Compulsive Sexual Behaviour/"Sex Addiction"
​Understanding Compulsive Sexual Behaviour and Finding Your Path to Recovery
​
It is important to acknowledge the courage it takes to explore this issue. Whether you're here because of your own struggles or because this has affected your relationship, I want you to know that what you're experiencing is more common than you might think, and there is absolutely a path forward.
​
What Causes Compulsive Sexual Behaviour
​
Compulsive sexual behaviour (CSB) rarely has a single cause—it typically develops from a combination of factors working together:
​
Emotional regulation: Many people discover that sexual behaviour becomes their primary way of managing difficult emotions—stress, loneliness, anxiety, anger, or even boredom. It's not really about sex itself; it's about finding relief from uncomfortable internal states.
​
Early experiences: Your relationship with sexuality often begins forming in childhood and adolescence. This might include early exposure to pornography, messages about sex being shameful or secret, experiences of trauma or neglect, or simply lacking healthy models for intimacy and emotional connection.
​
Relationship patterns: Sometimes compulsive sexual behaviour emerges in response to relationship difficulties—feeling disconnected from a partner, unresolved conflicts, avoiding intimacy, or seeking validation that feels missing elsewhere.
​
Neurobiological factors: Some people may have a predisposition toward behavioural patterns that feel compulsive, or co-occurring conditions like ADHD, depression, or anxiety that make them more vulnerable.
​
Accessibility and escalation: The internet has fundamentally changed the landscape. Pornography is now free, private, endless, and engineered to be maximally stimulating. What might start as occasional use can gradually increase in frequency and intensity over time.
​
The important thing to understand is that this isn't about moral failure or lack of willpower. It's about learned patterns of coping, neurological pathways, and often unmet needs that have found expression through sexual behaviour.​​
​​
​
What Happens in Your Nervous System
​
Understanding the neuroscience can be incredibly helpful—it explains why this feels so difficult to control and removes some of the shame.
​
When you engage with pornography or sexual behaviour, your brain releases a cascade of neurochemicals:
​
Dopamine: This is the key player. Dopamine creates anticipation and motivation—it's the "seeking" chemical. When you're searching for pornography or anticipating sexual activity, dopamine surges. This creates a powerful drive state that can override rational decision-making. Importantly, dopamine is released more intensely during the anticipation and pursuit than during the actual experience itself.
​
Norepinephrine and adrenaline: These create arousal and alertness, making the experience feel exciting and urgent.
​
Oxytocin and endorphins: Released during orgasm, these create feelings of pleasure, bonding, and relief from stress or pain.
​
Here's what makes this particularly compelling: when you're stressed, anxious, lonely, or bored, your nervous system is in a state of dysregulation. Sexual behaviour temporarily shifts you into a different state—first the dopamine-driven excitement, then the post-orgasm release and calm. It becomes a reliable way to change how you feel, quickly and privately.
​
Over time, your brain creates strong neural pathways. The behaviour becomes increasingly automatic—almost a reflex in response to certain triggers or emotional states. Your prefrontal cortex (responsible for judgment and impulse control) becomes less active, while the more primitive reward-seeking parts of your brain take over.
​
This is why it can feel like you're watching yourself make a choice you don't want to make—the decision happens before your conscious mind fully catches up.
​
Why Pornography and Sex Are So Compelling
​
Several factors make sexual behaviour particularly prone to becoming compulsive:
Novelty: Dopamine responds powerfully to novelty. The internet provides endless new images, videos, and scenarios. Your brain never fully habituates because there's always something new.
​
Intensity: Sexual arousal is one of the most intense experiences our nervous system can generate. Few other activities produce such powerful neurochemical responses so quickly and reliably.
​
Privacy and secrecy: You can engage completely privately, which reduces external barriers and accountability while simultaneously creating shame and isolation.
​
Immediate availability: Unlike substances or other potentially compulsive behaviours, sexual behaviour is always available—no purchasing, no leaving your home, no waiting.
