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Actor David Duchovny left sex addiction rehab on Monday with big plans to film a new movie and return to life as usual with his wife, actress Téa Leoni, and their two kids.

A month after checking in to the centre, a lawyer for the Californication star said the treatment was "successfully completed."

But what does that mean, exactly? In a world where sex addiction is absent from the Diagnostic and Statistical Manual of Mental Disorders, the clinical bible for psychiatrists and psychologists, fans and celebrity gawkers are left wondering how Mr. Duchovny spent his time in rehab. Was one month of therapy really enough to keep his sexual urges at bay?

Therapists and physicians who recognize the disorder say sex addicts definitely need more than 30 days to "get sober." People seriously hooked on sex face the same challenges as those who abuse drugs, alcohol and gambling, says John Pitt, director of Asklepion Toronto, a sex therapy clinic.

"It's all about trying to sort of soothe or avoid emotional dynamics inside the person," he says. "For some reason, some people choose sexual behaviour, some choose alcohol."

Addicts are stripped of all control when they enter sex rehab, barred from sexual activity and anything that might turn them on.

"Treatment of any addiction begins with abstinence," says Graeme Cunningham, director of the addiction division at Homewood Health Centre in Guelph, Ont. "Three months, 90 days of complete abstinence of sexual activity," he says, a pact that goes far beyond the standard one-month stay in rehab.

A typical day in an inpatient sex clinic starts at 6:30 a.m. with exercise, usually a brisk walk around the facility, Dr. Cunningham says.

The subsequent hours are spent talking about sex - patients learn how to banish sexual fantasies and realize that their actions are hurting others, he says. In groups of eight to 10 people, addicts will ask and answer questions such as "I thought about calling and paying for sex last night. What do you guys think about it?" Dr. Cunningham says.

"I teach my addicts: You're not responsible for the first thought, but you are responsible for the action afterwards."

Like a drug user coming down from a high with no powder or pills in sight, sex addicts go through slow and painful withdrawal, Dr. Cunningham says. "Agitation, depression, restlessness, anger, insomnia. There are a lot of emotional feelings and behaviours, like jonesing," he says.

Coffee, cigarettes, the Internet - anything addictive is strictly off-limits. TV watching is monitored and visits from family are usually verboten. There's a lot of trust-building too - with others and with themselves, he says.

Rehab centre staff do not peek in on patients to check whether they're masturbating. If a patient stumbles or relapses while in treatment, they need to own up to it in group therapy, and the therapy will intensify after that, he says.

The trick is teaching the sex addict how to be intimate in a healthy way after checking out, Mr. Pitt says.

"Unlike alcohol, we need sexuality in order to be healthy. While an alcoholic would need to move toward a life without alcohol, a sex addict would need to be moving toward healthy sexuality," he says.

Patients are finally ready to go when they recognize their problem, are able to follow the tenets of the 12 steps and can stick to a 90-day celibacy plan, Dr. Cunningham says.

But some physicians, such as Paul Fedoroff, don't think total abstinence is a cure. The co-director of the Sexual Behaviours Clinic at the Royal Ottawa Mental Health Centre says he once saw a patient who claimed to have sex 10 or more times a day.

After talking to the patient, the doctor linked his sexual behaviour to his frustration from being unemployed, and helped him find a job. The behaviour disappeared.

"It's kind of like a signal. ... Sex is never the problem. It's always the other problem coming out of that" that needs to be addressed, Dr. Fedoroff says.

Though celebrity gossip websites declared Mr. Duchovny "recovered" this week, addiction battles are not won in 30 days, says Doris Vincent, an Edmonton-based psychologist and certified sex-addiction therapist.

"Treatment doesn't provide recovery. Treatment sets you on the road to sobriety," she says.

But if even if Mr. Duchovny attends Sexaholics Anonymous meetings, visits a shrink and remains celibate, should he go back to playing his randy character on the Showtime drama?

"That's something he should take up with his therapist," she says.