This article is part four of a five-part series titled "The Business of Illicit Massage." Parts one, two , three, and five are also available online. 

It was mid-afternoon, and halfway through introductions, "Carole" paused to collect her thoughts. For several long seconds, the only sound in the room was the ticking of an old clock. Like others interviewed in this series, Carole is an alias. This suburban wife feared that someone reading or listening to this story might succeed in cracking open the secret she’s kept hidden for so long.

“Nobody knows — my family, friends, co-workers, my children never found out,” said Carole. “I’m the wife of a sex addict, whom I found out about three years ago.” 

Sex addiction is a controversial diagnosis, defined in its simplest form as “long-term compulsive and destructive behavior and craving for sex that persist despite negative consequences.” Carole said it explained why her husband had spent so much time and money in erotic massage parlors. Like on 9/11 and the day of the Boston Marathon bombing, Carole said the moment she discovered that her husband was not who he said he was is frozen in memory.

“It was the winter of 110 inches of snow, so I remember it very well," she recalled. "On my computer one day, somehow I got an e-mail response from a massage parlor thanking him for the night before. I completely flipped. Broke my heart. Married 36 years. Nicest guy in the world. Nicest dad. And like beyond shocking. Beyond.”  

Carole is now in group therapy and shares her well-hidden anguish with other women who speak only to each other about what they share in common: husbands who were caught.

One of them is a man named "Tom," a scientist in the Boston area who agreed to speak with WGBH News and the New England Center for Investigative Reporting if we guarded his identity. He visited local erotic massage parlors on a regular basis, and his wife knew more than she let on.

“She was watching me and suspected something," said Tom, who is still married. "I kept detailed records of what I did. She found those records, and it had all the dates and written in small print. On the top of the dates, I would have the parlor I went [to], and she was able to figure it out.” 

A former sex buyer, now in recovery, revisits Boston's Chinatown where he sometimes frequented erotic massage parlors. He says such establishments are all over the state.
Meredith Nierman/WGBH News

That discovery led to couples therapy and individual therapy for Tom. 

His therapist is Joel Ziff a Watertown psychologist. Ziff said a spouse’s shock that her husband is buying sex usually means the end of a marriage, but it can also lead to a cure for the addicted.   

“Most often it was discovery by a spouse that brings a person into therapy, said Ziff.

Unlike alcoholism or problem gambling, which might be forgiven, Ziff said spouses often question their own self-worth when faced with a husband addicted to massage parlor sex.   

“There's so much shame with this," he added. "It happens with other addictions, but with sex addiction it's even worse because who can you talk to? People either minimize it and say, ‘Oh, I wish I was a sex addict. Sounds like fun.’ Or else there's moral condemnation and indignity."

A Boston area business owner named "Michael," who used to frequent erotic massage parlors, has experienced that humiliation.

“The amount of shame that takes place is incredible," Michael said. "Once the massage is completed you know you can't get out of there fast enough. And then I would have a firm resolution. I will never do that again. This is dirty I want to wash this off of my body. But then a couple of days later it would just come back and even stronger sometimes.”

In an effort to stop, Ziff’s patients enroll in a 12-step program for sex addiction, much like the ones created to help alcoholics and opiate users. While the program is recommended by some organizations like the  American Society of Addiction Medicine, other groups like the American Association of Sexuality Educators, Counselors and Therapists argue that there is  not enough empirical evidence to classify sex addiction as a mental health disorder. Ziff, however, said the signs of addiction are clear and he encourages recovering users of illicit massage to build their own networks of individuals who can help them steer clear of storefront brothels.      

“A lot of times their compulsions are very strong," Ziff said. "They know people have to put filters on their computers, so it blocks them from going to sexual related sites. They have an accountability partner who has access to GPS on their phone, and they have monitoring of their bank accounts because they know that they have strong urges and can't stop.”

Joel Ziff, a sex addiction therapist in Watertown, has worked with hundreds of men who frequent illicit massage parlors.
Meredith Nierman/WGBH News

Carole said she’s dismayed that many people take a less than serious view of sex addiction diagnoses.

“We’re not talking alcoholism or drug addiction," she said. "I almost think that might have been easier. This is my whole sexuality. My life, my marriage, you know, partners. It’s devastating beyond anything I’ve ever dealt with in my entire life.” 

