Out-of-Control Sexual Behaviors
You know you have a problem when you keep breaking promises to stop or cut back.
There is no right or wrong amount of sex. Yet people reach out to me for help for “sex addiction” when they feel their life has become unmanageable in some way due to sexual behaviors.

Folks often 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, breaking agreements, or they’ve let themselves down. Sex is likely getting in the way of other responsibilities, or what they are doing goes against their own values. They keep making plans to turn over a new leaf, but they’re unable to stop.

Out-of-control sexual behavior (OCSB) is the term for sexual behaviors, urges, or thoughts feel out of control to someone. People with OCSB may also struggle with depression, anxiety, have histories of trauma, or addictive behaviors or impulsive/compulsive disorders. Other mental health conditions 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.


If you think sex is becoming hard to control and get a handle on, it makes sense to get professional help. I treat and support clients who identify as sex addicts. You get to decide how you label and identify your problems in order to get started with help. However, as a trained sexuality specialist I find the sex addict label to 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 a 12-step model.
Here’s the issue – there’s no clear consensus on what constitutes too much sex or what types of sex is better than others. Additionally, it’s a surprise to some, but there is no formal diagnosis of “sex addiction” that any health 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 problems.

If you have regrets 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 very useful in helping them contextualize what does feel out of control for them.
No matter your interpretation, 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.

Signs of being out of control sexually.

Across the board, there’s an underlying feeling that you’re out of solutions and looking for help. You feel stuck. While 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:

Virtual ouples counseling with licensed therapist Deva Segal.

People struggling with OCSB may relate to:

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.
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, then I am here to support. 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:
Understanding what consent looks like and who 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 connecting you up with appropriate professionals.
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.
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 if and your partners are having the experiences you both want.

Do you treat all problematic sexual issues?

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 ashamed and embarrassed. They want to change, but they feel stuck in their repetitive cycles. Like any compulsive behavior, it’s important to feel supported throughout the change 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 to a place that balances your pleasure and sexual health.

As a certified sex therapist, I am here to provide you with 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. 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 my 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.