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Saturday, November 5, 2022

Sexual Health: Treating Sexual Compulsivity in Sex Therapy - Is It a Sexual Addiction or Out of Control Sexual Behavior (OCSB)?

Language matters, especially in the field of mental health.  When mental health professionals pathologize compulsive sexual behavior by defining it as a "sexual addiction," they do clients a disservice.  

This article will focus on the difference between treating sexual compulsivity as out of control sexual behavior (OCSB) as defined by Doug Braun-Harvey, LMFT and Michael A. Vigorito, LMFT in their book Treating Out of Control Sexual Behavior: Rethinking Sex Addiction and treating the problem as a "sexual addiction," as in the work of Dr. Patrick Carnes (see my article: What is Sexual Health?).

Treating Sexual Compulsivity in Sex Therapy


What is Sexually Compulsive Behavior?
Let's start by defining sexually compulsive behavior.

Sexually compulsive behavior is an excessive preoccupation with sexual thoughts, urges and behavior where this behavior is disruptive and has a significant negative impact on a person's health, relationships, work and other important areas of life, including (but not limited to) the following issues:
  • Recurrent sexual thoughts, urges and behaviors take up a lot of your time.
  • These thoughts, urges and behaviors feel out of control to you.
  • Despite repeated attempts, you have been unable to reduce or control these thoughts, urges and behavior on your own.
  • Despite serious consequences, you continue to engage in out of control sexual thoughts, urges and behavior.
  • You have problems establishing and maintaining relationships, jobs or other important areas in your life because of your sexually compulsive behavior.
Sexual Addiction vs Out of Control Sexual Behavior (OCSB)
As of this writing, there is a heated debate in the mental health field about whether sexually compulsive behavior should be seen as a sexual addiction or as out of control sexual behavior (OCSB).

Treating Out of Control Sexual Behavior in Sex Therapy

Proponents of the sexual addiction perspective see compulsive sexual behavior as similar to other forms of addiction, including alcoholism and drug addiction.  In this model people who engage in compulsive sex are seen as "powerless" over their behavior.  Dr. Patrick Carnes, who has written extensively about "sexual addiction" is one of the biggest proponents of this view.

The main proponents of the out of control sexual behavior (OCSB) perspective are Doug Braun-Harvey, LMFT and Michael A.  Vigorito, LMFT.  They define six principles of sexual health in their book, Treating Out of Control Sexual Behavior: Rethinking Sex Addiction.  Instead of viewing this behavior as an addiction, they see it as sexual behavior that is out of control.  In their view it is a sexual problem but not a sexual disorder or an illness.


Treating Out of Control Sexual Behavior in Sex Therapy

Other proponents of the OCSB view, like Dr. Neil Cannon, see sexual compulsivity as being related to unresolved trauma, unresolved mental health issues, relationship issues and problematic habits.

Treating Out of Control Sexual Behavior in Sex Therapy

OCSB is not a diagnostic term.  The term OCSB refers to problems with self regulation of sexual thoughts, urges and behavior despite negative consequences.

Why Does It Matter How Compulsive Sexual Behavior is Labeled?
In my opinion (and the opinion of many others in the sex therapy field), labeling someone who engages in compulsive sexual behavior as an "addict" is harsh and shame inducing.  

Treating Out of Control Sexual Behavior in Sex Therapy

People who are labeled in such a shame-inducing way are often too embarrassed to admit they have a problem or to get professional help.

Unlike drug and alcohol misuse, people who engage in sexually compulsive behavior cannot be expected to give up having sex so labeling behavior as a sexual addiction is counterproductive to resolving the problem.

Getting Help For Sexually Compulsive Behavior
If you are struggling with sexual compulsivity, you're not alone.  Help is available to you.

Depending upon the particular circumstances, sexually compulsive behavior can be treated in individual sex therapy or in couples therapy with a sex therapist.

Working with a sex positive sex therapist who treats sexual compulsivity as out of control sexual behavior (OCSB) rather than as an addiction is affirming to your sexual health and overall well-being.

About Me
I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Somatic Experiencing and Sex Therapist.

I am a sex positive therapist who works with individual adults and couples (see my article: What is Sex Therapy?).

I have helped many clients to overcome psychological trauma (see my article: What is Trauma Therapy?

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.