I believe it is imperative that we move away from methods that focus on sexual dysfunction and pathologizing behavior when working with compulsive sexual behavior, and towards those that focus on cultivating sexual health and engaging the underlying causes of unwanted sexual behaviors. As a result, this article discusses the importance and impact of language in this work.
Definition of Sex Addiction
Dr. Patrick Carnes (2001) asserts that Sex Addiction is similar to other forms of addiction (e.g., alcohol and drug dependencies), wherein the addict has a pathologic relationship to a substance or process, in this case sexual behavior (ch. 1, What is a Sexual Addiction, para. 1-2). Furthermore, sex addicts are held up as powerless over their behavior; they have lost control over their sexual expression, which defines them as addicts (ch. 1, The Addiction Cycle, para. 10). In this view, Sex Addiction is considered an illness and disorder (Carnes, 2001, Preface to the 2001 Edition, para. 14).
Definition of Out of Control Sexual Behavior
Douglas Braun-Harvey (2014) defines Out of Control Sexual Behavior (OCSB) as “a sexual health problem in which an individual’s consensual sexual urges, thoughts, and behaviors feel out of control [to them]” (p. 10). Braun-Harvey views Out of Control Sexual Behavior as a sexual problem, not a sexual disorder or illness (personal communication, February 10, 2015). Furthermore, Dr. Neil Cannon (2015) finds that Out of Control Sexual Behavior is often not about sex, but rather untreated trauma/abuse, untreated mental health issues, unresolved relationship issues, and problematic habits (p. 18).
The Importance and Impact of Language in Sex Addiction Therapy and Out of Control Sexual Behavior Therapy
Some theorists in the field of psychotherapy believe that the language used to describe, assess, diagnose, and treat compulsive sexual behavior is just as important as the approach to working with it. Furthermore, they claim that the views and beliefs imbued in the language of a particular approach impacts how the therapist, client, and even society understands and relates to compulsive sexual behavior itself. For example, Herring (2011) explains that compassion, acceptance, and understanding of sexual addiction is increasing due to increased public awareness and a growing number of individuals who are directly or indirectly affected by sexual addiction. He contends that it is “becoming almost universally accepted that compulsive sexual behavior can literally devastate the lives of people who are fundamentally moral, thoughtful, and committed” (p. 57). Herring (2011) also believes that the label “addict” may be difficult for those dealing with sexual compulsive behavior to adopt because it is shameful or harsh to be thought of as an addict: identifying as an addict may be construed as an excuse for bad behavior; and the notion that in order to be sober an addict must give up their addictive behavior altogether (i.e., not engage in sex of any kind) is not helpful. This can be further complicated by the fact that not every individual who engages in behaviors associated with sexual addiction (e.g., soliciting prostitutes, viewing pornography, engaging in risky or anonymous sex, etc.) suffers from a sex addiction.
Concluding Thoughts on Sex Addiction Therapy and Out of Control Sexual Behavior Therapy
Herring (2011) concludes that regardless of how the individual chooses to label their compulsive sexual behavior, accepting the problem and seeking help is the most important aspect of recovery. However, it is important for the individual’s recovery to address this behavior in a forthright manner–because how one works with something can be influenced by how it is named. As a result, I work with sexual behavior that feels out of control as a potential symptom of some greater underlying cause that–when addressed and along with defining (for yourself) and moving towards sexual health–can lead to greater pleasure, fulfillment, and alignment in your sexual and intimate relationships.
References
Carnes, P. (2001). Out of the shadows: Understanding sexual addiction (3rd ed.) [Kindle Edition]. Center City, MN: Hazelden.
Cannon, N. (2015). A strength based approach to treating out of control sexual behavior (ocsb) [Presentation by Dr. Neil Cannon on February 6, 2015 at the Buehler Institute].
Braun-Harvey, D. (2014). Treating out of control sexual behavior [Presentation by Dr. Douglas Braun-Harvey on September 19-20, 2014 in San Francisco, CA].
Herring, B. (2011). A “sex addict” by any other name hurts the same. Sexual Addiction & Compulsivity, 18, 57-60. doi:10.1080/10720162.2011.57903