“I always had sexual desires—even before I discovered masturbation,” says E, a 26-year-old New Yorker. In his teens, he got into Skinemax, but soon progressed to phone sex. Years of phone sex, which culminated with him posing as a woman, calling massage parlors for free hot chats. “I did it almost every day,” he says, “and hid it from everyone.”

While E’s case isn’t as extreme as that of, say, Joseph Weir—who was arrested last year for grabbing and licking nearly 70 women’s feet on the subway—it illustrates how easily a fantasy can turn into an obsession. Current statistics show that 3 to 6 percent of Americans may suffer from sex addiction or compulsiveness—likely a conservative estimate. This can lead to potentially destructive behaviors: According to the Society for the Advancement of Sexual Health (sash.net), the consequences of sexual compulsiveness include anxiety, emotional distance and the loss of relationships, not to mention financial and legal woes.

Support groups for almost every obsession can be found through SASH, as well as organizations like Sex Addicts Anonymous (saa-recovery.org) and Sex and Love Addicts Anonymous (slaafws.org). The LGBT Center (gaycenter.org) also lists support groups in Manhattan.

E’s phone-sex obsession abated, although it did carry over into his adult life. “Until recently, I used to make fake AOL accounts to get girls to send me naked pictures of themselves,” he says. “I got off on creating fake personalities. I still find trickery that doesn’t really hurt anyone arousing.”