Patrick Carnes, the leading expert in sex addiction, defines it as "any sexually related, compulsive behavior which interferes with normal living and causes severe stress on family, friends, loved ones, and one's work environment." But here's the tricky part: What's the difference between the symptom of a compulsive disease and a disease itself? Repeatedly lathering up in the sink is a sign of OCD. We don't call those people hand-washing addicts, now, do we? Unlike most addictive substances, sex can't be smoked, snorted or mainlined. The term isn't recognized in the DSM (the Diagnostic and Statistical Manual of Mental Disorders), the bible of therapists everywhere (although along with other controversial diagnoses, like those relating to gender identity, sex addiction is being debated for a new version). But for many sex educators and sex-positive experts, hearing the term spoken about so casually, so frequently, is nothing short of maddening.

"People can behave in compulsive, self-destructive ways," popular Savage Love columnist Dan Savage writes in an e-mail. "It is possible to fuck too much, or fuck too many people, or fuck your life up fucking. But sex isn't a chemical substance. It's not a drug."

Addiction experts argue it's the hit of dopamine delivered during orgasm that is abused. (Similar arguments are used to explain gambling and shopping addictions.) But equating those "powerful hoo-haa endorphins," as Savage puts it, with harder substances like crack is "just ye olde sex negativity on display."

Other skeptics take issue with the model for sex addiction diagnosis. An online test designed by Carnes casts a wide, sweeping net in its search for signs of the condition. Anyone who enjoys regular masturbation, has a porn collection, or indulges in an active fantasy life will likely be labeled a potential addict ... potentially in need of Patrick Carnes' services.

Richard Siegel, a licensed sex therapist, says he frequently comes across "normal, healthy college-aged guys" who have been unfortunately convinced by "flimsy pop psychology" tests that they are sex addicts for simply masturbating every day. When "Sex Rehab" star Nicole Narain, she of the Colin Farrell sex-tape fame, went on "The Joy Behar Show" in November, she complained about staying in bed all of one day to masturbate. This gave longtime sex writer (and former Salon columnist) Susie Bright a good laugh. "It is of the same tradition of hair growing on your palms from masturbating too much! It's a werewolf fantasy," she said.

Says Savage, "We live in a culture that's torn between titillation and condemnation -- that's Dr. Drew's whole shtick, actually. Titillate and condemn, condemn and titillate."

The sex addiction world does indeed seem scolding and puritanical at times. Carnes' screening test asks whether your sexual behavior has "hurt anyone emotionally," whether you have used sex and "romantic fantasies" as "a way for you to escape your problems" and whether you "feel controlled by your sexual desire." Pain, fantasy, desire -- these are all normal parts of sexuality. Similarly, the test asks about paying for everything from a dating site to a dirty magazine. As for having a healthy and moderate interest in polyamory, swinging, BDSM, strip clubs, bath houses? Fuhgettaboutit. The truth, says Savage, is that "sex addiction" is merely a clinical euphemism for "sex they disapprove of for moral reasons." As Dr. Marty Klein, a sex therapist and the author of "America's War on Sex: The Attack on Law, Lust and Liberty," once wrote: "These people are missionaries who want to put everyone in the missionary position."

What makes the debate over sex addiction such a sticky one, though, is that not all of "these people" are that way. To hear sexual addiction therapist Sharon O'Hara describe the sex she would like her patients to enjoy is to feel as though you have stumbled into a Tantric sex workshop: " We want you to feel more connected to [your partner] and the universe in general -- to have transformational sex." As for those who like to take a walk on the kinky side, she says, "I won't sit in judgment" -- so long as they are honest with their partners and feel comfortable with their lifestyle, instead of imprisoned by it.

Consider the case of writer Benoit Denizet-Lewis, the author of "America Anonymous: Eight Addicts in Search of a Life," which chronicles his own recovery from sex addiction. "I have no judgment about men having anonymous sex," he told me over the phone. "The only judgment I have is that it had taken over my life and I couldn't stop. I think there are people who can live their life in the pursuit of sex, and have a pretty limited life, and they may be OK with that." For him, that simply wasn't the case. "It ceased to be about sex," he says. "It was about numbing my feelings and feeling validated and wanted and loved." In a Modern Love column that ran in the New York Times at the start of the year, he shared a portion of a rehab writing exercise in which he was to "give voice to the addict" inside him: "I will make Benoit lie and manipulate and chase sex every hour of every day, until he can't feel anything anymore, until everything good and decent about him is removed ... I keep him numb so he can function."

