I am a 24-year-old man. Recently, I watched a documentary on porn addiction that has given me the confidence to ask for help. I began looking at porn when I was 13. I was enthralled, masturbating regularly. I was shy in front of girls and didn’t have a girlfriend until I left university, when I stopped looking at porn and masturbating for a year, and tried to follow a spiritual life of yoga and meditation. I thought I had overcome my addiction and could casually glance at porn, but one look quickly escalated to three or four times a day. It makes me feel dirty and ashamed as well as depressed and angry. I enjoy a healthy, loving sex life, but feel sad that often I’m not comfortable in my own skin until I have looked at porn and masturbated. My loving girlfriend knows about it and gets upset that it affects me so strongly and that I complain about it but seem unable to stop. I would be really grateful if you had any advice on overcoming this addiction.

I salute your courage. This is a subject that needs to be talked about more openly. It is shrouded in shame, pain and secrecy, but is on the increase – perhaps because people find it so difficult to admit to, let alone ask for help. People laugh at sex addiction, but I get increasing numbers of letters about it. Usually, they are from women whose boyfriends and husbands are hooked on pornography. The pain caused to those women, and the shame and guilt those men feel, are not the subjects of comedy.

According to Life Works, one of the best treatment centres in the country: “When a sexual behaviour is being acted out, with recurrent failures to control it, and continued despite significant harmful consequences to the addict, it meets the criteria for an addiction.” Another term is sexual compulsivity but, whatever we call it, it is a disorder that causes people to act in ways unrecognisable to their real self. I have sat in meetings with sex addicts; watched a man cry helplessly as he described masturbating 20 times in one day; seen a woman racked with terrifying shame as she described multiple sexual partners in one evening, in a bar. Both people were in relationships. A man may rub his penis raw, a woman may contract a sexual disease, but even that is not enough to stop them, just as vomiting up blood and bile is not enough to stop the alcoholic.

You may think, well, that’s not me; I’m not nearly that bad. All I can say is, not yet. Addictions may start slowly, but they are progressive disorders. That’s why you can’t look at porn casually, just as an alcoholic cannot have the occasional drink. Addiction is sometimes called a disease of “never enough” and is marked by escalating tolerance or a need for more and more of the substance or activity to get a high. An addict may be able to put down the habit for a month or even a year, but the minute they pick up again, they return to the same level of use. That’s why the condition needs active treatment and constant vigilance.

Pornography is just one face of sex addiction, and may be the first sign of a full-blown compulsion. Others are obsessive masturbation, sex with multiple partners, anonymous sex, multiple affairs while in a committed relationship, habitual exhibitionism or high-risk sex.

The thing about pornography is that it is safe. Real sex can be unscripted and unpredictable; pornography, though, is about control and compliance. It portrays women as always hot and horny, eager to please. It also brings intense disappointment, because it is not what people are really searching for – satisfaction involves connection or intimacy. On top of that, pornography can inspire shame, guilt and self-loathing. And what’s the fastest way for an addict to blank out difficult emotions? By using more of their drug of choice. They want to stop. They promise to stop. Then they break those promises, and feel so guilty and ashamed that – guess what? – it starts all over again.

Sex, as an addiction, is a way of managing and containing emotional pain. I know you are in a happy relationship but I suspect that, at the moment, you are managing to compartmentalise your addiction. I also suspect that it’s only a matter of time before your girlfriend becomes angry and hurt that you cannot or – as she may see it – will not stop.

Recovery begins with admitting there is a problem, so well done. Your next step is to understand the condition (I have recommended a book) and go to a support group. A Twelve Step programme (such as Sex Addicts Anonymous) is a safe place to seek help.

Out of the Shadows: Understanding Sexual Addiction by Patrick Carnes (Hazelden £13.99). Carnes is one of the pioneers in the field of sexual addiction. His website is www.sexhelp.com. Sex Addicts Anonymous: www.saa-recovery.org. Lifeworks: www.lifeworkscommunity.com

If you have a relationship question for Sally, e-mail sally.brampton@sunday-times.co.uk. In case of publication, names will be withheld. We’re sorry, but Sally cannot answer letters personally

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