ON A SWELTERING DALLAS morning in August 1990, Ed got up early and went to work before the sun was up. At his office he began pecking away at his computer. At about six-thirty he called his wife to see if she was awake. He told her things were going well. Then he walked out of his office, got in his car, and began driving.

“I get undressed as I drive,” he later wrote in a detailed journal that was part of his therapy. “Once I’m naked, I pull into an alley, pop the trunk, and lock up my clothes. I get back in the car and drive on. I pull up behind an apartment complex where the parking lot joins an alley. My blood is roaring now. I am euphoric. I step out of the car. There is the thrill of those first few moments I always experience at this spot as I walk deliberately from the car to the alley.”

Ed (not his real name) proceeded, in what had become a well-practiced ritual of exhibitionism, to walk around the alleyways and streets that surrounded the apartment complex, flirting with the exhilarating danger of detection. At well over six feet tall and weighing more than two hundred pounds, he would be difficult to miss. But that was what made it so exciting. He wasn’t out to shock anybody—it was the risk that gave him the rush.

Ed recalls that, despite the light of day and the increasing traffic, he was obsessed with the idea of crossing a nearby freeway overpass, completely nude, during morning rush hour. The first few times he started to make a break for it, more cars approached. Finally, he managed to do it, but the police spotted him and blocked his escape route. The aphrodisiacal thrill of risk and escape was now replaced by the throbbing dread of getting caught.

He found a couple of towels draped over a fence and tied them around his waist. He tried to get back to his car by dashing across several lanes of freeway traffic, risking his life. But it was to no avail. “Suddenly four police cars converge on me,” he wrote in his journal. “There’s nothing to do. The numbness hits.”

Ed was taken to a police station in Farmers Branch, booked for indecent exposure, and fingerprinted. He called his wife, as he had on half a dozen other occasions, to come bail him out. And then the shame set in—huge, nauseating waves of it. “I knew then,” Ed later recalled, that I couldn’t go on hurting her like that, or my kids. This thing had total control of me. I had to do something.”

It wasn’t that he hadn’t tried before. Indeed, Ed had been counseled by one therapist or another for twenty years, ever since he was first arrested for indecent exposure, when he was 26. He knew it was wrong, and he knew it was crazy, but he always found himself returning to his bizarre compulsion to disrobe and masturbate in public. He was an intelligent man and, he wanted to believe, normal in most respects: He had been married to the same woman for 25 years, had fathered three children, and had made a success of himself in every career path he had set out on. He was a former PTA president and Sunday school teacher.

How does a guy like that wind up in jail for flashing? He didn’t know, but he desperately wanted to find out. And like increasing numbers of people in the grips of compulsive sexual behavior, he turned to a twelve-step, self-help group called Sex Addicts Anonymous (SAA). Recalling that first SAA meeting, Ed wrote in his journal, “Not a one of them was like me. Yet they were all like me. None of them acted out as I did. We all did different things, but, I realized, we all did them for the same reasons.”

THEY COME THREE EVENINGS A WEEK to this small room at a Baptist church: men and women, old and young, members of the professional and the working classes. People whose appearance is as ordinary as their problems are extraordinary. Some are like Ed, citizens whose sexual “acting out” is so mystifying that much of society simply regards them as irredeemable. Many more are like Ron (also not his real name), a middle-aged attorney who began attending an SAA recovery group almost ten years ago simply because he was what many of us would call oversexed—promiscuous with multiple partners, female and male, to the extent that it had destroyed two marriages and stunted his career.

They are aware that much of society regards their “addiction” with, at best, bemusement, at worst, derision. “This is even more difficult than, say, alcohol or drug recovery,” says Ed, who eventually served a one-year, unadjudicated probation for his exhibitionism that August morning and has now been “sober” for more than six years. “With [alcohol and drugs], you have a problem that society recognizes, a form of self-help that it endorses. With sex addicts, most of them have come in here on their own—their attempt to recover is as secret as their behavior was.

“Everybody has a private sex life,” he adds. “Sex addicts have a secret sex life.”

It was the secret sex life of an untold number of Americans that prompted Minneapolis addiction therapist and researcher Patrick Carnes to write Out of the Shadows, the 1983 best-seller that first introduced the concept of sexual addiction to the masses. Though Carnes’s book didn’t ignite the sort of firestorm that The Kinsey Report had 35 years earlier, he did propose a highly provocative notion: Much compulsive sexual acting out—ranging from chronic promiscuity like Ron’s to more-aberrant behaviors, like Ed’s exhibitionism—could be understood best as the product of an addictive disease, not unlike alcoholism. Sex had entered the realm of “addictionology.”