Progressive tolerance: Over time, you may find you need more frequent use, longer sessions, or more extreme content to achieve the same effect. This is your nervous system adapting to the stimulus.
​
Relief without resolution: While sexual behaviour temporarily relieves difficult feelings, it doesn't address their underlying causes. This creates a cycle where the same triggers keep returning, driving the same behaviour.ur pattern.
​
Why "Compulsive Sexual Behaviour" Rather Than "Addiction"
​
This is an important distinction, and understanding it can actually be quite liberating.
The field has moved away from the addiction model for several important reasons. Dr. Doug Braun-Harvey, a leading researcher and clinician in this area, has developed the framework of "Out of Control Sexual Behaviour" (OCSB), which offers a more helpful way of understanding what's happening.
​
The addiction model can be limiting: When we label something an addiction, it implies you're powerless, that you have a chronic disease requiring lifelong management, and that total abstinence is the only solution. For sexuality—which is a normal, healthy part of human life—this creates impossible choices and often increases shame.
​
The compulsive behaviour model is empowering: This framework recognizes that the behaviour has become problematic and feels difficult to control, but it's not about a diseased brain or moral failing. It's about patterns that developed for understandable reasons and can be changed. You're not powerless—you're learning new skills and awareness.
​
It acknowledges context and meaning: Rather than simply counting behaviours or days of abstinence, this approach asks: What function does this behaviour serve? What needs is it attempting to meet? What would need to change for you to not need it in the same way?
It allows for nuance: Not everyone needs or wants to eliminate all pornography use or specific sexual behaviours. Some people work toward reduced use that doesn't interfere with their life, while others choose abstinence. The compulsive behaviour framework allows for individual goals rather than one-size-fits-all solutions.
​
It reduces shame: The addiction model often increases shame by framing sexuality itself as the problem. The OCSB model reframes the issue as behaviour that's become disconnected from your values and wellbeing—that's something you can address without pathologizing your sexuality itself.
How Therapy Can Help
Therapy offers several powerful pathways toward change:
​
Understanding your patterns: A therapist helps you identify the triggers (emotional states, situations, times of day), the cycle of the behaviour, and what you're actually seeking through it. This awareness is the foundation for change.
​
Developing emotional regulation skills: Since compulsive sexual behaviour often functions as emotional regulation, therapy teaches you alternative ways to manage stress, anxiety, loneliness, and other difficult states. This might include mindfulness, distress tolerance skills, or somatic practices.
​
Addressing underlying issues: Therapy creates space to explore what's driving the behaviour—perhaps trauma, attachment wounds, relationship difficulties, depression, anxiety, or internalized shame about sexuality itself.
​
Reconnecting with values: Rather than focusing solely on stopping a behaviour, therapy helps you clarify what matters to you and how you want to live. Behaviour change becomes about moving toward something meaningful rather than just away from something problematic.
​
Building a healthy relationship with sexuality: This includes examining the messages you've internalized about sex, developing sexual values that feel authentic to you, and if relevant, working toward intimacy and connection in relationships.
​
Practical strategies: Therapists provide concrete tools for managing urges, creating barriers to impulsive behaviour, and building a life that naturally reduces vulnerability to compulsive patterns.
​
Different Treatment Options Available
​
You have several pathways to explore, and often a combination works best:
​
Individual Therapy Approaches
​
Cognitive Behavioural Therapy (CBT): This helps you identify and change thought patterns and beliefs that maintain the behaviour. You'll learn to recognize triggers, challenge rationalizations, and develop coping strategies. CBT is practical and skills-focused.
Acceptance and Commitment Therapy (ACT): Rather than trying to eliminate urges or uncomfortable thoughts, ACT teaches you to accept them without acting on them while taking action based on your values. It's less about control and more about willingness and choice.
