Problematic Sexual Behaviors
What is a “problematic sexual behavior?”
A problematic sexual behavior refers to any sexual activity or patterns of sexual conduct that cause distress or harm to the individual engaging in them or to others. However, this alone does not equate to sexual addiction.
The term “problematic sexual behavior” is a focal point of the PSB framework developed by Bill Herring (LCSW), which assesses sexual behavior patterns across five distinct but oven overlapping categories:
(1) commitment violations;
(2) values conflicts;
(3) diminished self-control;
(4) negative consequences;
(5) lack of sexual responsibility.
What is the significance of this framework?
The PSB framework asks an individual five questions that get right to the heart of what makes any pattern of sexual behavior problematic:
(1) “Are you keeping your promises?”;
(2) “Are you ok with what you’re doing?”;
(3) “Are you in control of yourself?”;
(4) “Is everything ok?”;
(5) “Are you protecting others?”
The PSB Framework uses descriptions rather than labels, is applicable across cultures and values, and is useful in many settings.
What is “sex addiction?”
Sex addiction is characterized by a compulsive pattern of engaging in repetitive sexual activities despite experiencing adverse consequences which one fails to stop and eventually becomes a central focus of one’s life.
Sex addiction is an intimacy disorder; which is psychological condition where a person has difficulty forming or maintaining close, emotional, or physical connections with others. It often involves fears of vulnerability, trust issues, or an inability to communicate authentically in relationships, which can hinder the development of healthy, intimate bonds.
What are common behaviors in sex addiction?
An individual battling against sex addiction may be engaging in any of the following sexual behaviors:
(1) engaging in high-risk sex acts;
(2) engaging in behaviors that cross boundaries (intrusive sex);
(3) anonymous sex;
(4) voyeurism;
(5) exhibitionism;
(6) maintaining secret relationship(s) outside of primary relationship;
(7) paying for sex (transactional/trading sex);
(8) compulsive masturbation and/or porn usage;
(9) high preoccupation with sexual fantasies;
(10) cruising behavior in public settings.
Screening Tools
WHO Diagnostic Criteria
In 2018, the World Health Organization (WHO) included "Compulsive Sexual Behavior Disorder" (CSBD) as an official diagnosis. The criteria for diagnosing CSBD as outlined in the International Classification of Diseases (ICD-11) are as follows:
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1. A persistent pattern of failure to control intense, repetitive sexual impulses or urges resulting in repetitive sexual behavior.
2. Repetitive sexual activities become a central focus of the person’s life to the point of neglecting health and personal care or other interests, activities, and responsibilities.
3. Numerous unsuccessful efforts to significantly reduce repetitive sexual behavior.
4. Continued repetitive sexual behavior despite adverse consequences or deriving little or no satisfaction from it.
5. The pattern of failure to control intense sexual impulses or urges that results in repetitive sexual behavior is manifested over an extended period of time (e.g., 6 months or more).
6. The pattern of failure to control intense sexual impulses or urges that results in repetitive sexual behavior causes marked distress or significant impairment in personal, family, social, educational, occupational, or other important areas of functioning.
Sexual Addiction Screening Test-Revised
The Sexual Addiction Screening Test (SAST) is designed to assist in the assessment of sexually compulsive or “addictive” behavior. Developed in cooperation with hospitals, treatment programs, private therapists and community groups, the SAST provides a profile of responses that help to discriminate between addictive and non-addictive behavior.
To access this free assessment and to view additional assessments, please visit the following website: RECOVERYZONE.COM.
PATHOS Questionnaire
The “PATHOS” is a brief sexual addiction screening questionnaire developed by Dr. Patrick Carnes. The PATHOS assessment questions serve as a tool to help identify potential signs of sexual addiction. However, they are not intended to offer a definitive diagnosis.
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Preoccupied
Do you often find yourself preoccupied with sexual thoughts?
Ashamed
Do you hide some of your sexual behavior from others?
Treatment
Have you ever sought help for sexual behavior you did not like?
Hurt Others
Has anyone been hurt because of your sexual behavior?
Out of Control
Do you feel controlled by your sexual desire?
Sad
When you have sex, do you feel depressed afterwards?
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If you answer “Yes” to 3 or more of these questions, it is recommended you contact us to explore your responses, receive support, and attain recovery.
It’s really not about the sex. Sex addiction is about disconnecting, escaping, and not feeling pain.
Recovery is possible. Let us guide you toward lasting change.
Sex Addiction is Not…
How We Can Help You
The below list has been formulated to indicate what sex addiction is not.
A moral failure: Sex addiction is not about a person's morality or lack of ethics; it is a behavioral and psychological condition that involves compulsive patterns of sexual behavior.
Simply enjoying sex: Enjoying sex or having a healthy sexual appetite does not equate to addiction. Sex addiction often involves compulsivity, lack of self-control, and negative consequences.
A sign of poor character: Being addicted to sex is not indicative of weak character or willpower; it is a complex issue that may involve emotional, psychological, or biological factors.
A preference or lifestyle choice: Sex addiction is not a conscious choice to engage in excessive sexual behavior. It is a disorder that often involves a loss of control and lack of pleasure over sexual impulses.
Simply hypersexuality: While people with sex addiction may engage in numerous sexual encounters, hypersexuality alone does not constitute addiction. Addiction is marked by compulsive, uncontrollable behavior and negative consequences.
A sign of not loving your partner: Sex addiction does not mean you do not love your partner, nor that you are incapable of receiving or giving love. It involves using sex to cope with emotional pain, stress, or distress.
An indication of abnormal sexuality: While sex addiction may involve excessive or harmful sexual behavior, it is not an abnormal or perverse desire; it is a condition where sexual behavior becomes dysfunctional.
Something that can be easily "fixed" with willpower: Sex addiction may not be overcome even with the most sincere intent to stop the behaviors. It often requires professional treatment to address the root causes.
Your treatment plan at our practice will be personalized on your specific needs and identified goals. These are some of the ways we can assist you:
Understand the key characteristics of sex addiction
Create a relapse prevention plan
Build emotional resilience to cope with life's adversities
Build effective stress management skills
Gain ability to acknowledge the depths of the problem
Discover what it means to take accountability
Enhance the way you see yourself when looking in the mirror
Identify what has made your previous sobriety attempts unsuccessful
Adopting healthier habits and positive activities
Find useful resources
Understand your past and how your past brought you here
Learn how to not depend on sex for validation
Process underlying trauma driving your behavior(s)
Build a supportive network of friends and fellows
Receive guidance on establishing healthy sexual behaviors
Developing a sense of purpose
You have an important story to tell. We are ready and willing to hear it.
Your unique life circumstances have led you to this website. Your instincts are telling you it’s time to get help. Don’t hesitate any longer. Give yourself the gift of quality psychotherapy and begin your journey of recovery today.