Though still married, Carole and her husband live in separate rooms in a suburb of Boston. Children also suffer, said another local woman named "Erika," who separated from her husband because of his behavior.        

“The behavior continued throughout our marriage," Erika said. "We had kids together. We had a lot of kids all at once. And I just noticed kind of a detachment from family life.” Her children seem to sense there is a problem, and "certainly know more than they should at their age,” she added. Both she and her husband are in therapy.

Mental health specialists say the trauma experienced by the spouses and the shame of sex buyers is magnified many times over with the women who actually work in illicit massage. WGBH News and the New England Center for Investigative Reporting found that many work in the business to pay off smuggling debt. They are almost universally poor. Many are trafficked, stigmatized and out of view of most of us. 

Because of their ages — they are generally between 30 and 50 years old — advocates say they may not be viewed as sympathetically as teenage victims and survivors of the commercial sex industry. Large numbers of illicit massage parlor workers are single mothers with children back in China, Thailand, Korea and elsewhere in Asia. And unlike the typical massage parlor user, who according to a Polaris Project study is a professional white male making over $100,000 per year, women suffering the trauma and violence of illicit massage have few mental health resources.

“Where do they go?” asked Dawn Sauma, co-director of the Lowell-based Asian Task Force Against Domestic Violence. “What infrastructure do we have in place to help them? What do victims of sex trafficking have? They need to know they have somewhere to go.”

The task force, also known as ATASK, offers counseling for exploited Asian women at three confidential sites in Eastern Massachusetts. But Sauma said not a single survivor of illicit massage parlors rescued or taken into custody by law enforcement in Massachusetts has reached out to ATASK for help. Some may simply be unaware, said Sauma, but many of these women fear the police and other outsiders more than the criminals who force them to work and many go right back to the spas.

“If you have a victim right now who’s at a police department, their safety, as ironic as that sounds, is the perpetrator," she said. "There is a reason for them to return. That’s their home. That’s where they’re receiving their food.” 

Dawn Sauma, co-executive director of the Asian Task Force Against Domestic Violence, in Boston's Chinatown.
Meredith Nierman/WGBH News

Julie Dalhstrom, who directs Boston University’s Immigrants' Rights & Human Trafficking (IRHT) Program, said another reason exploited undocumented women seem to be going back into the shadows in larger numbers is because of a greater fear of deportation.

“The increased immigration enforcement has made it almost impossible for a survivor that's a non-citizen to make a decision to move forward," said Dalhstrom.

Dahlstrom, unlike Sauma, has seen a trickle of massage parlor survivors come forward to receive psychological counseling and other help, including assistance in applying for human trafficking visas. But Dahlstrom said she has never seen this much fear.  

“Part of the issue is that involvement in commercial sex can impact their immigration case if they're undocumented or if they are documented there's a greater risk that they'll be placed in removal or deportation proceedings,” said Dalhstrom. “And in the cases involving illicit massage businesses there’s a lot of fear, stigma or a variety of different issues always present. And given the current climate is it has just worsened.”

Experts say broader immigration protections combined with culturally competent services, including counseling, are needed to assist these women. Tom, the illicit massage customer, said he is also looking for a way to help the very women he once took advantage of as part of his process toward recovery from sex addiction. In doing so, he said, he also hopes to help his wife who still wrestles with thoughts of betrayal. 

“When I was contacted about doing this interview I had a lot of second thoughts," Tom said. "I didn't want to do it because I was afraid of triggering her memories and making it harder on her. But she encouraged me to do this, and maybe I can help some people you know not go down this road. Maybe [I] could help some victims of human trafficking."

There’s no data to offer, but Tom and other men who quit illicit massage and seek mental health counseling are believed to be rare among frequent sex buyers. Police, prosecutors, licensing agencies and anti-trafficking groups say that the norm for most buyers is to continue as usual. So, the question police and advocates are now asking is, what to do next — if anything — about these illicit massage businesses that seem to open up as soon as another closes in neighborhoods across Massachusetts.

This story has been updated.

Phillip Martin is a senior reporter with WGBH News. Jenifer McKim is a reporter for the New England Center for Investigative Reporting, a nonprofit news partner of WGBH News.