Sex Addiction Out of Control Sexual Behaviors


Man with his hands together looking worried
You know you have a problem when you keeping breaking promises to stop or cut back.
There is no right or wrong amount of sex. Yet people reach out to me for help with sex addiction when they feel their sex life has become unmanageable in some way. Folks feel frustrated and confused about how to change things. Some feel deep shame that things have gotten to this point. It could be that they’ve screwed up again in their relationship, or they feel like they’ve let themselves down. Sex is likely getting in the way of other responsibilities, or what they are doing goes against their personal values. Clients can find themselves in conflict between what they want to do and what they think they should do in their sex life.

Out-of-control sexual behavior (OCSB) refers to when someone thinks their consensual sexual behaviors, urges, or thoughts feel out of control to them. People with OCSB may also struggle with depression and anxiety, or have histories of trauma, addictive behavior, or other mental health conditions which can make their situation more complex.

OCSB is treatable, and therapy can help you reclaim a sex life that makes sense and supports your emotional well-being.
Signs of Being Out of Control Sexually
Across the board, there’s an underlying feeling that you’re out of solutions on how to change and feel stuck. Each person’s problematic sex looks different. It can be expressed through more masturbation, porn watching, or sex partners than you think is healthy; spending more money on sex than you want; persistent infidelity or broken relationship agreements due to sex; or just risky activities that put your safety and health in danger. In any case, there is a real need to address what is happening.

People with OCSB may do things like:

  • hours searching for sex partners, using chat rooms, or watching pornography
  • prioritize sexual activity over other important commitments or relationships
  • regularly pay for sex or go to strip clubs
  • make impulsive decisions about sex
  • feel fixated on certain types of fetishes or types of sex
  • treating performance issues with more sex
  • finding themselves in sexual situations they could lead to arrest or escalate into violence
  • combining drugs or alcohol with sex
  • ignoring safer sex habits, like condoms or birth control
  • have struggled to pay bills because of purchases related to sex
People struggling with OCSB may relate to:

  • trying to stop or change what they’re doing, but being unable to do so for very long
  • hiding, downplaying, or lying about what’s going on to others
  • ashamed they are failing themselves or others
  • isolating because of their secrets
  • cycles of getting a rush from sex and then a crash of guilt
  • worry their sexual habits go against their values or ethics
  • uncertain about what or how to change their sex life
  • turning to sex in times of stress
  • relationship instability and drama due to impulsive or compulsive behaviors
Untreated compulsive sexual behavior tends to get worse over time, and stress or relationship problems often aggravate your attempts to get better. Remember you’re not alone. Many people struggle with OCSB symptoms, and a certified sex therapist is competently trained to compassionately support you in changing your relationship to sex.
Am I a Sex Addict?
If you are having problems because you think sex is becoming unmanageable and hard to control, it makes sense to get professional help. I treat and support clients who identify as sex addicts. You get to decide on how you identify your problems in order to get started. However, as a trained sexuality specialist I find the “sex addict” label can be tricky.

The public and some professionals use the terms “sex addiction,” “love addiction,” or “porn addiction” to describe patterns of compulsive sexual behavior based on the 12-step model. Here’s the issue – there’s no clear consensus on what constitutes too much sex or what types of sex we should be having. Additionally, it’s a surprise to some, but there is no formal diagnosis of “sex addiction” that any professional can give. It is a social concept rather than a recognized pathology. Certain abstinence-based recommendations for out of control sex may not be a workable solution for all clients. In some instances, it can cause more injury.

If you have some regret or feel like you’ve made some mistakes with sex, that alone does not mean something is wrong with you. For some, taking on the identity of sex addict implies that your sexuality is inherently dangerous and will be that way your whole life. For other clients, the identity of being a sex addict is useful in helping them contextualize what does feel out of control for them.

