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Are Tiger Woods and Jesse James Sex Addicts?

Shortly after their extramarital affairs became public knowledge, Tiger Woods and Jesse James sought treatment for sexual addictions. In doing so, their obvious contention is that their relationships with women outside their marriages are essentially no different than an alcoholic's binges or a compulsive gambler's junkets.

Some people argue that sexual addictions don't even exist-that all such behavior is entirely willful and reflects no underlying psychological disorder at all.
I disagree with the naysayers. I believe there are, in fact, those who use sex compulsively to distance themselves from underlying depression or anxiety or severe low self-esteem. They seek out sex for the "high," in order to not dwell on troubling thoughts or feelings-such as a gnawing sense of not being loveable at all. They aren't having sex simply because it is available to them and they enjoy it. They're "driven" to their drug of choice, much as others are driven to gamble, or work ceaselessly, or get high on marijuana. It's all about distracting themselves with powerful erotic energy that makes their bodies and their brains speed up in a futile attempt to outdistance their emotional pain.
Indeed, there may be those whose brain chemistry makes them more vulnerable to needing an escape. Those who tend neurologically (perhaps genetically) toward depression or anxiety or addiction may be at special risk.
But, let's get back to Tiger and Jesse. True addicts generally can't hide their addictions from loved ones for years. They tend to need their drugs so much that they lose control and run into problems that make their disorders very apparent. Alcoholics get drunk, fall down, have trouble at work, drive under the influence or end up gravely disappointing their spouses or kids or friends. Heroin and oxycontin addicts end up with tolerance to their drugs-needing more and more to get the desired effect, until they don't work at all. Then they go into withdrawal and/or collapse into depression. Compulsive gamblers end up in debt, losing homes and retirement accounts and businesses and, yes, marriages.
Tiger and Jesse have very strange addictions, if they have them at all. These "addictions" were silent until revealed by the media. These "addictions" would, if the two men were unmarried, possibly be called their lifestyles, plain and simple. You see, every other addiction involves using too much of one thing, not needing a wide variety of it. Alcoholics don't go shopping for new, pretty bottles of beer. They often stick to one brand, in fact, almost religiously. Compulsive gamblers don't scour the world for the sexiest new casino. They like being high rollers at their special table. Heroin users don't switch dealers again and again and again and again. Workaholics stay long hours at one job; they don't moonlight at 16 of them.
I wonder when someone will get caught with a lover outside of marriage and simply say, "I enjoyed it. I chose to indulge my passion. I didn't think I would be caught and I intended to hide this forever. I'm not sure I would make a different decision today, except for the price tag I am now paying. I was ill-equipped for marriage. I felt like I was suffocating. And, anyhow, it's really none of your business." That kind of honesty might heal us all a little bit.

Dr. Keith Ablow is a psychiatry correspondent for FOX News Channel and a New York Times bestselling author. His book, "Living the Truth: Transform Your Life through the Power of Insight and Honesty" has launched a new self-help movement including www.livingthetruth.com. Dr. Ablow can be emailed at info@keithablow.com.

Dr. Keith Ablow is a psychiatrist and member of the Fox News Medical A-Team. Dr. Ablow can be reached at info@keithablow.com.