Even "Sex Rehab"-ber Jennie Ketcham, a former porn star known as Penny Flame who starred in her own rough-sex guide, waxes poetic about the preciousness of sex: "It is the ultimate display of intimacy and should be treated as such," she wrote in an e-mail. "This isn't to say we shouldn't be kinky, or dirty, or have a great time in between the sheets. I just want to care about the person I'm getting dirty with, and I want them to care about me. I want sex to be as meaningful and beautiful as it is filthy and kinky." These aren't Puritans by any stretch. They are people whose lives have been steamrolled by behavior they didn't feel they could stop.

There is a staunchly religious and traditional fringe of the sex addiction community, though. Many conservative Christian counselors and organizations, including Focus on the Family, provide "treatment" for both sex addiction and homosexuality, often conflating the two. That certainly explains much of the resentment within the liberal, sex-positive community. But most sex addiction experts do not subscribe to that parochial view. The Sexual Recovery Institute has clearly stated it does not consider homosexual relationships a sign of sex addiction.

For the most part, the larger community acknowledges that "healthy" sex is subjective, so diagnoses of sex addiction often rely on the patients' feeling ashamed about their behavior. Still, who among us doesn't sometimes feel ashamed? We live in a world polluted by sexual shame and taboos. You might feel embarrassed about your porn collection -- but is it because you're morally opposed to it or because you worry your significant other might find it and ream you out? Do you regret last night's one-night stand because you did it compulsively without being able to stop, or because you're afraid of being labeled a slut?

As Susie Bright put it, we're all "fearful of lust" and "being found out" as sexually abnormal or sick -- but that doesn't mean that we actually are.

Compare that to an online survey published earlier this year by CosmoGirl.com and the National Campaign to Prevent Teen and Unplanned Pregnancy which found that 20 percent of teens have "sexted." At the time, I wrote about the research and noted that although voluntary polls tend to be self-selecting, "the results seem obvious, maybe even understated" -- because, hey, I still vividly remember what it was like being post-pubescent with access to the Internet and all manner of new technology. According to the Pew study, though, teenagers must be far less pervy and far more well-behaved than they were back in my day.

Well, that or they aren't relying on their cellphones to conduct their naughty business. Remember, the study only takes into account sex and cellphones, which leaves out e-mail, MySpace, Facebook, chat rooms and -- the list goes on. Plus, the study was conducted in late summer and early fall of this year, well after "sexting" hysteria in the media had reached its peak. Considering the extent of parental handwringing and the number of high-profile cases of kids being charged as sex offenders for sending explicit texts, they would have been smart to find another outlet -- and teenagers are nothing if not smart about findings ways to do what they want without adults finding out. 

Truly, it's like striking tabloid oil. It's pretty tough to strike oil, however, without getting coated in a slick layer of suffocating goo. And even in this largest of larger-than-life dramas, there are still fragile, mistake-prone human beings. Which is how we got in this whole pickle in the first place.

Yesterday Radar Online reported that Child Protective Services investigated the Woods family regarding possible domestic violence involving a weapon. The site posted an "incident history" from the Florida Department of Children and Families dated Dec. 11. The document lists "units at gate" of the now infamous Windemere address for a "domestic in front of children" situation that ends in "negative contact" (presumably meaning they didn't get in to talk with the embattled sports star).

Fueled by the image of a raging, club-wielding Elin Nordegren, the blogosphere promptly erupted in new speculation that Nordegren "attacked" Woods. But as CBS reported Monday, the state is obliged to investigate any complaints that come in, which means any guesses regarding the welfare of Woods' 2-year-old-daughter, Sam, and 10-month-old son, Charlie, are highly premature. It is, however, a sobering reminder that in the midst of this ongoing train wreck, there are very young children whose parents are going to have work very, very hard to keep them clean from the taint of their strained relations, two high-profile people whose worlds changed forever on Thanksgiving night. But where do they go from here?

Radar Online says Nordegren's talking to a divorce lawyer. The Daily News says she'll stick it out for the kids. Nordegren herself, meanwhile, has been spotted pumping her own gas in Florida without her wedding ring. 

That's surely not some random left-it-by-the-soap-dish-while-puttering-in-the-yard thing. If you've ever taken off a wedding ring, you know -- that symbol your beloved slipped on in front of all your friends and family and the whole world on the alleged happiest day of your life is not so lightly sloughed off. I don't know anyone who's ever done it painlessly, and I don't know anyone who wasn't making an unmistakable statement when they did so. (Elizabeth Edwards, who's still married to her famously philandering mate John, made a splash last year when she started making the rounds similarly bare-fingered.)

