Every week, 10 men meet in Alexandria to talk about a common addiction they have long feared discussing.
The men, including a 44-year-old defense analyst who started the group in November, have uncontrollable compulsions for sex. They are not simply "oversexed," psychologists who treat them say; they are powerless over sexual impulses that can destroy their jobs, marriages and lives.
"I would think about sex 24 hours a day," said the military analyst, who asked not to be identified. "I would drive around for hours looking for women . . . .
"There were times I doubted my sanity," he said. "There was so much guilt, and yet it was like a force I couldn't stop. Once I felt pressure from work or anxiety, I'd go looking for it again . . . . Then I discovered I wasn't alone."
A highly regarded Minnesota sex psychologist says that as many as one in 12 Americans may have compulsive sexual behavior, of which there are various types. Individuals -- women as well as men, and homosexuals as well as heterosexuals -- can be affected by such preoccupations, which can result in behavior that ranges from prostitution to exhibitionism to rape.
Part of the problem is how to define such sexual conditions. Patrick Carnes, the Minneapolis psychologist and author of the pioneering work, "The Sexual Addiction," describes compulsive sexuality as secret, abusive and empty. "There is no such thing as a normal sex life," Carnes said. "But there are clearly abnormal ones.
"It can be such an intoxicating emotion for some that they become powerless," he said. "They have no sense of limits."
Carnes recalls that a physician whom he counseled was vexed by an overpowering compulsion to have sex with prostitutes. That addiction cost him as much as $23,000 a year, forced him to mortgage his home, destroyed his marriage and almost cost him his job.
Michael Quadland, a psychologist who counsels sex addicts in New York, said it is not surprising that we hear of prominent persons arrested for homosexual acts in public toilets, or public officials caught with prostitutes.
"You think when you hear these things: 'They should know better.' But this problem affects all kinds and is not something that you can stop, even if you know what you are risking," he said.
"I spoke with an attractive, sophisticated, well-educated woman in her twenties," Quadland said. "She was involved with a sadistic man, and the only way she felt affirmed was to get recognition from him." Quadland says the woman grew up without a father and was totally confused about relationships with men.
The guilt, depression and anxiety felt by afflicted individuals often leaves them with so little feeling of self-worth that some may wish to kill themselves, other researchers say.
There are no firm statistics on the number of persons affected by such compulsions because the topic is difficult to research, but many believe the problem is widespread.
Patricia J. Aletky, an administrator at the American Psychological Association in Washington, said that the "number of people for whom sex is totally out of control is more frequent than rare."
"You can't exactly do a Gallup Poll on this," said John Money, the director of the psychohormonal research unit at Johns Hopkins Medical School in Baltimore.
"There are no statistics," he said, "but there are a lot of people out there who are suffering."
Their problems, however, are beginning to win national attention. In January, the first in-patient clinic specifically to help sex addicts opened at the Golden Valley Health Clinic in Minneapolis. About 200 groups similar to the one in Alexandria have organized around the country.
Modeled after the successful Alcoholics Anonymous groups, the Alexandria organization is part of a network called Sex Addicts Anonymous.
"By calling it an addiction and treating it as you would a chemical dependency, you give the people who are suffering from this a chance to get over this very serious illness," Carnes said. "For too long they have been stigmatized by the words nymphomaniac, exhibitionist, voyeur."
Carnes' notion of equating sexual compulsion with alcohol dependency -- rather than with perversion -- is gaining acceptance among medical authorities. Last week in Philadelphia he began a five-city tour in which he is addressing hundreds of sex therapists, counselors and health professionals.
Still, the notion of sex addiction remains controversial in the medical and mental health professions.
Though most agree that the first step toward solving the problem is recognizing that it exists -- just as an alcoholic must admit that he or she is drinking excessively before the problem can be stopped -- some think the alcohol analogy ends there.
For one thing, the critics note, reformed alcoholics are never supposed to touch alcohol again.
"Sex is a healthy, positive thing," said New York psychologist Quadland, "but the term sex addict suggests the abuse of something that is bad for the body."
Clive M. Davis, the editor of the Journal of Sex Research, the publication of the Society for the Scientic Study of Sex, said that if the addict label reinforces any cultural ideas that sex is bad, "The cure could be worse than the problem."
Money, of Johns Hopkins, also questions the value of a broad term that "lumps together the problems of a man who gets stimulus from an 8-year-old and someone who constantly buys pornographic materials and pays for prostitutes."
"But by whatever name -- sex athlete, bed hopper, addict," said Nancy J. Dickinson, the executive director of the Human Sexuality Institute in Washington, the problems of destructive obsessions and excesses have been around a long time. "What's new is that we're looking at them in the light now."
With the alarming spread of herpes and AIDS, authorities say, some type of help is needed to curb the activities of people who find they no longer know how many sexual partners they have had or even who they were.
There is no recognized formula for treating compulsive sexual behavior, but most authorities say that finding the root cause of the behavior is the first step.
Abuse or neglect in childhood, a severe lack of self-worth, loneliness or a repressively religious background could trigger the compulsion, the researchers say.
"My father was a . . . minister . . . ," began the founder of the Alexandria group as he lit another cigarette over a Howard Johnson's cup of coffee.
"It was a small town," he said. "I remember being 4 or 5 and being physically abused. I don't think it was ever sexually, just beaten. First I sought release in drink, and then later whenever I wanted momentary relief I'd lose myself in sex."
Counselors agree that more people than ever are seeking help through such activities as joining a Sex Addicts group.
"We are where we were with alcoholics 15 years ago," Carnes said.
"More people are starting to talk about it, but we have a long way to go. If only people could read the letters I get, they would cry instead of sneer."
"I don't know if in my lifetime I'll be able to talk freely about this," the Alexandria military analyst said.
"I'm telling you because I know how painful this has made my life, and I want to tell others they're not alone. And yet, I would never dream of telling my boss." The middle-aged man shook his graying head. "The shock that it would cause."