What is Sex Addiction and Out of Control Sexual Behavior?
There’s no shortage of language floating around that describes the same set of conditions: excessive use of pornography, excessive self-pleasure, or even behaviors involving affairs, sex workers, and secrecy. We can assign whatever labels we choose, but we know it when we see it. Some people refer to this as sex addiction. Others call it Out of Control Sexual Behavior (OCSB) or Compulsive Sexual Behavior (CSB). So what exactly is “it?”
There is a school of thought that assigns the label “sex addiction.” While my views do not align with this terminology, I will give some credence to this description, given that the way that we treat this condition parallels treatment for substance use and techniques employed by substance use therapists can also be used to treat OCSB and CSB. Furthermore, for some people, using the term “sex addiction” to describe the experience feels validating and helps them find words to talk to loved ones. I see great value in that, and would never advocate for moving away from helpful terms based on technicalities.
However, the literature doesn’t exactly bear out that sex can be an “addiction,” and the DSM V, the manual for diagnosing all psychological disorders, does not include “sex addiction” among its pathologies. In contrast to other addictions, there is no tissue damage or withdrawal risks from stopping sex. Sex isn’t actually a need (though connection is). This set of behaviors is classified, more accurately, as a compulsion.
Doug Braun-Harvey, one of the pioneers in the field, began using the term “Out of Control Sexual Behavior” and described the condition as sexual behavior that feels out of control to the individual. It is certainly a subjective experience, but is far less pathologizing, in my opinion, and better describes that these behaviors may be accompanied by problematic consequences such as job loss or discipline, marital problems, and even self-injury. The term “Compulsive Sexual Behavior” stemmed from the work of Eli Colman, who described intense, distressing sexual urges and behaviors that interfered with daily functioning.
Regardless of the words we use to describe the experience: sex addiction, out of control sexual behavior, or compulsive sexual behavior, please know that this is a treatable condition and therapy can help. Sometimes what seems innocent enough, such as using pornography to manage anxiety just takes on a life of its own. Pornography use or sex gets uncoupled from pleasure or connection and becomes a way of coping with a feeling or avoiding managing a difficult situation. That’s where the slippery slope starts. The way out of the problem may not be easy, and frankly, I can guarantee that, but finding a healthier relationship with sex is possible.
