Therapy for Compulsive Sexual Behavior in Pittsburgh & Online
When the Behavior Won’t Stop and the Shame Won’t Quiet Down
You’ve tried to stop. More than once. You’ve made promises to yourself — sometimes to your partner — and broken them. You’ve deleted apps, installed blockers, sworn that this was the last time. And then the cycle starts again.
What makes this so painful isn’t just the behavior. It’s the gap between who you believe yourself to be and what you keep doing. You think of yourself as a good person — thoughtful, ethical, someone who cares about the people in your life. And yet there’s this other thing. This pattern that keeps pulling you under despite everything you know and everything you want.
That gap — between your values and your behavior — is where the real suffering lives. And it’s where the real work begins.
Not sure if this is the right fit? Book a free 15-minute consultation to talk through your situation.
Schedule your free consult →Beyond the “Addiction” Label
You’ll notice I use several terms on this page: “sex addiction,” compulsive sexual behavior (CSB), problem sexual behavior. There’s a reason for that.
“Sex addiction” is the term most people search for, and it captures something real — the feeling of being out of control, of doing something you don’t want to do and not being able to stop. If that language fits your experience, there’s nothing wrong with using it.
But clinically, I find it more helpful to think in terms of compulsive sexual behavior — because the addiction model, while useful, can also oversimplify what’s actually happening. Not everyone who struggles with their sexual behavior fits neatly into an addiction framework. Some people are dealing with a values conflict more than a compulsion. Some are using sex to manage emotions they don’t have another way to reach. Some are caught in a shame cycle that looks like addiction but runs on different fuel.
What matters is not the label. What matters is understanding what’s actually driving the pattern for you — and finding a way to change it that doesn’t rely on willpower, white-knuckling, or more shame.
What This Usually Looks Like
The people who come to me for this work are usually dealing with some combination of the following:
Compulsive pornography use. Hours lost. Content that escalates in ways that disturb you. A pattern that feels less like a choice and more like a gravitational pull. Often accompanied by deep shame and secrecy.
Repetitive sexual behavior that causes harm. Infidelity you can’t stop. Compulsive use of dating apps or anonymous encounters. Risky behavior you know is destructive but can’t seem to interrupt. The behavior varies; the underlying pattern of escalation, secrecy, and regret is remarkably consistent.
The shame-behavior cycle. This is the engine that keeps it going. You act out, feel crushing shame, vow to stop, white-knuckle it for a while, feel the pressure build, act out again. The shame itself becomes the trigger. The worse you feel about yourself, the more you need the escape — which produces more shame.
Relational damage. A partner who’s found out, or who suspects something. Trust that’s been shattered. The isolation of living with a secret that would change everything if it came to light.
A deep sense of disconnection. Beneath the behavior, many people describe a feeling of profound emotional isolation. The sexual behavior becomes a substitute for something they can’t access — genuine connection, vulnerability, aliveness, or simply feeling something other than numb.
How I Work With This
My approach is serious, non-judgmental, and psychologically precise. I don’t moralize, and I don’t use a one-size-fits-all recovery program. But I also don’t minimize — if your behavior is causing real harm to yourself and the people you love, I’ll be direct about that.
Understanding the function. The first step is always understanding what the behavior is doing for you. What feeling does it manage? What does it help you avoid? Compulsive sexual behavior almost always serves an emotional function — numbing, escaping, soothing, feeling alive — and until we understand that function, any attempt to simply stop it is fighting against a need that hasn’t been met.
Working with the shame. Shame is not a treatment tool. Shame is the thing that keeps the cycle going. A significant part of this work involves learning to look at your behavior with clarity and self-compassion — not to excuse it, but to understand it well enough to actually change it.
Building genuine coping. This means developing real skills for managing the emotional states that currently get outsourced to sexual behavior — stress, loneliness, boredom, anger, emptiness. Mindfulness, distress tolerance, and emotional awareness aren’t buzzwords here; they’re practical capacities we build together.
Addressing the relational dimension. If your behavior has affected a partner, that’s its own layer of work. Betrayal trauma is real and serious, and supporting a partner through this requires more than apology — it requires sustained, accountable change.
Understanding the deeper roots. Compulsive behavior doesn’t come from nowhere. Often there are early experiences of shame, emotional neglect, rigid messages about sexuality, or attachment disruptions that set the stage. Psychodynamic understanding — not as an intellectual exercise, but as a way of making sense of why you do what you do — is a core part of how I work.
You do not have to have it figured out before you call. A free consultation is a confidential first step.
Schedule a free consult →What This Is Not
This isn’t a 12-step program, though I respect the value those programs hold for many people. This isn’t faith-based counseling. There’s no shaming, no moralizing, and no assumption that all porn use is pathological or that high desire is the same as compulsion. (It’s not.)
What this is: a serious, confidential therapeutic relationship where you can be honest about what’s happening, understand why, and do the sustained work of changing it.
Explore Specific Patterns
I work with specific patterns that fall under the broader umbrella of compulsive sexual behavior, including compulsive pornography use, compulsive infidelity, concerning sexual fantasies, understanding problematic sexual behaviors, and compulsive use of sex workers. Each page explores that specific concern in more detail.
Practical Details
I offer this work in person in Pittsburgh’s East End and online across Pennsylvania, New Jersey, New Mexico, and Rhode Island. This is a private-pay practice — which, for work this sensitive, offers a level of confidentiality that insurance-based treatment cannot.
