Chances are you've known someone, maybe even someone in your own family, who's struggled with a addiction to cigarettes, or alcohol, or drugs. But what about an addiction to sex? A growing number of medical experts are saying compulsive sexual behavior is a very real disorder that an estimated 16 million Americans are fighting -- men and women.

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“Daily, I sit down with people who look back at the wreckage in their life and say knowing all along, ‘Why would I do this stuff?’ says Dr. Patrick Carnes, director of sexual disorders services at Arizona's Meadows Treatment Center, where they first coined the term sexual addiction.

He says the same way people can be addicted to drugs, alcohol or gambling, they can be addicted to sex,anything from Internet sex, to obsessive masturbation, to out and out affairs.

How do experts tell what makes a person a sex addict as opposed to just liking sex?

“You look for the obvious things, like bad things happening, knowing that you are doing something that is going to hurt you so you make efforts to stop that don't work,” says Dr. Carnes. “Obviously, you’ve got a problem.”

“There was that selfish needy, lonely, angry part of myself that didn't want to stop and saw that sex was my solution to other things,” says Mark Laaser. Laaser seemed to have an insatiable need for secret sex. To anyone who knew him it would have seemed incomprehensible. He was married with children, a minister and counselor, an icon of respect. But that wasn't enough. Mark says, early on he felt an emptiness, a loneliness that sex seemed to fill.

“It was just an excitement, a raw excitement- kind of like what a drug addict would describe,” says Laaser. “It was just a high.”

It was a high Mark started experiencing at a young age. When he was 11, he says he discovered  pictures, what we'd call soft porn now.

“And some of that is not abnormal for a person seeing that for the first time,” says Laaser. “Of course when it becomes abnormal is how preoccupied you get with it.”

He was so fixated by what he saw, he started stealing Playboy magazines from the local drugstore.

“And then also for me, I started crossing moral boundaries almost right away…Stealing magazines -- and I’m a preacher's kid, a minister's son,” says Laaser. “So I knew that stealing was bad. But I was willing to go ahead with it because the high was so fantastic of what I was experiencing.”

How to get help • National Council on Sexual Addiction and Compulsivity • The Meadows addiction treatment center

In high school, Mark hoped his behavior might stop when he met Debbie, the girl he thought could change him.

“There was a part of myself that she just didn't know because I wasn't revealing it to her or anybody for that matter,” says Laaser.

He wasn't revealing that he was now doing more than looking at magazines. He was watching porn videos, masturbating daily. Debbie, unaware of Mark's double life, trusted him and they got married. Mark hoped that married life would bring an end to a life pre-occupied by sex.

“ All this crazy stuff in the past, that will be over now. I’m getting married. I'll have a regular sexual partner and so forth,” says Laaser. “But I was amazed early on, even in the first year of marriage, that my temptation to masturbate and look at pornography returned rather quickly.”

A lot of people think human beings are preoccupied by sex a lot of time, so what would be so unusual about your feeling?

“The part that was unusual was where my mind tended to go with it,” says Laaser. “I wanted to experience it. I wanted to act it out. Eventually I had a lot of preoccupation with planning or doing or thinking what it would be like.”

Mark soon was no longer planning, but doing, paying monthly visits to massage parlors, having sex with so-called "masseuses,” all the while hiding it from Debbie, whom Mark says, he still loved deeply.

“I was always completely attracted to her,” says Laaser. “There was just something so much deeper in me that can not be satisfied by sex.”

He says something deeply emotion was missing, and he wondered why he didn’t just stop.

“Probably a million times over the course of my acting-out history,” says Laaser.

“I was wracked with shame and tried time and time again to stop,” says Marnie Ferree.

Like Mark Laaser, she knows what it's like to be out of control. For Ferree, it wasn't so much about  sex itself, but about the relationships she thought she could have by engaging in sex with acquaintances and friends.

“The sexual part was pleasurable and it was a nice byproduct for me but that wasn't the most important thing,” says Ferree. “I was trying to get non sexual needs met sexually and that was the only way I knew how to meet those needs.”