So while Tiger and many,  many,  many,  many of his conquests have issued their own statements, Nordegren seems content, for now, to let her finger do the talking. And it speaks volumes.

To say that Berlusconi has had a bad year would be a monumental understatement. On Sunday, a protester's shockingly brutal attack landed him in the hospital and allegations of his mafia ties have been renewed once again -- but he also has a whopper of a woman problem. He's had not one but two sex scandals: This spring, his wife publicly announced she was leaving him following rumors about his romance with an 18-year-old girl, and an Italian businessman recently alleged that he supplied the prime minister with 30 aspiring starlets -- including one prostitute -- for personal entertainment at his various vacation homes.

Then, Berlusconi dug his hole even deeper by telling Rosy Bindi, vice president of the Chamber of Deputies and one of Italy's most powerful female politicians, on state TV that she was "always more beautiful than intelligent" -- a comment many interpreted to mean that she was especially unintelligent. Her retort, "I'm not one of the women at your disposal," galvanized some 100,000 women to send in photos and notes of protest to a liberal newspaper, many of which declared, "Mr. Premier, I'm not at your disposal."

A new documentary, "Videocracy," also takes a critical look at Berlusconi's "skin is in" approach. In the film, "crowds of eager parents and grandparents egg on skittish young women" auditioning for the coveted role as a "velina," one of the many pieces of eye candy featured on Italian news programs and game shows, the Associated Press reports. (Think Barker's Beauties or "Deal or No Deal" models.) In the (NSFW) trailer for the documentary, a bevy of girls wiggle their hips and flip their hair in the desperate mating dance of 20-somethings everywhere. On a similar tack, the popular video "Il Corpo delle Donne," which translates as "The Body of Women," compiles some of the most shameless moments of T'n'A from Berlusconi's stations and state television. The most egregious example: A woman is shown suspended from the ceiling in skimpy underwear next to a literal piece of meat clad in a matching pair of panties; it's awfully reminiscent of that infamous meat-grinder Hustler cover. Worse than anything shown in either video, though, is the fact that a recent poll of young girls in Milan found that most want to grow up to be a velina.

Of course they do. In Berlusconi's world, there is no dividing line between politics and entertainment; instead, he's created a politi-tainment conglomerate of sorts. His minister for (of all things) equal opportunity is a perfect example of this: She started as a showgirl on state TV; that alone is her qualification for the job. Formidable female politicians like Rosy Bindi are derided as ugly old crows for forgoing the cleavage and collagen look of veline, while inexperienced Berlusconi appointees are giddily celebrated for being fuckable. There are many factors at play here (like a deeply entrenched patriarchal culture) but it would be hard to overstate Berlusconi's particular influence on the current sexual culture; the guy holds sway over an estimated 90 percent of Italian media.

The recent outcry shows there is hope yet for those little girls, though. More and more Italians are looking beyond the nearly naked women Berlusconi has surrounded himself with to discover that it's the emperor who has no clothes.

Technically, male prostitution wasn't expressly prohibited before, but health codes required "that prostitutes must undergo 'cervical' testing for sexually transmitted diseases," leaving those without a cervix out of a job. Bobbi Davis, owner of the Shady Lady Ranch, hired an ACLU lawyer to ask that the language be changed, and the health board approved the request. Davis intends to have male prostitutes working for her in the new year. Like her female employees, they'll decide whether to accept men, women or both as clients.

Although Davis and other brothel owners will probably be happy to have a new revenue stream in tough economic times, you know that whenever the subject of men having sex with men comes up, somebody's going to A) be unhappy and B) say something remarkably stupid on the record. In this case, the outrageously offensive overstatement of the day award goes to George Flint, longtime lobbyist for the Nevada Brothel Owners Association (and a former Assemblies of God minister), who called the decision "Pearl Harbor for the brothel industry." He predicts "fallout and backlash" because "Some may feel it's a repugnant thing to do or something that does not have the appetite of the state as a whole." As opposed to female prostitution, which everyone's thrilled about? Yep, if you ask Flint. "We've worked hard for years to make the traditional brothel business in this state socially acceptable and something we can be proud of that most Nevadans accept," he said. But clearly, a population that's cool with female prostitution, gambling and drive-thru wedding chapels will find the idea of men selling sex unacceptably tacky. Of course.