If you’re concerned that your sexual thoughts, urges, or behaviors feel out of control, are causing you distress, or are leading to negative consequences in your life, you might encounter various terms like Compulsive Sexual Behavior (CSB), hypersexuality, or “sex addiction.” Understanding what these terms mean—and how they relate to what is broadly called Problem Sexual Behavior (PSB)—can be confusing.
At The Center for Mind & Relationship, we aim to provide clarity and compassionate, expert support, regardless of the specific label you might identify with. Our focus is on understanding your unique experience, the underlying factors contributing to these patterns, and helping you regain control and cultivate a healthier relationship with your sexuality. This page offers insight into these terms and outlines our approach, which is a core part of our specialized ‘Sex Addiction’ and Problem Sexual Behavior (PSB) Therapy services.
Defining the Terms: A Landscape of Understanding
Problem Sexual Behavior (PSB)
This is often used as an umbrella term to describe any sexual behavior that an individual perceives as problematic due to its compulsive nature, the distress it causes, or the negative impact it has on their life, relationships, health, or functioning. It focuses on the impact and experience rather than a specific diagnosis. Our therapy generally addresses “problem sexual behavior” in this broad, client-centered sense.
Compulsive Sexual Behavior (CSB) / Compulsive Sexual Behavior Disorder (CSBD)
Compulsive Sexual Behavior Disorder (CSBD) is recognized as a mental health condition in the World Health Organization’s International Classification of Diseases (ICD-11).
It’s characterized by a persistent pattern of failure to control intense, repetitive sexual impulses or urges, resulting in repetitive sexual behavior that is engaged in over an extended period (e.g., six months or more).
Key features include:
- Sexual activities becoming a central focus of the person’s life to the point of neglecting health, personal care, or other interests, activities, and responsibilities.
- Numerous unsuccessful efforts to control or significantly reduce the repetitive sexual behavior.
- Continuing to engage in repetitive sexual behavior despite adverse consequences (e.g., relationship distress, job loss, health risks).
- Continuing to engage in repetitive sexual behavior even when the person derives little or no satisfaction from it.
The pattern results in marked distress or significant impairment in personal, family, social, educational, occupational, or other important areas of functioning. Our blog post on understanding CSB provides more general information.
Hypersexuality / Hypersexual Disorder (Proposed)
“Hypersexuality” generally refers to unusually frequent or suddenly increased sexual urges or activity.
“Hypersexual Disorder” was a proposed diagnosis for the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) but was not formally included. The proposed criteria involved recurrent and intense sexual fantasies, urges, and behaviors in association with specific criteria related to distress, impulsivity, and negative consequences.
While not a formal diagnosis in the DSM-5, the term “hypersexuality” is still used clinically and by individuals to describe experiences of heightened and often problematic sexual drive or behavior. (Blog: How to differentiate high libido from compulsive behavior)
“Sex Addiction”
“Sex addiction” is a widely used and recognized term in popular culture and by many individuals and some treatment programs. It typically implies a model similar to substance addiction, where sexual behavior becomes compulsive, progressive, and engaged in despite negative consequences, with experiences of tolerance and withdrawal (though the “withdrawal” aspect is debated for behavioral addictions).
It’s important to note that “sex addiction” is not currently a formal clinical diagnosis in major diagnostic manuals like the DSM-5 or ICD-11.
However, this does not invalidate the very real distress and loss of control that people experience when they identify with this term. Many find the “addiction” model helpful for understanding their struggles and finding support in 12-step or addiction-focused programs.
- A Comprehensive Clinical Interview: Discussing your specific behaviors, thoughts, and feelings; the history and development of these patterns; the perceived triggers and consequences; your relationship history; and your goals for therapy.
- Exploring Underlying Factors: Gently investigating potential co-occurring issues (like anxiety, depression, trauma, stress – which can be explored in our Individual Therapy services, unmet emotional needs, attachment patterns (learn about your attachment style, and defense mechanisms that might be contributing to the PSB.
- Assessing Impact and Distress: Understanding how these behaviors are affecting your relationships, work, self-esteem, and overall well-being.
- Collaborative Goal Setting: Working with you to define what healthy sexuality and behavior change would look like for you.
While we are knowledgeable about formal diagnostic criteria (like for CSBD), our assessment is holistic and person-centered.
Tailored Treatment for Problematic Sexual Behaviors: Finding Your Path to Health
Our therapeutic approach is integrative and tailored, drawing from evidence-based practices to help you manage urges, address underlying causes, and build a healthier relationship with your sexuality. Treatment may include elements of:
- Cognitive Behavioral Therapy (CBT): To identify and challenge unhelpful thought patterns that trigger or maintain problematic behaviors, and to develop new coping strategies.
- Acceptance and Commitment Therapy (ACT) / Mindfulness-Based Interventions: To increase awareness of urges and thoughts without impulsively acting on them, develop distress tolerance, and clarify values to guide behavior. Our Mindfulness-Based Therapy and Buddhist Psychology offerings can be very supportive here.
- Psychodynamic Exploration: To understand deeper, often unconscious, motivations, past experiences, and relational patterns that may contribute to PSB.
- Motivational Interviewing: To strengthen your own motivation and commitment to change.
- Relapse Prevention Planning: Developing concrete strategies to manage high-risk situations and maintain progress.
- Focus on Healthy Sexuality: Moving beyond just stopping problematic behaviors to defining and cultivating a positive, value-aligned, and fulfilling sexuality. This is a core tenet of our Sex Therapy services.
- Addressing Co-occurring Issues: If issues like anxiety, depression, or trauma are present, these will be addressed as part of the comprehensive treatment plan. For men, these issues often intersect with our Therapy for Men speciality.
We emphasize a non-judgmental, compassionate stance. Our private pay model supports the often in-depth and personalized work required.
A Note on Terminology: Our Focus is on Your Experience
While understanding different terms can be helpful, the most important thing is that you feel understood and that the therapy addresses your specific struggles and goals. Whether you identify with “compulsive sexual behavior,” “hypersexuality,” “sex addiction,” or simply “problematic sexual behavior,” we are here to help you find a path toward greater control, peace of mind, and healthier connections. We also recognize that these issues can be particularly complex for men struggling with ‘sex addiction’ or when it involves problematic porn (‘porn addiction’).
Furthermore, we understand the profound impact these behaviors can have on partners. If you are seeking support as a loved one, please see our resources on supporting a partner with CSB.
Frequently Asked Questions
