A lot of people, and some therapists, don’t believe that porn addiction exists. They believe that men who act out sexually or watch porn do so because there is something wrong with their ability to have ‘normal’ sex. But for the thousands upon thousands of men, and in some cases women, whose lives have become controlled by their need to fulfil their sexual urges through various sexual activities this addiction is a real issue.

Nor is it a condition of the young. I have worked with clients in their sixties and seventies who have become addicted. One, Sean*, had been visiting prostitutes since his wife had their first child and had been doing so for 36 years without her knowing.

So, what is sex addiction? Sex addiction is an umbrella of addictions tied in with sexual acting out and is an uncontrollable, overwhelming, need to perform this activity regardless of the consequences. For some this can be masturbating to porn. And, in fact, the use of porn is not only the increasingly main way to get a sexual thrill but is also affecting younger and younger men.

Others are addicted to dogging, visiting prostitutes, having affairs, or exposing themselves - the list goes on and on. The key is that this behaviour is consciously, or subconsciously, helping us reduce sadness, disappointments or boredom in our lives.

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With the introduction of the internet fifteen years ago the watching of porn, initially pictures but soon videos, was made much easier. And unlike buying ‘dirty’ magazines off the newsagents’ top shelves, porn became accessible in one’s bedroom with the click of a button. So no embarrassment was involved and there was less likelihood of being caught. Now, of course, with smart phones one can look at porn in the office toilet too.

Addiction to sex has always been with us. The general belief over the ages has been that these were men who had high sex drives and couldn’t keep it in their pants. But increasing awareness of this devastating condition and the introduction of internet porn has meant that therapists are seeing more and more people addicted to, or compulsive about, sex. It is estimated that some 3 to 5 per cent of the population may now be affected.

Sex addiction shouldn’t be confused with a high sex drive nor thought to only affect men. Women can become addicted but it seems that although some women desire the physical side others become addicted to having relationships.

There are believed to be two main reasons that cause addictions in general. The existence of a trauma in one’s life or that there was poor attachment with one’s primary caregivers in early childhood. However, I, and some other therapists, believe that with internet porn in particular there is a third reason - opportunity addiction.

We are now seeing young men who have been looking at porn consistently since the age of 11 or 12 or even earlier. Paul* is a good example of someone who came to me desperately trying to stop as he was unable to develop open and trusting relationships. He started watching porn at the age of 13.

The excitement he felt quickly developed into it being normal to watch every day. Especially as his mates told him they did too and they even told each other which were the best sites. In turn this became an uncontrollable need to watch videos. Now at the age of 24 he is emotionally drained and sees himself as a bad person as he is unable to control himself.

Unfortunately watching porn is now also becoming even more ‘normalised’, as the professional videos using models are being replaced by amateur videos of people performing sexual acts. To a young teenager this suggests that it is OK to watch others perform - otherwise why would these adults put videos of themselves online?

But it is not the behaviour, or sexual acting out that is addictive. In fact it is the behaviour that gives the body perhaps the most addictive drug there is - dopamine. Dopamine is the body’s feel good chemical and we all get hits of it through the day. When we eat nice meal or a bar of chocolate; when we have a drink; when someone praises us and so on. For most it makes us feel good but we are not controlled by it.

For some reason that we don’t know fully yet, although there are some theories, a small proportion but important number of people need the dopamine fix more and more and more. To the extent that their lives are focused on getting the next fix. Just like other drug addicts and alcoholics.

So, how do therapists treat sex addicts? The challenge is that unlike other addictions it is not viable to ask the addicts to completely abstain. Although with porn addiction this is an option. The reason being that sex is an integral part of living. And if we want close intimate relationships, being sexual intimate is usually part of this.

So therapists, trained to work with sex addicts, focus with the client on discovering the triggers that set them on the road to act out. Then, mainly using CBT, the client develops strategies to avoid these triggers and so reduce the possibility of sliding into the sexual activity that they do not want to perform.

There is no point in denying that it is hard to take back control, especially with porn addiction, but it is possible and many, many clients have done so successfully. The key is to want to stop, to work with a therapist who believes that sex addiction exists and has some training in the area and to accept that occasionally you might slip up. But you are determined to get back up and start again.

* Names have been changed to protect my clients