Out of Control Sexual Behavior

Yes. It is a thing. And, therapists see a lot of it! Client’s coming in married or in a committed relationship having multiple affairs on the side-without their partner knowing. The devastation is unbelievable for unknowing partners. Yet, the behavior continues and is growing in numbers.

So, what is the story behind out of control sexual behavior and why does it happen? The answers to these questions are unique to each person of course, like all therapeutic issues. The general idea is one or more of these; a mishap in sexual messaging growing up, reinforcement of out of control sexual behavior, trauma, bipolar, low-self worth/esteem.

In an article written by Scott Church MA, LPC (2015), “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).”

There’s been a long debate in the mental health field about whether there is a such thing as out of control sexual behavior-formerly called “sex addiction.” As more therapists are seeing these types of sexual patterns in the office there is strong discussion now about creating an official diagnosis called Compulsive Sexual Behavior Disorder (CSBD) (WHO, 2018). With advances in technology, allowing such easy access to sex and pornography, it is no wonder why these sexual behaviors are on the rise.

So, what do we do about it? First, any untreated mental health issues need to be worked on with a mental health therapist. When I work with out of control sexual behavior most often early on in sessions (but can come at a later time) there is a referral for a mental health evaluation by a mental health therapist, if they are not already working with one, to see if there are any issues that need to be worked on simultaneously while working on sexual value systems/messaging, honesty, self-growth, behavioral patterns, the meaning of sex, relationship issues (past and present). We will often utilize different modalities such as 12 steps as well as newer models such as Cannon (2015) uses, dealing with language (a sex problem) and exploring problematic “habits.”

Helping people through these problems is possible but the first step for individuals is admitting there is a problem- something many are not ready to do. One has to first own their behavior and not blame others. Working with relationship issues with self and others will come soon enough in treatment. With the right treatment people can control their behavior and lead happy productive lives both individually and relationally. A client can begin to look at what is sexual health- something that isn’t thought about when someone is out of control sexually.


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].

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].

World Health Organization (2017) Taken from Compulsive Sexual Behavior Is Now Recognized as a Disorder, But It Isn’t the Same as Sex Addiction (SELF, NA, 2018).