those with genuine sex addiction were abused as children and up to two thirds have other addictions, to drugs or drink.

Tim Kendall, deputy director of research at the Royal College of Psychiatrists and a consultant practising in Sheffield, says: "There is always a danger with a new psychiatric diagnosis that people think they have a specific problem. But it is rarely like that. There is a very small number of people who feel compelled to have sex with multiple partners. It has a lot in common with extreme promiscuity, but it includes an element of degradation – of the people [with whom they are having the sex] or of someone else such as their [regular] partner."

For Dr Kendall, the monogamous sex addict, while unusual, is not unknown. "I had a female patient who had sex six or seven times a day with her husband for a number of years. That was one of her problems – she also self harmed and drank excessively and took a lot of drugs. Her husband couldn't keep up. When she broke up with him she had a lot of sex with whoever was willing," he says.

But these cases are the exceptions. The danger, according to Dr Kendall, is that medicalising the problem neutralises the debate about promiscuity, as practised by Lord Laidlaw, Max Mosley and Russell Brand.

"This is a moral debate and it is necessary we have it. There are some circumstances in which consenting adults may choose to have multiple partners and that may be an acceptable choice. But there are many times when that is not the case, because people are behaving abusively or exploiting their position – such as someone in a senior position at work, or they have destructive feelings and seek multiple partners as a way of injuring others."

"Russell Brand says his relationships are fine – but is that really the case? He would be naive not to realise there are power relations involved and that people can get damaged. Lord Laidlaw is seeking therapy and I would have sympathy with anyone who said they had been overwhelmed [by their desire for sex] and it had done damage and they needed help. But we should not mix that up with the important moral perspective on how we should conduct our relationships."

Almost every sexually active person has at some time indulged in risky behaviour and bears the scars of damaging relationships – though few will have done so on the evidently heroic scale of Laidlaw, Mosley and Brand. Our fascination with sex addiction reflects our longing for the quick fix, the pill that can solve the moral conundrums thrown up by the complexity of human relationships.

But no such pill exists. For most of us, the psychiatric clinic offers few answers that cannot be found in the debris of our own lives.

‘I just like girls, all different ones, in an unsophisticated, unevolved way’
By Russell Brand

Addiction, by definition, is a compulsive behaviour that you cannot control or relinquish, in spite of its destructive consequences. This formula can be applied to sex just as easily as it can be to drugs or alcohol.

I have always accrued status and validation through my indiscretions (even before I attained the unique accolade of "Shagger of the Year" from The Sun – not perhaps the greatest testimonial), but sex is also recreational for me.

We all need something to help us unwind at the end of the day. You might have a glass of wine, or a joint, or a big, delicious blob of heroin to silence your silly brainbox of its witterings, but there has to be some form of punctuation, or life just seems utterly relentless.

And this is what sex provides for me – a breathing space, when you're outside of yourself and your own head. Especially in the actual moment of climax, where you literally go, "Ah, there's that, then. I've unwound. I've let go." Not without good reason do the French describe an orgasm as a "little death".

That's exactly what it is for me (in a good way though, obviously) – a little moment away, a holiday from my head. I hope death is like a big French orgasm, although meeting Saint Peter will be embarrassing, all smothered in grog and shrouded in post-orgasmic guilt.

Part of my problem was that these holidays – incessant as they were – no longer seemed to have the required calming effect. I suppose if you kept frantically scuttling off to Pontin's every half hour and ejaculating in the swimming pool then it'd become depressing after a while. At the time, I was on the brink of becoming sufficiently well-known for my carnal overindulgences to cause me professional difficulties.

The nature of my early sexual encounters had also unravelled any mystique or sentimentality around my sexuality, and made it something quite raw and rude. But I'm fortunate in that there's nothing especially peculiar or odd about my erotic predilections. It's the scale of my sexual endeavours that causes the problems, not the nature of them.

I just like girls, all different ones, in an unsophisticated, unevolved way, like a Sun reader or a yobbo at a bus stop in Basildon, perhaps because, at my core, that's what I am. I'm a bloke from Grays with a good job and a terrific haircut who's been given a Wonka ticket to a lovely sex factory 'cos of the ol' fame , and while Augustus Gloop drowns and Veruca Salt goes blue, I'm cleaning up, I'm rinsin' it, baby.

To this day, I feel a fierce warmth for women who have the same disregard for social conventions of sexual protocol as I do. I love it when I meet a woman and her sexuality is dancing across her face, so it's apparent that all we need to do is nod and find a cupboard.

Extracted from My Booky Wook, published by Hodder and Stoughton (£18.99)

'Trying to go cold turkey – one day at a time'
Elizabeth, 29, attends a therapy session for sex addicts

It's mid-afternoon on a random weekday, and I'm at a meeting of Sex and Love Addicts Anonymous in central London. Though I've arrived 10 minutes early, the room is already packed.

There is about a 50/50 split of men and women, aged from 20 to sixty-something. If it wasn't for the palpable sense of despair and lack of cocktails, this could be a book club meeting in someone's living room.

A buxom brunette wearing a "Trouble" T-shirt, which she jokes to the woman next to her "used to be her middle name", kicks off proceedings by introducing herself as "Sharon".

"For years, I was a fantasy girl who had these random encounters to cover up my loneliness. I got such a rush from sex. But I was like a drunk stumbling around in the dark: I wasn't feeling pain because I was getting my fix, but I was still getting bruised. Now I'm more vulnerable, and I'm learning that's OK. I'm being myself."

Next up is a forty-something man. "My name is Charlie, and I'm a sex and love addict," he says. "I'm in withdrawal right now, on day four of no contact with my ex. I'm so tempted to drive by her house or dial up an escort service, or go out to a bar and pick someone up just to get a fix, but I'm fighting it."

Sex and Love Addicts Anonymous has a similar modus operandi to Alcoholics Anonymous, and countless other "12-step" addiction cures. Treating it in this way does makes sense, since experts on addiction have proven that being in love – and having lots of sex – is physically similar to the buzz of taking drugs, and also has withdrawal symptoms.

Everyone takes turns to speak. Soon it becomes clear that, for most of the group, sex addiction isn't just about having a healthy libido. For many, sex and destructive relationships have become a compulsion, not a choice.

A twenty-something blond who introduces himself as "Marcus" is on Step Nine of the treatment programme, which involves making amends to people he's harmed. He admits it's been tough. "I've sent several letters and emails of apologies to women I've cheated on, and several have told me to go fuck myself and die," he says. "But with the help of my sponsor, I've got to take it one day at a time!"

Going into the meeting, I was sceptical, believing that SLAA's focus on surrendering to a higher power meant that it could be a form of cult. But in a world where relationships are the new religion, I've seen that it can in fact be a life-saver for those trying to go cold turkey.

The author asked for her name to be changed

Take the test: Are you a sex addict?
The "Sex Addiction Screening Test"

The test was compiled by Brunswick Therapy Services (www.sexual-recovery.com; 01273 302 779)

Further places to get help:

* British Association for Sexual and Relationship Therapy (www.basrt.org.uk)

* Promis Recovery Centre (www.promis.co.uk)

* Sex Addicts Anonymous (www.sexaa.org)

* Sex and Love Addicts Anonymous (www.slaafws.org)

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