As I’m studying it, the door swings open and a tall woman with a pear-shaped body walks in. She has brown hair, unwashed and pulled back in a tight bun. She’s wearing a loose-fitting flowered top over brown slacks and flat shoes. The corners of her lips are pulled slightly downward in a permanent frown. She looks the group over, careful not to make eye contact with anyone or acknowledge his individuality. Whatever the opposite of sex is, she embodies it.

      She lands with a thud in the rolling chair. Sifting through a stack of manila folders, she shows no tenderness, no humanity, no humor. She is our doctor and judge, the stern mother we’ve been fucking women to try to escape from and the bitter wife who’s caught us.

      Her name is Joan. And her mere presence ripples through the flesh of each man in the room like a violent chill.

      “Have you completed your assignment?” she asks a man in his mid-thirties. He’s thin and blond, with a sweet, boyish face, ruddy cheeks, and the beginnings of an oddly incongruous potbelly.

      “Yes,” he says nervously. “Should I read it?” His red name tag identifies him as Calvin.

      “Please.” There’s no warmth or caring in her voice, only authority and a drip of condescension. In fact, everything she does and says is so measured that her personality seems artificial, like a mask she puts on before walking into a room to face ten male sex addicts. And she fears that if she drops it, if she gives up any ground, she’ll lose control of these predatory animals she must tame and civilize.

      “These are the ways in which my sexual addiction has hurt my life,” Calvin begins. “I lost my house and my brother. I booked a trip around the world with him and snuck away to see escorts in almost every city. I’ve spent a total of a hundred and twenty-five thousand dollars over the course of my life on escorts.”

      “Are you counting everything you’ve spent?”

      “I think so.” He braces himself as if he’s about to be attacked.

      “Did you include your Internet bill?”

      “No.”

      “Do you use the Internet to find escorts?”

      “Yes.”

      “Then include your Internet bill. And your phone bill, if you called any of these women you dehumanized.” She spits out the last word like a preacher damning him to hell. “Include the money you spent on taxis to see these women and the money you spent on condoms and the entire cost of any trip where you saw them.”

      “Okay, then maybe it’s two hundred and fifty thousand?”

      A quarter of a million dollars is still not enough for Joan. As she pushes him to add up every penny even peripherally involved in the pursuit of sex, I think about how I’ve made my living off my so-called sex addiction. My sex addiction pays for my phone, rent, and health insurance. It pays for breakfast, lunch, and dinner; for movies, books, and the computer I’m writing on; for socks, underwear, and shoes. Fuck, I couldn’t afford to be here getting treatment without it.

      When I look back on my childhood, I see a malnourished nerd wearing cheap black-rimmed plastic glasses, too big for my little face yet too small for my gigantic ears. And I see greasy brown hair chopped awkwardly short—at my request. I hated my curls. Everyone else had straight hair and I wanted to fit in. Even my own mother called me a follower.

      My losing streak continued not just through high school—where my junior prom date left the dance with another guy and my longest interactions with attractive women were during haircuts—but through college and my twenties. I sat on the sidelines, watching other people have fun. Eventually I made that a full-time job and started writing profiles of musicians for a living. When things got particularly lonely in the long droughts between girlfriends and I craved female touch, I’d go to an Asian massage parlor. And even there, I got the feeling they were making fun of my awkwardness behind my back.

      But one day, everything changed. I embedded myself with the world’s greatest self-proclaimed ladies’ men, hoping to turn my losing streak around. After living with them and traveling the world with them for two years, I finally developed the confidence to talk to women I was attracted to and, for the first time in my life, the ability to attract them to me. The book I wrote about my education at the hands of these unlikely Lotharios became so infamous that it eclipsed everything I’d done before. And so my pursuit of sex didn’t destroy my life, it made my career.

      How frustrating, then, to find myself in rehab some five years later, trying to unlearn everything I’ve spent so much time and energy learning.

      “Do you realize that you’re harming these women when you use their bodies to masturbate with?” Joan admonishes Calvin. She senses he’s on the verge of tears, then tries to bring him over the edge. “They don’t care about you. These are hurt and abused women. And you’re reenacting their childhood trauma. You are their father, their first boyfriend, the predator who raped away their innocence.”

      And that’s it. Calvin is done. His head rolls down and he covers his eyes with his palms as the tears spill out. Victorious, Joan takes a verbal lap around the room, asking different patients to report on what their sexual addiction has cost them, breaking down each of their defenses, stripping them of the last vestige of ego and pride they’ve retained from any affair or adventure or transaction.

      When a thin, laid-back patient with thick black hair and a cratered face mentions a girl he had an affair with, Joan recoils and spends ten minutes lecturing him on the use of the g-word. “As a therapist, when I hear the word girl, I have to automatically assume that you’re talking about a minor. And I’m obliged to report that.”

      The air in the room thickens with confusion and discomfort. Finally, the accused replies, “I’m a sex addiction therapist also. I’ve been practicing for fifteen years. And I have never heard that interpretation of the word girl before in my life.”

      Joan raises her head like a cobra about to strike: “If I hear you use that word again, I will report you. And you will not make it to your sixteenth year as a CSAT.”

      That shuts him up. Another man down.

      A CSAT is a Certified Sex Addiction Therapist, a designation invented by Patrick Carnes, the Johnny Appleseed of sex addiction. While working with sex offenders in the seventies, he began to view sex as an addiction like alcohol and he believed it could be treated with the same twelve-step program. So in the decades that followed, he started lecturing, writing books, setting up treatment centers, studying thousands of sex fiends and their families, and crusading to get psychiatrists to recognize sex addiction as a mental disorder.

      On the wall over Joan’s desk, there’s a small framed photograph of Saint Carnes himself in a majestic dark suit and striped tie, forehead shining below his receding hairline like the halo of an angel, wedding-band-consecrated left hand resting in the foreground. He’s smiling crookedly and looking down beatifically on the room of sex addicts prostrate before him.

      Except for Calvin, who’s never had a serious girlfriend and is here because he got a Brazilian hooker pregnant, every other sinner seems to be in the room for cheating—some regularly for decades, others once or twice. And so they come here, trying to work off the sins of the flesh and hoping Saint Carnes can perform a miracle and save the family that is both their greatest achievement and their greatest burden.

      Looking at abject Adam and scared Santa Claus and penitent Charles, I think: I need to fix this problem now. Because otherwise I’ll be right back here like them after I’m married, fighting to keep my family together.

      When Joan releases us, I stand up to head to the cafeteria, but she stops me. “You need to stay and sign some paperwork.” She makes no eye contact.

      Instead, she turns to her