If you’ve been thinking about making this call for a while, that’s normal. Most people have. The fact that you’re reading this page means something is already shifting.
Ready to Take the Next Step?
Whether you are just exploring or ready to begin, I am here to help. Schedule a free 15-minute consultation to see if we are a good fit.
Schedule a Free ConsultationIs This the Right Fit?
Not every therapist is equipped for this work. Compulsive sexual behavior sits at the intersection of sexuality, shame, attachment, and often trauma — and it requires a clinician who can hold all of those dimensions without reducing the problem to a single framework.
As an AASECT Certified Sex Therapist with specialized training in both sex therapy and compulsive behavior, I bring a perspective that most addiction counselors and most general therapists do not have. I understand sexuality. I understand compulsion. And I understand the difference between the two — which matters enormously for getting the treatment right.
A free 15-minute consultation is the best way to find out whether this is the right approach for your situation. We will talk briefly about what you are dealing with, and I will be direct about whether I think I can help.
CSB & Sex Addiction Therapy in Pittsburgh & Online
I offer this work in person at my Pittsburgh office — 134 S Highland Ave, in the East Liberty neighborhood — and online throughout Pennsylvania, New Jersey, New Mexico, and Rhode Island.
For work this sensitive, confidentiality matters more than usual. A private-pay practice means no diagnosis on your insurance record, no insurance company reviewing your treatment, and no documentation trail beyond what is clinically necessary.
If you are in Shadyside, Squirrel Hill, Highland Park, or elsewhere in Pittsburgh’s East End, the office is easy to reach. If you are farther afield or prefer the privacy of your own space, online sessions work well for this kind of therapy. Evening and Sunday appointments are available.
Further Reading
Understanding Compulsive Sexual Behavior (Often Called ‘Sex Addiction’)
Healing, Not Shaming: Why a Sex-Positive Framework is Essential for Treating ‘Sex Addiction’
Beyond the “Addiction” Label: Is Your Deepest Need for Connection Fueling Problematic Sexual Behavior?
What Are the First Steps to Take if I Think I Have a ‘Sex Addiction?’
Frequently Asked Questions
Is what I’m dealing with really “sex addiction”?
Maybe, maybe not — and that distinction matters less than you might think. What matters is whether the behavior is causing you distress, damaging your relationships, or conflicting with your values in ways you can’t resolve on your own. We’ll figure out the right framework together.
Will you make me feel ashamed?
No. Shame is the fuel that keeps compulsive behavior going — adding more of it would be the opposite of helpful. My approach is direct and honest, but never shaming. You can expect a space where you can say what’s actually happening without judgment.
Do I have to tell my partner?
Disclosure is a clinical decision, not a moral mandate. If and when disclosure happens, it should be thoughtful, well-timed, and supported. We’ll work through the question of disclosure carefully — when it makes sense, how to do it in a way that minimizes harm, and how to support your partner through it.
How is this different from a 12-step program?
12-step programs can be valuable support communities. What therapy offers is individualized understanding of what’s driving your specific pattern, processing of the underlying emotions and experiences, and a sustained therapeutic relationship focused on deep change — not just abstinence.
Can my relationship survive this?
Many relationships do survive and ultimately deepen through this process, though it requires real work from both partners. If your partner is willing to engage in their own healing process, couples work can be profoundly helpful — but the timing and pacing matter enormously.
How long does treatment take?
There is no fixed timeline. Some clients begin to feel a meaningful shift in the first few months as they understand the cycle and develop real alternatives. Deeper work unfolds over a longer arc. We check in regularly about what you need and where you are.
How much does therapy for compulsive sexual behavior cost?
This is a private-pay practice. For work this sensitive, many clients prefer not to involve insurance. I can provide superbills for potential out-of-network reimbursement if you choose to submit them.
I am not sure my situation is serious enough for therapy.
If the behavior is causing you distress, that is enough. You do not need to meet a clinical threshold or convince me that your situation is bad enough. The question is whether it is interfering with the life you want.
What about my partner? Should they be involved?
It depends on your situation. If a partner has been affected by your behavior, supporting them is part of the process — but the timing matters. The priority at the start is usually individual work: understanding the pattern, building stability, and developing honesty.
Do you work with porn use that is not compulsive?
Yes. Some people are dealing with a values conflict — their use does not feel out of control, but it conflicts with who they want to be. The distinction between high desire and compulsion matters clinically, and I take it seriously.
Is everything I share confidential?
Yes, with the standard legal exceptions. The private-pay model adds another layer — there is no insurance company receiving diagnoses or treatment summaries. For many clients dealing with secrecy and shame, knowing that confidentiality is airtight makes it possible to be honest for the first time.
I have relapsed before. Will that happen again?
Setbacks are a normal part of changing deeply ingrained patterns. The goal is not perfection — it is understanding. When you understand what triggered the behavior, a setback becomes information rather than proof that you are broken. The shame-relapse cycle is the thing we are interrupting, not just the behavior itself.
About Your Therapist
Jonah Taylor is a Licensed Clinical Social Worker (LCSW) and AASECT Certified Sex Therapist practicing in Pittsburgh, PA. He specializes in Emotionally Focused Therapy for couples and individuals, with a particular focus on the intersection of attachment, sexuality, and shame. Jonah integrates psychodynamic understanding, mindfulness, and attachment science to help clients move beyond surface-level coping toward genuine change.