Ferree says that as a child, she was sexually abused by a family friend, a not uncommon precursor to later addiction. Ferree’s promiscuity lasted from her teen years through two marriages, with numerous affairs. She felt an emotional void she says that sex filled -- at least initially.

“At the time there is an incredible adrenaline rush,” says Ferree. “It’s a connection that I found I couldn't replicate anywhere else. But immediately after that experience is over, I mean driving back home there is this incredible let down and you're just in a wash of shame.”

That shame that worsened after Ferree was diagnosed with cervical cancer. The cause, she was told, was a sexually transmitted disease.

“That was the lowest point,” says Ferree. “I experienced three surgeries in a year as treatment of that cervical cancer. Had a major hemorrhaging after one of those surgeries. I mean my life was literally in danger and I found still that I could not stop.”

She was sick, married, a mother, and yet none of those things could make her change, even though she was horrified by what she was doing.

“It's about feeling rotten,” says Ferree. “I want to feel better. What way am I going through a ritual to feel better? I’m connecting with someone, I’m going to act out sexually. I feel horrible after that and the whole cycle starts over again.”

Ferree was desperate. Sex with her husband was not enough, and she believed the only way to stop having sex outside her marriage, was to end her life.

“I had really strong suicidal thoughts,” says Ferree. “But I knew I couldn't keep on living but I was too afraid to die.”

Ive sometimes gone home with people Im not even that attracted to and yet I feel like if I dont have sex with them it's just the most horrible feeling.

Another woman, we'll call her “Karen,” was overtaken, too, by the addiction, and by her own shame, so raw that she asked us to hide her face and use a different name.

“It’s just this 24 hour distraction,” she says. “Like the shame that causes I feel like it just stole my soul.”

Karen is in her 30's, she's single, and for almost as long as she can remember she's been pre-occupied with finding love -- which for years , she says, meant having sex, several times a week with strangers she would pick up in bars, frequently putting herself in dangerous situations.

“I ended up going home with a group of guys like 10 year younger than me,” says Karen, “and I figured I would have sex with one of them and maybe have a relationship. But I ended up having sex or doing sexual things with several of them. And that was a new low… Absolutely humiliated. What horrified me the most about it is that these guys were graffiti writers and they wrote on my body and that's what made me feel like oh my God, I was just completely used as an object.”

She even found herself contemplating prostitution.

“That actually seemed like a logical thing to do since I found myself having sex with people I didn't know anyway,” says Karen. “And I kind of became obsessed with some ads in the back of a free newspaper for escort services and I went on a couple of interviews.”

Mark Laaser was also building toward behavior he would never have thought was possible for him.

He had degrees in religion and divinity, had attended seminary school, was a deeply committed Christian who by this time was an ordained minister.

“There was that good side. There was that moral side. There was that caring side,” says Laaser.

And yet, he'd escape, furtive and guilty, to feed his sexual addiction. At the same time, he was working on getting his PhD in, of all things, psychology.

“Now I’m  the Reverend Dr. Laaser,” he says. “And there are people that are going to be attracted to that and I actually wound up becoming sexual with some of my clients at that time… It happened multiple times over a 10-year period…[I was] frightened, incredibly frightened…I think for years I felt totally worthless. I can’t describe to you the times I would sit in church, even preaching on a Sunday morning, thinking God's grace was for everybody else but certainly not for me.”

Laaser was preaching redemption, but for him, redemption might be more difficult. He betrayed parishioners, colleagues, and clients. It was a trust  about to be shattered.

“One of the people I was involved in with had reported that... yes, the very thing I was afraid of actually happened. Eight very angry people called me in, canceled my appointments for that day,” says Laaser.

He says he didn’t even realize what they knew, “until the first one opened his mouth and started talking. Then it all came crashing in on me.”

Laaser’s colleagues at the center where he was a counselor angrily confronted and fired him. They would help him get treatment for his sexual misbehavior, but first, they said, he had to  tell his wife Debbie, everything.

