When golfer Tiger Woods made a public apology to his wife and family for the pain and humiliation his sexual escapades had caused them, he said he was caught up in an "intoxicating cocktail of entitlement, fame and money."
"I thought I could get away with whatever I wanted to," Woods said. "I was wrong. I don't get to play by different rules." Woods did not describe himself as a sex addict.
Nonetheless, Woods' sexual excesses, his intensive treatment in one of the country's premier addiction centers, and his subsequent apology have placed the controversial subject of sex addiction onto center stage.
An array of experts argue that sex addiction is real and treatable. Costly centers like the one Woods is attending have sprung up along with support groups and individual therapists who specialize in the area.
Yet mental health experts disagree sharply about what sex addiction is, how treatable it is and even whether it exists.
Rob Kurzban, an experimental psychologist at the University of Pennsylvania, is incredulous that Tiger Woods' behavior would be called an addiction and is stunned that the media have bought into that concept.
"It is not that Tiger Woods or other high-profile people are addicted to sex," Kurzban says. "They are addicted to cheating, to sexual variety. They could have all the sex they want with their wives and no one would find that upsetting."
Sex addiction is not included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), the encyclopedia of the American Psychiatric Association, and it will not be listed as an addiction in the DSM-V, which will be published in 2013, though it could make later editions.
"There just isn't enough evidence in peer literature, as there is in alcohol, drug or even gambling, to classify it as an addiction," says Charles O'Brien, professor of psychiatry at the University of Pennsylvania and chair of the DSM-V working committee for substance-related disorders.
Does this mean, as Kurzban suggests, that Woods and other luminaries like Eliot Spitzer and David Duchovny may not be sex addicts, as has been suggested, but may simply have a broken moral compass? Would more ordinary men be called cheaters or worse?
The answer depends on whom you ask.
Those who treat sexual addiction maintain that while it is perplexing, there is no question that it exists. "The myth is that you have to take chemicals to be addicted," writes Patrick Carnes, considered a guru in the field of sex addiction and who heads the Gentle Path program where Woods was treated for 45 days before heading for another facility in Arizona. "We accept that people can be sick with alcoholism or destroy themselves with gambling or food - but not sex."