Carnes had first struck on the theory while treating sex offenders, alcoholics, and drug addicts in the seventies. He eventually theorized that for certain people, the euphoria of sexual arousal and satiation performed a function similar to the blissful stupor of booze or the rush of cocaine, “medicating” an emotional malaise. The self-medication generally came via some inappropriate or excessive pattern of behavior: compulsive masturbation, promiscuity, exhibitionism, obscene phone-calling, or voyeurism. Carnes came to believe that sexual acting out, like alcoholism, tended to be ritualistic, compulsive beyond the addict’s “best thinking,” progressive, and ultimately self-destructive. It most frequently presented itself in concert with another addiction—alcohol or drug abuse, an eating disorder, or compulsive gambling or shoplifting (most addicts, he said, were “polyaddicted”). It was frequently an inherited condition, and three quarters of a group of addicts he studied had been sexually or physically abused as children. For those who had escaped outright abuse, Carnes found varying levels of neglect or dysfunction in the families.

Carnes further proposed that compulsive sexual acting out should be treated differently. Professional therapy was still required, of course, as was appropriate punishment for addicts who broke the law. But sex addicts—as opposed to sex offenders—would benefit most, Carnes said, from the combination of tough love, peer group support, rigorous self-examination, and spiritual growth provided by a twelve-step group fashioned after the venerated Alcoholics Anonymous.

At the time, the treatment of sexual acting out—if it was treated at all—was mostly punitive. The chronically promiscuous husband went to marriage counseling with his wife. An exhibitionist like Ed was offered counterconditioning, or aversion therapy, such as popping an ampule of ammonia and sniffing it every time he found himself fantasizing. The most serious of deviates were treated with powerful libido-suppressing drugs such as Depo-Provera, or they were simply sent to prison. The Carnes approach addressed the addict’s pain, suggesting that inappropriate sexual acting out should be treated with compassion and understanding. The emphasis was less on taking blame than accepting responsibility, the goal not merely to modify misbehavior but to address its roots.

Even though Freud had identified masturbation as the “original addiction” a century ago, Carnes’s theory of sex addiction invited skepticism. To many people, the whole idea seemed to be just another example of the twelve-stepping of America, one more group of misbehavers claiming victimhood. “I got it from all sides,” recalls the therapist, who now practices at the Meadows, an addiction-treatment facility in Wickenburg, Arizona. To some, the theory seemed overly prudish: Was promiscuity or an obsession with pornography really a self-destructive addiction requiring treatment? Others found Carnes’s notion far too liberal: How could incest be compared with compulsive eating or even alcoholism?

The skepticism was perhaps to be expected. Alcoholics Anonymous had gone through the same sort of public doubt, even scorn, during its formative years in the thirties, and the fact that this latest alleged addiction involved sex only heightened the reaction. Yet for every skeptic there seemed to be a believer. Following the publication of his book, Carnes was deluged with mail from sexually tormented individuals who had never known what to call their problem and who had had trouble finding help. Self-help groups for sex addicts—which had actually sprouted up in a few isolated quarters as early as the mid-seventies—began growing, and today SAA (founded in Minneapolis in 1977 and now based in Houston) has 500 chapters across the nation. (Texas, by the way, has the second largest number of local SAA groups—61; only California has more.) A similar group, Sex and Love Addicts Anonymous, has about 1,000 affiliated local groups in the U.S. The Internet lists about a dozen sex-addict self-help groups, including Prostitutes Anonymous. The total number of sex addicts is impossible to pin down, as is the total of alcoholics and drug addicts. Carnes estimates that at least 6 percent of American adults may be afflicted with some form or degree of it, with a male-to-female ratio of 3 to 1, including certain clergymen who sexually molest young parishioners. And don’t forget about a certain president brought to the brink of political destruction by his “inappropriate” sexual behavior. Indeed, since Clinton’s problems with Monica Lewinsky were publicized, the main question on peoples’ mind has been: Why would the most powerful man in the world risk everything for the momentary pleasure of an illicit sexual encounter? Ed and Ron think they understand why.

THE TWO MEN CAME TO SAA FOR DIFFERENT reasons: Ed in a last-ditch effort to corral a behavior that would sooner or later land him in prison, Ron to gain control over a voracious and indiscriminate libido. Like AA’s, SAA’s twelve-step program does not pretend to be able to cure the addict—its goal is to help him manage his affliction. Both Ed and Ron had tried and failed, despite the havoc they were wreaking on their lives. And they were both all too aware that the public saw their behavior as a matter of weak character, to be remedied by an extra dose of willpower.

But for Ed, no amount of willpower could rein in his compulsion to take his clothes off and traipse around in public. “There were two of me,” he says today. “There was the normal, hardworking family man with a more or less normal sex life. Then there was the exhibitionist me.”

Ed’s exhibitionistic behavior began early in life, around age five. He does not remember being abused sexually as a child, though he does remember that his father was rather liberal about his own nudity around the house. He also recalls being extremely lonely as a child and having an inclination to act compulsively, going on occasional shoplifting or vandalism binges.

