Sex Rehab: Real Therapy, or a Band-Aid for Infidelity?

Tiger Woods. David Duchovney. And now Jesse James.

All would appear to have had way too much of a good thing.

Unlike drug or alcohol addictions, the world depends on people having sex. But lately, what more celebrity husbands are finding is that, like drugs and alcohol, things can get out of hand with sex, too.

James, the focus of a cheating scandal that may spell the end of his five-year marriage to Oscar-winning actress Sandra Bullock, is seeking professional help to deal with "personal issues" — reportedly at a sex rehab clinic in Arizona.

A representative for James told People magazine on Tuesday that he “realized that this time was crucial to help himself, help his family and help save his marriage."

Psychiatrist and Fox News contributor Dr. Keith Ablow said he thinks James may have to address some issues he has with his image — and not just his tattoos.

“With sexual relationships there may be some underlying self esteem issues, like questions about how desirable you are, whether as a person or as a man,” Ablow said.

James will have a long road of recovery ahead of him at the Sierra Tucson clinic. Dr. Ian Kerner, a New York City-based sex therapist and author of "Sex Recharge," said the program is much like what alcoholics and drug addicts go through, but with a more specialized level of intensity.

“Sex therapy is based on a classic 12 step program, a combination of group therapy, cognitive behavior therapy, and looking at what triggers are, psychoanalysis,” Kerner said.

The most challenging part of being in sex rehab is that the environment is sex-free.

“You are not exposed to triggers. No internet, erotic materials, access to anything that might trigger arousal. It’s about isolating and detoxing someone from triggers,” Kerner said.

The rumors of James’ unfaithfulness surfaced not long after Bullock gave a tearful speech honoring her husband at the Screen Actors Guild Awards.

Kerner said James could learn a lesson from Bullock’s attitude toward their marriage and apply it to his therapy. He said he thinks the success of the recovery may depend on whether the patient is able to look past just the physical aspects of sex.

“The key is that he needs to associate it with emotions — developing a bond and using sex as an expression. Program him to use [sex] as intimacy, not gratification,” Kerner said.

Ablow said he thinks James and Bullock’s situation is not that uncommon, and that women in Bullock’s position need to ask themselves -- not just their partners -- some tough questions.

“We have a crisis in this country in which many people feel their marriages are a source of stress, not strength, and where more than half of marriages end in divorce,” Ablow said. “I think if you were Sandra Bullock you would have to say to yourself, ‘Is this an addiction, or is this my partner’s character?’”

Ablow said he believes in the reality of sex addiction, but wonders about James’ genuine motive for recovery, since he is admitting himself to rehab only after his affair was discovered.

“It shouldn’t be a case that an addiction only becomes a problem when the press and other disclosures find out about it. So to declare an addiction only after being found out makes a very thin case,” Ablow said. “Is this an addiction that you could have had for the next 30 years? Addictions take their toll whether people know about them or not.”

In some ways, sex therapy can be even tougher than drug or alcohol therapy, because no one expects a patient to give up his addiction forever.

“If you’re an alcoholic, drug addict, you can stop and go cold turkey—just stop using," Kenner said. "Someone in sex rehab has to be able to return to sexual activity. They need to have sex again, and are going to have sex again.”