​
Dialectical Behaviour Therapy (DBT): Particularly helpful if emotional dysregulation is central to your experience. DBT teaches powerful skills for distress tolerance, emotion regulation, mindfulness, and interpersonal effectiveness.
​
Trauma-focused therapy: If trauma is part of your history, approaches like EMDR or Sensorimotor Psychotherapy can help process those experiences, reducing their power to drive compulsive coping.
​
Psychodynamic therapy: This explores deeper patterns, early experiences, and unconscious motivations. It can be particularly valuable for understanding why certain behaviours developed and what they represent emotionally.
​
Sex therapy using the OCSB model: Therapists trained in Doug Braun-Harvey's approach work specifically with sexual behaviour concerns without pathologizing sexuality itself. They help you develop what Braun-Harvey calls "sexual health principles"—a personalized framework for sexual wellbeing aligned with your values.
​
Group Support Options
​
12-Step Programs (SAA, SA, SLAA): These include Sex Addicts Anonymous, Sexaholics Anonymous, and Sex and Love Addicts Anonymous. They provide community, accountability, and a structured approach based on the addiction recovery model. Many people find the fellowship and shared experience invaluable.
​
The benefits include free access, meetings widely available (in-person and online), sponsorship relationships, and a sense of not being alone. The potential drawbacks include the emphasis on powerlessness, the requirement for abstinence (definitions vary by group), and religious/spiritual focus that doesn't resonate with everyone.
​
Sexual Compulsives Anonymous (SCA): Similar to other 12-step programs but with a particular awareness of LGBTQ+ experiences and concerns.
​
SMART Recovery: An alternative to 12-step that uses a science-based approach without the disease/powerlessness model or spiritual component. It teaches self-empowerment and practical skills.
​
Therapy groups: Many therapists offer groups specifically for compulsive sexual behaviour. These provide community and shared learning within a therapeutic framework, often combining education, skill-building, and mutual support.
​
Partner and Relationship Support
​
Couples therapy: If this is affecting a relationship, working together with a therapist trained in these issues can be transformative. You'll address the impact of the behaviour, rebuild trust, improve communication, and work on the relationship dynamics that may have contributed.
Partner support groups: Organizations like COSA (Codependents of Sex Addicts) or therapy groups for partners provide space for the partner's own experience, feelings, and healing.
Harm Reduction Strategies
​
Not everyone is ready for or chooses complete abstinence. Harm reduction offers a pragmatic middle path:
Principles of Harm Reduction
Meet yourself where you are: Rather than an all-or-nothing approach, acknowledge your current reality and work toward gradual change.
Reduce frequency and intensity: If you're using pornography daily for hours, perhaps the first goal is reducing to every other day, or limiting to 30 minutes. Small changes matter.
Increase awareness: Keep a simple log of when and why you engage in the behaviour. Understanding your patterns is crucial for change.
Create speed bumps: Make impulsive engagement more difficult. Remove apps, use website blockers, keep devices out of private spaces, or require a waiting period before you can access material.
Substitute healthier coping: When you notice a trigger or urge, try an alternative first—walk, call a friend, exercise, engage in a hobby. You're building new neural pathways.
Shift the content: If you continue using pornography, consider moving toward material that's more aligned with your values—perhaps less extreme, more ethical productions, or content focusing on intimacy rather than purely visual intensity.
Protect relationships: If you're partnered, create agreements about behaviour that honor both your process and your partner's needs. This might include: being honest about any use, not engaging in behaviour during specific times or places, or other boundaries you both agree on.
Practical Harm Reduction Tools
The urge surfing technique: When an urge arises, imagine it like a wave. Notice it, observe it without judgment, and ride it out. Urges typically peak and diminish within 20-30 minutes if you don't act on them.
The 5-minute rule: Before engaging in the behaviour, commit to waiting 5 minutes and doing something else. Often the urgent quality of the urge diminishes.
Environmental design: Remove temptation and opportunity. Don't keep devices in bedrooms, use accountability software, arrange your environment to support your goals.
