You are struggling with some sexual behavior that you feel is out of control.
Perhaps your partner has mentioned to you that this specific behavior is a problem or maybe has even labeled it as an addiction.
You are feeling shame and guilt that often spirals out of control and leads to you partaking in the behavior even more.
You are feeling embarrassed, broken, and helpless in what to do about these specific behaviors.
You may be wondering who can help me and what are my options?
Labels: The Sex Addiction vs. Out of Control Sexual Behavior (OCSB) Controversy
The phenomenon of someone feeling ‘out of control’ in their sexual behavior is unfortunately still debated about in the therapy and counseling community.
Some people, including the media, have labeled this as sex addiction and believe it to look and act like any other addiction.
This gave rise to the diagnosis and treatment of sex addiction through a mainly abstinence based and 12 step model program. Another way to look at this phenomenon is through the lens of what has now been labeled as Out of Control Sexual Behavior (OCSB). In his book, Treating Out of Control Sexual Behavior: Rethinking Sex Addiction, Dr. Braun-Harvey 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.” There is emphasis here on consensual sexuality and Dr. Braun-Harvey does make clear distinctions between consensual urges, thoughts, and behaviors needing to be treated differently than non-consensual.
The similarity between these models is that they can agree there is some component of ineffective impulse control that contributes to problematic behavior for the individual and often has a negative impact on their relationships and family.
The differences however are stark. The biggest differences in these models are: the belief of whether or not you have control over the problematic behaviors and how this phenomenon is treated.
Sex Addiction Model
In a blog post titled, What Happens in Sex Addiction Counseling?, Dr. Linda Hatch describes the process as having three key components: acceptance, action, and accountability.
Clients are asked to accept that they are powerless to the addiction and that they need help. They are then instructed to engage in “sexual sobriety,” where they must abstain from ALL forms of sexual behavior including masturbation and any sexual experiences with their partner. This period of abstinence can last three to six months or more.
Client’s must then educate themselves on sex addiction, report any relapse behavior to their therapist or support group, engage in a sex addiction 12 step program, and learn how they became an addict and what other addictions they may have.
At some point, the clients are instructed to disclose all of their problematic sexual behavior to their partner with the help of the counselor or therapist.
All of these expectations are classified as the “initial phase” of treatment that lasts a year or so and long term recovery is said to take three to five years. Dr. Hatch states that later phases work more on building healthy relationships and healing from traumas, however it does not specify how to get back to a healthy sex life, especially with a partner.
Out of Control Sexual Behavior (OCSB) Model
The Out of Control Sexual Behavior model looks at these behaviors as only being a ‘problem’ if the client themselves is reporting distress and disruption to their lives. This model aims to be sex positive and not label any behavior within the normal realm of sexual expression as problematic unless again, the client themselves sees it as a problem. If behavior is identified as a problem, this model seeks to normalize and educate about what sexual behavior is within the realm of ‘normal’ and uses curiosity to understand what about their behavior feels out of control and what function the behavior is playing in the client’s life.
Often times the problematic behavior is going against a client’s morals and values around sex and pleasure. The therapist works with the client to bring the client’s behavior and morals and values into alignment. This could be by changing the morals or values to allow for such behavior or it could be finding ways to reduce the behavior and learn other coping skills in order for the behavior to not be as disruptive to this person’s life.
This model aims to make sure the client knows there is hope and agency around their behavior and they do have the power to create change.
The last important aspect of this model is it looks to foster healthy sexual expression of the self and have healthy and pleasurable sexual experiences with the client’s partner(s). This model believes that sex is an integral part of life and relationships and wants to work towards reducing the feeling of being out of control without shaming and blocking a person from having any sexual experiences at all while also forcing a client’s partner into abstinence as well.
How Do I Treat This Phenomenon?
In my pursuit to become a certified sex therapist, I am conducting my training through the American Association of Sexuality Educators, Counselors, and Therapists (AASECT). This organization has in recent years taken the position that they do not believe in the labels of sex addiction or porn addiction as mental health disorders and want to make sure that their members are treating clients with a “standard of care supported by science, public health consensus and the rigorous protection of sexual rights for consumers seeking treatment for problems related to consensual sexual urges, thoughts or behaviors.” https://www.aasect.org/position-sex-addiction
Because of this I do follow the Out of Control Sexual Behavior (OCSB) model when working with client’s dealing with sexual urges, thoughts, or behaviors that feel out of control. My hope is for client’s to understand the purpose and function these behaviors have been serving them, to reduce judgement, shame, and guilt in order to gain hope and a sense of power and control over the problematic behavior, to align their behaviors with their morals and values, learn new coping skills, and to help them have pleasurable, satisfying, and connecting sexual relationships with themselves and their partners.
If you are struggling with consensual sexual urges, thoughts, or behaviors that feel out of control and want a path toward healthy pleasurable sexual relationships without shame or judgment, please click the button below to schedule your FREE 30 minute consultation and I would be happy to help you get the power back you have been seeking.