No matter your terminology, treatment with me for out-of-control sexual behaviors does not mean that ‘anything goes’. The reality is that some people’s sexual habits can cause real harm to themselves or people close to them. Broken promises, lies, stress, guilt, hiding, and isolation can take over. You’re looking for help and solutions.
Treating Out-of-Control Sexual Behavior

If you’re serious about changing your sex life to something that looks more manageable and right for you,  I follow a holistic treatment approach to problematic sex with clients. This framework has been endorsed by the American Association of Sexuality Educators, Counselors and Therapists (AASECT), the leading certifying body for sexuality professionals. The process is to explore behaviors, obstacles, values, and identify goals. There is no assuming or judging – it’s all about coming together to understand what’s causing the unwanted situation.

First, we will get a good assessment of what you think is going wrong in your sex life and where the breakdown is occurring. Next, we will take a look at the impacts sex has on your life and the underlying factors that contribute – relationship history, trauma, substance use, and other challenges that make change difficult. Finally, you and I will take stock of your needs and beliefs. We create a navigable, concrete plan to empower you to get to a healthier place with sex. We apply Six Principles of sexual health to guide your endgame:

Consent: Understanding what consent looks like and whom can give consent is the foundational step in treating any sexual issue or behavior. If identifying this boundary is difficult for you, we can work on setting you up with the best professionals.

Non-exploitative: Partners should consider impacts and risks of potential power differences when having consensual sex. In some cases people struggling with OCSB have histories of being exploited sexually themselves, and they may need support around this.

Honesty: Clear and direct communication maintains sexual well-being. Together, we can work on what might affect your ability to be honest about your desires or intentions to yourself or your partners.

Shared values: Culture, gender, religion, and societal roles all play a key part in shaping sexual values. Therapy provides a safe place to explore and gain clarity on these values (and they may change over the years).

Protection for health and safety: Safe(r) sex is important for both your and your partner’s physical well-being. We will review best practices and talk about your relationship to risk in this area.

Mutual pleasure: Pleasure is the leading motivation for sex. We examine your desires and fantasies more in depth, and talk about how know you and your partners are having the experiences you both want.

No, not all of them. I see clients who have consenting sex partners of legal age. If you need help correcting non-consensual behaviors, I am not the best therapist for you. In some cases, I can direct you to other professionals upon request. If you’re unsure about where you land on this or you are currently in the legal system due to sexual issues, you may set up a consultation to speak with me more in detail.
People struggling with out-of-control sexual behavior often feel lonely, afraid, and embarrassed. They want to change, but they feel stuck in their repetitive cycles. Like any compulsive behavior, change takes time, and it’s important to feel supported throughout the process. The goal in your therapy with me is to find concrete solutions and ethical pathways that make sense for your life. We want to bring your sexuality in that balances pleasure and sexual health.

As a certified sex therapist, I am here to provide you with support, guidance, and practical solutions for recovery. Things can get better, and you don’t have to do all this alone. Contact me today to schedule a free consultation.

I see clients in my office in San Francisco, California or virtually on Zoom. I welcome all genders, sexual identities, and different relational and monogamy agreements. I am a sex work ally and have advanced competency in kink practices. Many of clients are LGBTQIA+ identified. Matching my own background, I often work with people of mixed ethnic and cultural identities, first and second-generation immigrants, and BIPOC clients. Come as you are.

Book a free consultation to see if we’re the right fit.

“God keeps breaking the heart again and again until it remains open.” – Inayat Khan
Deva is a licensed psychotherapist (LMFT CA #103816 / ME #MF7207 / SC #TLC 825 MFT) and AASECT Certified Sex Therapist practicing in the downtown Financial District of San Francisco, CA. She has worked with clients aged 6 to 88 in different settings since 2011. These days, she helps individuals and couples get more in tune with their wants and needs. She has a special focus on sexuality and folks of mixed ethnic or racial backgrounds.

She slightly prefers pie over cake, but loves dogs and cats equally.

© Deva Segal, Marriage and Family Therapy and Consulting, Inc. SF Therapist. All rights reserved. 2023