Editor’s Note: This is the first installment of a two part series examining sex addiction and its effects.

At first, Beth Meier, 29, of Kansas City, Kan., couldn’t understand why she needed group therapy for her husband Sam’s addiction to Internet pornography.

“When a counselor said, ‘You should look into getting help through a spousal support group,’ I looked at her like, ‘Are you kidding me?’ Finding help for Sam, we thought, would be the answer to the problem. He’s got the problem, so he needs to fix it,” she said.

Meier discovered, however, that sex addiction isn’t a disorder that can just be fixed. And since it is not a widely understood addiction, many therapists are reluctant to diagnose sex addiction, said Dennis Detweiler, social worker and sex therapist in Lawrence.

Sex addiction is a topic not often talked about and even less often understood.

Since the Diagnostic and Statistical Manual, a manual used by psychologists, psychiatrists and therapists to diagnose disorders, has not officially acknowledged sexual addiction as a mental illness or disorder, there is much confusion over the matter.

However, the DSM, or as Detweiler called it, “A big word for the book we use to determine diagnosis and mental health,” will soon include a notation on the disorder in the manual’s fifth edition, expected to be released in 2013. But it won’t be classified in the DSM as a sex addiction. Instead, it will fall under the category of a compulsive disorder.

“(The American Psychiatric Association is) very reluctant, still at this point, to call it an addiction per se, because it’s not something conduced; it’s a process addiction,” Detweiler said. “In other words, it’s something one does – especially with sex – that is so integral to who we are as people. So to call it an addiction (seems) a little far-fetched.”

Whether it’s dubbed a compulsion or addiction, many people are affected.

In fact, about three to six percent of Americans suffer from a sexual compulsion disorder, according to a December 2008 Psychiatric Clinics of North America article by medical doctors John Kuzma and Donald Black.

Epidemiology is difficult to determine, however, because the statistics are based on people seeking help for the addiction, Detweiler said.

“Whatever statistic you would come up with, you would have to say, ‘Well, for every statistic we have, there are probably hundreds of thousands of people undiscovered,'” he said.

For many, the lack of understanding of sexual addiction among therapists, psychiatrists and counselors is what halted progression of moving past it.

Sue William Silverman, the author of “Love Sick: One Woman’s Journey Through Sexual Addiction,” a writing professor at Vermont College of Fine Arts and a recovering sex addict, said she visited 11 to 12 therapists with hopes of putting a name on her struggle but admitted, “I got nowhere with any of those therapists.”

The lack of understanding was also dispiriting for Meier.

“The confusion to whether or not this is really an addiction was really discouraging because (counselors) didn’t address it that way,” she said. “We knew (Sam’s addiction) was a problem – at least in our marriage – and it was really affecting us, so we didn’t know what to do. Sam was really lost.”

The hallmark of the addiction is that sex becomes the systematic standard of daily life.

“People who are sexually addicted are usually preoccupied,” said Dawn Opitz, psychologist at Cornerstone Family Counseling in Manhattan. “They have a loss of control and they continue the addiction despite adverse consequences. They are having affairs, they are being found out, their family and jobs are at risk, but they continue anyway.”

But not all sexual compulsion disorders include contact with another individual. There is also a sexual addiction happening outside of the bedroom and involving images and video on computers. This is the case for cybersex addict Sam Meier. Like sex, images can produce a chemical reaction in the brain for an addict.

“There seems there is a physical dependency that accompanies arousal accentuation of fantasy, and these produce chemical alterations in the brain,” said Opitz. “People are getting high from their own brain chemicals (that accompany arousal), and that is a sign of an addiction.”

About 40 million U.S. adults view pornographic websites on a regular basis, according to a 2003 article, “Internet Pornography Statistics,” by Jerry Ropelato, founder of the website, which includes reviews of internet filter software. Ten percent of adults admitted to having an online addiction to sex.

How a sex addiction stems is heavily debated, but many think an individual’s childhood can shape a person’s developmental process.

Silverman said the fact that her father molested her as a child shaped her sexual habits as an adult.

“It was my father that taught me sex was love and love was sex, so I could never differentiate between the two,” she said. “I was basically looking for love. Because you assume your father loves you and this is the way he is showing his love.”

And statistics show incestuous relationships are not uncommon. According to a 2007 National Center for Post Traumatic Stress Disorder article by Julia Whealin, Ph.D., incest is the most common form of child abuse, and 30 percent of abused children were abused by a family member.

Growing up part of an incestuous family, Silverman said, led her to mirror the behavior of hiding the truth from others as an adult.

“Any kind of addiction, including sexual, is marked by deceit and secrecy,” said Detweiler. “(Sex addicts) substitute real intimacy, really being known to the other person, with the addiction behavior. And it becomes their fall back position, their double life.”

For Silverman, she said she became “quite skilled” at leading her double life, so much so that neither of her two husbands found out about any of her extramarital affairs.