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Awakening in the ICU, she at last understood what she had become: a sex addict.

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For Valerie, sex was a form of self-medication: to obliterate the anxiety, despair, and crippling fear of emotional intimacy that had haunted her since being abandoned as a child.

“In order to soothe the loneliness and the fear of being unwanted, I was looking for love in all the wrong places,” she recalls.

He also learned that his fixation on sex was a way of avoiding his insecurities and tackling the emotional issues that first led to his addictive behavior. “We treat it very much like sobriety for an eating disorder,” says Robert Weiss, founder of the Sexual Recovery Institute in Los Angeles. ’ We look at your goals and figure in your sexual behaviors and validate what’s going to lead you back to the behavior you don’t want to do.”Although sex addicts sometimes describe behavior akin to obsessive-compulsive disorder, research hasn’t directly correlated the two.

“The addiction will take you to a place where you’re walking the streets at night, so keyed up, thinking, ‘Maybe I’ll just see if there’s anybody out there,’” he says. “They have to define for themselves based on their own goals and belief systems: ‘What is healthy eating for me? But a growing body of research shows how hypersexual disorder can fit into other forms of addiction.

Valerie called phone-sex chat lines and pored over online pornography, masturbating so compulsively that it wasn’t uncommon for her to choose her vibrator over going to work.

She craved public exhibitionism, too, particularly at strip clubs, and even accepted money in exchange for sex—not out of financial necessity but for the illicit rush such acts gave her.

In perhaps the least sexy sex scene in the history of moviedom, Brandon appears to lose all humanity during a frenzied ménage à trois with two prostitutes.

“It’s a foursome with the audience,” says director and co-writer Steve Mc Queen. Not just in terms of people liking the movie, but psychologically.”However powerful and queasy Shame’s odyssey into full-frontal debasement may be, the film only begins to tap into the dark realities connected with sex addiction.

Where previous generations had to risk public embarrassment at dirty bookstores and X-rated movie theaters, the Web has made pornography accessible, free, and anonymous. And though watching porn isn’t the same as seeking out real live sex, experts say the former can be a kind of gateway drug to the latter.“Not everyone who looks at a nude image is going to become a sex addict.

But the constant exposure is going to trigger people who are susceptible,” says Dr.

Some 1,500 sex therapists treating compulsive behavior are practicing today, up from fewer than 100 a decade ago, say several researchers and clinicians, while dozens of rehabilitation centers now advertise treatment programs, up from just five or six in the same period. “Where it used to be 40- to 50-year-old men seeking treatment, now there are more females, adolescents, and senior citizens,” says Tami Ver Helst, vice president of the International Institute for Trauma and Addiction Professionals.