WHEN celebrities are exposed for their sexual shenanigans, and as part of the damage control exercise to redeem themselves in the public’s eye, the way to go usually involves “sex rehab”.

Think Tiger Woods, Ashley Cole, Jesse James. Caught with their pants down and no way out, and desperate to save their image as well as their marriage, they would plead that what they had done was beyond their control, that they needed therapy. They need help for their sex addiction – that is their mantra.

The jury’s still out though if “sex addiction” is actually a medical condition. (See stories on P3.) That aside, what goes on in a sex rehab centre? Details so far have been sketchy and fuzzy.

Hollywood Life quoted a recovering “sex addict” who reported that during a typical six-week stay, patients sign a celibacy vow and must abstain from masturbation. They are also forbidden to bring along or use any computers or mobile phones. Presumably that’s a measure introduced to stop patients from slobbering over porn or indulging in online sex chats.

There’s also “Disclosure Day” when the patient has to tell his wife about all his affairs and every indiscretion he had committed.

In a Time.com report, Dr Douglas Weiss, executive director of the Heart to Heart Counseling Center in Colorado, the United States, said addicts were encouraged to disclose the full range of their behaviour to their partner when confronting their distortions of reality in the second stage of treatment.

“Recovery is a three-legged stool for a couple – his recovery, her recovery and healing, and then the marriage recovery,” noted Dr Weiss, who claimed that his 20-year addiction to sex was now a thing of the past.

The duration of rehab varies from two-week outpatient seminars to inpatient clinics that involve stays of up to six weeks. Treatment – to address both the addiction and its underlying causes – covers a mix of one-on-one sessions, group therapy (including art therapy) and family counselling, with addicts and their partners encouraged to participate in supplemental 12-step programmes. (See saa-recovery.org/ for a sample of one programme; there are variations used by other organisations all modelled on the original constructed by Alcoholics Anonymous.)

According to Rob Weiss, founder and executive director of the Sexual Recovery Institute in Los Angeles, the first stage of treatment involves a full evaluation of a patient’s history and any past trauma. Weiss claimed that all the men he had worked with experienced some form of abuse or neglect in childhood. The resultant sexual, physical or emotional trauma needs to be addressed before the patient can be freed of his “addiction”.

In the second stage, the patient is confronted with his distorted view of reality. Hard questions are put to them, that might seem shameful but are meant to force them to understand what really happened.

“We may not stop the behaviour, but we’re going to ruin it for you,” said Weiss.

The final stage requires relapse prevention − triggers of the addictive behaviour are identified and ways to avoid it examined. For one patient, Brian McGinness, who was addicted to porn in the first nine years of his marriage, this meant supervision by members of his church and a neighbourhood friend.They acted as “accountability partners” who monitored his Internet usage; with that, he has been “sober” for the past four years.

Does it work?

No one in their right mind believes that “sexual addiction” can go away with just weeks of rehab. So at Heart to Heart, clients are encouraged to come back for annual polygraphs to test their sobriety.

According to Maureen Canning, a clinical consultant at Meadows Addiction Treatment Center in Arizona, simply working through the “addiction” could take two to five years of therapy, enhanced by 12-step programmes for both partners; working through related trauma could take a lifetime.

Benoit Denizet-Lewis (who has been treated for sex addiction himself), author of America Anonymous: Eight Addicts In Search Of A Life, says sex addiction is not about remaining abstinent for the rest of your life. “It is about learning to have sex in a way that makes you happy again.”

Going into rehab is not just for anyone. According to a 2008 BBC report, for a typical 35-day stay, it would set someone back by £20,000 (RM107,500 in 2008). So for those with no money in the bank, the best bet (for those in the United States) is to give one of those organisations like Sexaholic Anonymous and its 12-step programmes a try.

The demystifying of “sex addiction” and sex rehab has been taken to new levels, with reality TV even getting into the picture. There is a show called Sex Rehab With Dr Drew in which participants live in a facility for 21 days. Viewers are shown “actual” therapy sessions with the participants, handled mainly by Dr Drew Pinsky who claims to be an addiction specialist. Dr Pinsky has even gone on The Oprah Winfrey Show to publicise his work.

Does rehab really work? Dr Petra Boynton, a British psychologist and university lecturer, said via e-mail that many centres had not evaluated their practice nor made it clear what kind of therapy they offer. So it is unclear what happens within different therapy settings.

“Once patients return home, different therapeutic approaches make different demands on them − some stipulate no masturbation, others allow it but only with a partner. Some forbid any sexual stimulation aside from sex with a spouse. Some require continued therapy for clients and their partner, others insist on lie detector tests,” added Dr Boynton.

She questioned the effectiveness of such treatment for patients and their partners as little is known of the results.

“Very little research has been done in this area, which is worrying. If we are offering therapy, we ought to know how it works and how effective it is in repairing relationships or helping people recover,” pointed out Dr Boynton.

Options

According to Integrated Psychology Network Sdn Bhd consultant psychologist Valerie Jaques, there are no sex rehab centres in Malaysia.

However, she noted that some drug rehabs do assist those with “sexual addiction” as, in some cases, multiple addictions are involved.

For those in Malaysia who think they might need treatment, the suggested route is therapy. “The patient needs to have very strong willpower,” noted Jaques.

There is also the medical option. Dr Boynton said that while antidepressants and hormonal treatments can reduce libido, it is presumed that problematic sexual behaviour is only about sexual activity.

“In many cases, what causes distress when a partner cheats is not just the physical act of betrayal, but other behaviours including emotional intimacy with another or lying, that can also cause harm. Simply medicating someone is unlikely to address whatever is driving underlying behaviour,” she explained.

In an online New York Daily News article, Denizet-Lewis said that despite widespread scepticism about rehab for sex addicts, the addiction is no less crippling than a bout with booze or drugs.

“You can put down a drink or a drug and not have to see it for a while,” he said. “But you can’t go anywhere without your genitalia or your brain − those are attached to you.”