“I was totally blindsided,” says Debbie. “I had no idea that this man I had been living with for 15 years -- married to for 15 years -- could possible have been doing all these things. And Ill never forget the look on Mark's face. Actually he was sitting in a chair across from me and I guess today what I know is broken-ness in a person… I think there were times truthfully when I questioned whether I would stay. There were times I know when I felt so extremely sad, that I wasn't sure we would ever be able to have happiness in our life again.”

And then in the midst of all that pain, her husband felt something else.

“This pent up secret that is now over 30 years old is now all of a sudden out of the bag,” says Laaser. “I don’t have to protect the secret anymore. So I think mixed up with fear, sadness and confusion there was a sense of relief.”

So is it really about the sex?

“No,” says Dr. Carnes, “but that's the mistake people often make. It's really about pain…or escaping or anxiety reduction. It's a solution.”

Marnie Ferree thought sex was her solution to painful feelings, but it was a solution that was not working. After years of failing to  will herself to stop having sex with acquaintances, she was ready to take her own life. And then, at last, she confided in someone.

“I picked up the phone and called a dear friend and poured out this awful saga of my life and said I need help,” says Ferree.

She did get help help. A therapist helped her learn to deal with the childhood sexual abuse that contributed to her many affairs. Her second marriage survived and is, she says, better.

Ferree was suprised to find she wasn't alone. About a third of sex addicts are female, which is why, to do something to help other women, she went back to school to get a degree in counseling.

“I didn't choose sex addiction,” says Ferree. “Sex addiction chose me and this field chose me.”

She now runs a counseling program for sexually addicted women, called Bethesda Workshops.

“Women are afraid to talk about it,” says Ferree. “We're afraid of being labeled as whores. It's kind of guys will be guys, men will be men. But for a woman to be out of control in her sexual behavior, there is just a whole other level of shame.”

Karen, awash in that shame, one day found herself surfing the Internet to see if she was the only woman in the world who suffered her way – which is how she came across Web sites for sexual addiction. She learned about and entered a 12-step program and has been dealing with sex appropriately for a year.

“The real problem for most sex addicts they would say to you, I wouldn't know healthy sexuality if it hit me over the head. So how do I know when I am in my craziness and when what am I doing which is a normal healthy reaction to have. And that's part of what recovery teaches,” says Dr. Carnes.

Mark Laaser has been in recovery for over a decade. He say's it's a continuing process. After his sexual misbehavior was exposed, Mark entered a sex addiction treatment center for a month, where he received psycho therapy, called Faithful and True Ministries. He still occasionally goes for counseling and relies on the support of those around him -- like Debbie -- who stayed by his side through it all.

“I never had these real feelings of just running and leaving,” says Debbie. “I wasn't aware that running would solve anything necessarily.”

Their relationship eventually strengthened. They dealt with some of the loneliness Mark felt and both found comfort in their religious faith.

“Now that Debbie and I are more spiritually intimate, sex in our relationship is totally satisfying,” says Laaser.

His work has also helped him. He is again counseling others -- including men with problems like his. So why can’t people just stop?

“When you have a compulsive gambler,” says Dr. Carnes, “you’re not taking a chemical. When you have compulsively overeating, you’re not taking a chemical. In other words, we produce chemicals in our brain whether we use an outside chemical or not.”

Increasingly, studies, like one at Vanderbilt University, are being undertaken to see if brains of sex addicts are somehow different, if sex addiction is a true, measurable disorder. Yet despite growing interest in such research, there are still some who do not believe it is a true addiction. The American Psychiatric Association's diagnostic manual, for example, does not list sex addiction as a disorder.

“That book is always changing,” says Dr. Carnes, “and a consensus is starting to build. People who work in the addiction realm are starting to get a common agreement about how to start describing this.”

But however the scientific debate works out, people like Marnie Ferree, karen , and mark Laaser want to help other people recognize the problem they could not, and find out that there is hope.

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