At the time, his urge to disrobe in public places might have seemed like harmless child’s play. But it most definitely had lost its innocence by age 26, when he was first arrested for wandering around naked in a parking lot in the wee hours. Ed says that a few days before that evening, he had been fired from his job but was in a good mood—he was excited about his prospects for the future. “I was driving home late, like after midnight, and I just found myself pulling off into this shopping center parking lot, taking off my clothes, and then just walking around.” The police eventually showed up at the scene, and after a spirited chase around the empty lot, Ed was arrested and charged with misdemeanor public indecency.

“I look back on that,” he says, “and I realize that I was acting out like that as some kind of relief from anxiety, just like an alcoholic might go get drunk. It was my way of medicating myself, and I kept on doing it.” Everyone “medicates” occasionally, seeking respite from depression or grief with a drink or two. And sexual intimacy has long been known to relieve stress. But the difference with individuals prone to addictive behavior is the degree of their emotional suffering—and hence, their compulsion to self-medicate. Ed, Ron, and other sex addicts I spoke with all described “something missing” that their compulsive behavior filled for them, a formless anxiety that it relieved.

Over the years, science and sociology have speculated about the source of this amorphous angst felt by all addicts—sexual and otherwise. There are nature and nurture hypotheses. Many addicts inherit their addictive predisposition. According to much recent research, a defective gene, or genes, causes a chronic shortage of neurotransmitters such as dopamine, a chemical in the brain associated with feelings of pleasure and well-being. Mood-altering substances, such as alcohol, or activities, like sex (which prompts a dopamine release in the brain), are abused by such individuals as a means of neurochemical compensation. This is why addicts often report that they are not abusing to get high but to feel normal. Addictive tendencies can also be a matter of nurture. Early childhood experiences such as physical, sexual, or emotional abuse—and consequent feelings of shame—can literally alter a child’s developing neurochemistry, causing deficiencies that he will later seek to self-medicate. Frequently, the addict who has been abused as a child will find his acting out to be, in fact, a reenactment of the particular form of abuse that was inflicted on him. He becomes addicted, as it were, to the trauma.

Whether it’s nature or nurture (Carnes says it’s usually both), the person predisposed to addictive behavior enters adulthood with a pathological self-esteem, a self-image of unlovability. Once the addict finds his medication of choice—alcohol, drugs, sex, food, gambling, or some combination—his neurochemistry can become further imbalanced. The medication is now not merely desired but required. A craving is created.

So for Ed, getting arrested that night in the parking lot, which should have been an ignominious ending to his bizarre compulsion, was really just a beginning. Over the next twenty years, as Ed and his family moved to different cities and he undertook different career paths, the one constant in his life was his exhibitionism. By his own estimate, he has acted out at least 10,000 times, often engaging in his compulsive ritual three or four times a day. Over time he began to romanticize it. “I always cast myself in the role of the outcast hero rebelling against the mores of a too-staid society,” he recalls. Like other addicts, he was living in a kind of trancelike state. “During my waking hours,” Ed says, “I’d be in a near-constant state of fantasy and inner agitation.”

By the time he was arrested that morning in 1990, he says, “I knew it was over. There was no real thought process per se. I realized I’d already done my thinking. I still had the number of SAA and a therapist. The only way to not get arrested again was to stop doing this.”

FOR RON, FACING UP TO HIS ADDICTION was much less dramatic, but in its own way, just as difficult. Ed had the advantage of engaging in compulsive sexual behavior that was clearly illegal and bound to bring him into contact with the law. But Ron’s acting out had always been not only legal but also, because of an increasingly permissive society, generally acceptable. “You remember how the seventies were,” he says. “It was a sex addict’s dream.”

After his playing around led to a divorce from his first wife, Ron found “the perfect sex partner” in his next wife. Except his dream girl didn’t dampen his lust for extramarital sex. Indeed, to his consternation, he suddenly found himself philandering not just with women but also with men—even though he had never been sexually attracted to them before. Ron came to view it as a matter of efficiency. “Sometimes I’d meet a woman, and of course, I’d immediately begin thinking about how to get her into bed,” he says. “But then I’d realize that it might take dinner and a lot of conversation to accomplish that. With men, I could just go to a bath house, and it was all very quick. I didn’t really consider myself bisexual; I was just behaving bisexually. My partner in sex didn’t matter at all.”

Like compulsivity, objectifying sex—draining it of any of its emotionally nurturing qualities—is a hallmark of sexually addictive behavior. Soon Ron was out of control, operating in the same sort of trance that Ed was in when he exposed himself. “I was acting out three, four times a week,” he remembers. “After a long day’s work, I’d begin thinking about what kind of sex I was going to have later. You know, male or female, pick somebody up in a bar, or go to the woods someplace. There was a point at which I began to realize it had control of me, not the other way around.”

