Sex addiction...stolen from Fox News

The past few years have put a very public face on what's usually a rather private issue: sex addiction.

As a contributor to Good in Bed, and a therapist who's certified to treat sex addiction, I'm pleased that celebrities like Tiger Woods, Jesse James and David Duchovny have come out of the shadows, and admitted they have a problem with sex, and checked themselves into rehab.

Unfortunately, not everyone is so supportive. If these men were drug addicts or alcoholics, we'd all be praising them for taking responsibility for their lives. Instead, they're fodder for tabloid stories and jokes by late-night talk-show hosts. It's easy to dismiss “sex addiction” as an excuse for bad behavior.

But it's not that simple. Although you can be unfaithful to your partner and a sex addict, there are big differences between plain old infidelity and sex addiction. For one thing, cheaters have more control over what they do: They choose to cheat. Yet sex addicts feel little control over their actions. Sure, they have sex — but, believe it or not, they don't really want to. It's a compulsion. In fact, sex addiction has little to do with sex itself. It's about the person's relationship to sex, much the way eating disorders aren't really about food, but how a person acts around it.

So how do you know if you or a loved one is grappling with sex addiction? In general, sex becomes a problem when it begins to control you and interfere with your life. It often begins quietly, with solo activities like looking at porn and masturbating. I know: I just described a lot of you! (And while sex addiction is most common in men, it affects everyone — male, female, straight, gay and bisexual).

But sex addicts can't stop there. They masturbate at the cost of their relationships and productivity by preferring it over sex with their partners and doing it at work at the cost of their jobs. As their tolerance for pleasure increases, they move on to sex with other people, always pushing the envelope and often putting themselves at risk for health, relationship and even legal consequences. Still, they can't stop. For sex addicts, the drug of choice is that neurochemical cocktail of adrenaline, dopamine and other feel-good substances released by the body during sex. And they'll do whatever they can to keep chasing that rush.

If you suspect your spouse or partner is addicted to sex — and that's easier than ever with access to e-mail, Internet browsing histories and other technological footprints — try not to feel betrayed. Sex addicts don't deliberately try to hurt their partners, and the problem has nothing to do with their existing relationship. While it's tough not to explode with anger, don't shame him or her. Chances are, he or she already feels ashamed of his or her actions. Instead, frame your conversation in terms of how his problem affects you (“I feel hurt,” “I'm worried about our relationship,” etc.). Don't put the burden to get better on your partner — this is your problem, too. After all, you're in this together.