Scheduling and ritual: Some people find that allowing specific, limited times reduces the sense of deprivation and desperate, compulsive quality. This is controversial but can work as a transitional strategy.
Compassionate self-interruption: If you find yourself engaging in the behaviour, you can still make a choice to stop partway through rather than continuing to completion. This isn't failure—it's practicing agency.
Harm Reduction Strategies
​
Not everyone is ready for or chooses complete abstinence. Harm reduction offers a pragmatic middle path:
​
Principles of Harm Reduction
​
Meet yourself where you are: Rather than an all-or-nothing approach, acknowledge your current reality and work toward gradual change.
​
Reduce frequency and intensity: If you're using pornography daily for hours, perhaps the first goal is reducing to every other day, or limiting to 30 minutes. Small changes matter.
Increase awareness: Keep a simple log of when and why you engage in the behaviour. Understanding your patterns is crucial for change.
​
Create speed bumps: Make impulsive engagement more difficult. Remove apps, use website blockers, keep devices out of private spaces, or require a waiting period before you can access material.
​
Substitute healthier coping: When you notice a trigger or urge, try an alternative first—walk, call a friend, exercise, engage in a hobby. You're building new neural pathways.
Shift the content: If you continue using pornography, consider moving toward material that's more aligned with your values—perhaps less extreme, more ethical productions, or content focusing on intimacy rather than purely visual intensity.
​
Protect relationships: If you're partnered, create agreements about behaviour that honor both your process and your partner's needs. This might include: being honest about any use, not engaging in behaviour during specific times or places, or other boundaries you both agree on.
​
Practical Harm Reduction Tools
​
The urge surfing technique: When an urge arises, imagine it like a wave. Notice it, observe it without judgment, and ride it out. Urges typically peak and diminish within 20-30 minutes if you don't act on them.
​
The 5-minute rule: Before engaging in the behaviour, commit to waiting 5 minutes and doing something else. Often the urgent quality of the urge diminishes.
​
Environmental design: Remove temptation and opportunity. Don't keep devices in bedrooms, use accountability software, arrange your environment to support your goals.
Scheduling and ritual: Some people find that allowing specific, limited times reduces the sense of deprivation and desperate, compulsive quality. This is controversial but can work as a transitional strategy.
​
Compassionate self-interruption: If you find yourself engaging in the behaviour, you can still make a choice to stop partway through rather than continuing to completion. This isn't failure—it's practicing agency.
A Final Word
What you're dealing with is difficult, but it's not insurmountable. Thousands of people have walked this path and found their way to healthier, more integrated lives—lives where sexuality is connected to intimacy, values, and genuine wellbeing rather than escape and compulsion.
​
This isn't about becoming someone who never experiences sexual desire or who views sexuality as dangerous. It's about reclaiming agency, developing real intimacy with yourself and potentially others, and building a relationship with sexuality that enhances rather than diminishes your life.
​
The shame you carry is heavy, I know. But shame thrives in secrecy and isolation. As you bring this into the light—whether through therapy, groups, or honest conversations—that shame begins to lose its power.
​
If this has affected your relationship, know that many couples not only survive this but eventually report their relationship becoming deeper and more authentic than it was before. The crisis forces honesty, vulnerability, and real intimacy in ways that comfortable avoidance never required. It's a difficult path, but it can lead somewhere meaningful.
​
You're not broken. You're human, doing your best to meet needs and manage pain with the tools you had available. Now you're learning better tools, and that takes courage.
​
Be patient with yourself. Change happens through thousands of small choices, not one dramatic transformation. Each moment you pause, each time you choose differently, each honest conversation—you're rewiring your brain and your life.
​
You deserve a life free from compulsion, connected to what matters, and aligned with who you want to be. And that life is absolutely possible.
​
You're not alone in this journey.
Resources and Support
Let’s Work Together
Get in touch so we can start working together.