By 1988 Ron began to think he might need help. The problem wasn’t just the damage to his second marriage. “It had just diminished my potential as a lawyer and a human being. There were peers of mine making half a million a year and up in the legal profession, and I was just in private practice. It takes a lot of time and energy to be an addict. When my mind was the slightest bit blank, I’d immediately think of sex. And it would hang in there until I did something about it.”

By happenstance, Ron read a reference to SAA in a newspaper advice column. “It was the first time I’d ever thought of the idea of sex addiction. I thought, maybe that’s my problem with sex.” He wound up at an SAA group. “The first meeting I went to was in this guy’s living room,” he recalls. “There were a handful of the most ordinary people I’ve ever seen there. Then they started talking about their troubles. The main thing I began to realize is that a lot of the sex-addiction problem isn’t just about sex.”

EVEN THOUGH THE SEX-ADDICTION SELF-HELP movement has attracted a huge following, it has an uneven track record at actually “sobering up” sex addicts. “Sobriety with this addiction is tough,” says Ron, who admits to relapsing several times during his ten years in recovery. “See, there’s a critical difference here. An alcoholic’s bottom line is just don’t take a drink, period. With us, no one’s saying, ‘Don’t ever have sex again.’ They’re saying, ‘Find a normal sex life.’ That’s hard. Sex is much more difficult than booze or drugs because of that element of fantasy that is often the real addiction. That’s why, for the time being, my bottom line is celibacy until I get things figured out.”

The movement has also suffered from its own popularity. “There may be too many different groups to achieve the unity that AA has,” Carnes says. “I’d say the sex-addiction recovery movement is about where AA was in 1960 or so—still struggling for respectability.” Some of the splintering has been over the issue of the addict’s bottom line. A group calling itself Sexaholics Anonymous, for example, eschews the idea of allowing addicts to set the parameters of their own recovery and flatly states that the only healthy recovery from sex addiction is one that allows sex only within marriage. Groups have also diverged because of gender. As with AA in its early years, women were slow to show their faces at meetings. The brutally frank, male-dominated discussions of sexual misbehavior often put them off, and as one female addict told me, “The nature of the addiction and how it shows is going to be different with a woman. A woman’s problem may just be that she’s codependent with a male sex addict, or it could be that she’s more of a love addict than a sex addict—addicted to the guy and the relationship, not necessarily the sexual acting out.”

Many sex addicts use private therapists to augment their self-help recovery programs, though, as Ron and Ed agree, maintaining a productive, long-term relationship with a therapist can be hard. Managed care doesn’t look kindly on most mental health claims, let alone those involving a condition that is not officially recognized by the psychiatric establishment. (The American Psychiatric Association does not list sex addiction as a psychiatric disorder in its most recent edition of the Diagnostic and Statistical Manual, which was published in 1994, and the American Society of Addiction Medicine does not yet recognize it as an addiction.) A sex-addiction problem frequently has to be piggybacked on a more acceptable diagnosis, such as depression. Similarly, most large treatment centers, which have been effective in treating alcoholism and drug addiction, don’t treat sex addiction, but addicts have found help by seeking out those that embrace the polyaddiction concept. One facility that does is the Sante Center for Healing near Denton. Though Sante doesn’t treat extreme sex offenders, like pedophiles and rapists, many of its patients either manifest a sex addiction in addition to a substance-abuse problem or face up to a sexual compulsion once they are in drug or alcohol treatment. “Treating addictions as somehow different from one another doesn’t make sense,” says the center’s clinical director, Deborah Corley. “The whole point is to get at the source of the urge to relieve internal pain by somewhat maladaptive means.”

For Ed and Ron, it’s one day at a time. In the tradition of recovering alcoholics, both do volunteer work with sex addicts, counseling sex offenders in Texas prisons and on parole. Ron is thinking about starting a clearinghouse “where people with this problem who don’t know where to turn can get referrals.” Ed has spoken at police stations, telling his story in an attempt to explain the mind-set of individuals who act out as he used to. He has also offered them tips on how to catch sex offenders.

Despite such efforts, Ed is not overly optimistic about the future of SAA and its brethren. “I’m not sure the sex-addiction programs will ever be accepted the way AA has been. Maybe the best we can hope for is that society will at least realize that we are humans and we are generally trying as best we can with dysfunctional self-beliefs and that we—some of us—can get better.” Ron, for his part, is seeing a woman seriously for the first time in years. By mutual agreement, they have decided not to have sex until they get married. “It’s very exciting for me that this is working so well, but I’m nervous,” he says. “I’ve messed up most relationships because of sex. That’s why we’re doing this the good old-fashioned way.”