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How to Cure a Sex AddictWhat kind of counseling did Bill Clinton get?

By Christopher Beam
Posted Thursday, Dec. 21, 2006, at 7:00 PM ET

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A recent article on Hillary Clinton's political engine-revving mentioned that her husband, Bill, has received "counseling for a sex addiction." How do you cure a nymphomaniac?

The same way you'd cure any kind of addict: with counseling, group therapy, and, in some cases, medication. You won't find an entry for "sexual addiction" in DSM-IV, the standard manual of mental disorders. In fact, there's some controversy as to whether "addiction" is the best terminology for what might just be a naturally heightened sex drive. But many doctors discuss it in the same terms as a chemical dependency: Like drug addicts, sex junkies exhibit escalating behavior, withdrawal symptoms, and an inability to stop despite adverse consequences. Self-deceptive thinking and denial (e.g., "I did not have sexual relations with that woman") may play a role, often accompanied by feelings of shame. Having lots of sex isn't the only symptom. Looking at lots of porn also counts, as does acting out with anonymous partners, or excessive masturbation. (Sound familiar? Find out if you're a sex addict here.)

The treatments for sex addiction, like those for drugs and alcohol, are diverse, and experts differ on which works best. Psychologists might treat a sex addict with a cognitive behavioral therapy that focuses on the mental processes that lead to addiction, or a psychodynamic approach that looks at underlying causes, such as childhood trauma and longstanding feelings of neglect. (One British man recently claimed he became an addict after suffering a head injury.) Organizations for people with sex addictions—Sexaholics Anonymous, Sex Addicts Anonymous, and Sex and Love Addicts Anonymous, to name a few—offer volunteer sessions across the country and tend to feature 12-step programs modeled after the Alcoholics Anonymous template. Some treatments have a religious component, too: A Washington Post article from 2000 claimed Bill Clinton received weekly "pastoral therapy sessions."

When conventional methods fail, a sex addict might consider enrolling at a residential treatment facility—better known as rehab. Some of the best-known centers treat all types of addictions—and nearly all sex addicts have other dependencies, too. Programs vary in length, but they're never cheap: Costs usually run about $800 to $1000 a day.

In some cases, a doctor may recommend medication to suppress sexual appetite. Drugs like Depo-Lupron (normally used to fight prostate cancer) and Depo-Provera (used for contraception purposes) lower androgen levels and, thus, sex drive. You can't get them over the counter, though—a specialist will usually administer the drug once a month via injection. Because sexual addiction is usually accompanied by other disorders, the patient will often take these meds along with antidepressants.

It's hard to say what constitutes recovery from sex addiction. The goal isn't to eliminate sex from your life—although temporary periods of abstinence may be necessary. Some therapists describe it as the difference between alcoholism and social drinking—you're healthy when you can handle moderate amounts in nondestructive ways.

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Christopher Beam is a Slate political reporter.
Photograph of Bill Clinton on Slate's home page by Tang Chhin Sothy/AFP/Getty Images.
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