Understanding and Managing Out-of-Control Sexual Behaviors with a Paradise Valley Sex Therapist (in training)
This blog post may be different from what you were expecting. It may challenge a lot of what you believe to be true about sex addiction. By incorporating insights used in sex therapy, I hope that you can keep an open mind and walk away with a healthier way to understand and categorize out-of-control sexual behavior.
Sex Addiction
Sex addiction is a term used when someone has trouble “controlling” their sexual desires, thoughts, behaviors, and actions. The American Psychiatric Association has rejected the concept and diagnosis of sex addiction consistently for over forty years because there is no definite science that says it exists. It is not listed in the Diagnostic Statistical Manual of Mental Disorders, DSM-5 (the book all mental health therapists and professionals use to diagnose their clients).
You might be saying, I have had personal experience with a sex addict, or if it does not exist, then why is the term so widespread? Let’s get into the history of how this term came to be and how our culture and media have shaped the way we think about and view sexual behavior.
History of The Term Sex Addiction
The term sex addiction was created in the early 1980s. During this time period, our society was struggling with AIDS and the HIV epidemic. The terms sex addiction and pornography addiction became a way to make people, especially gay men, feel guilty or ashamed for their sexual preferences.
During the 1980s, our society was shifting its ideals on sexuality and gender norms. Before, powerful, rich white men were often allowed to do whatever they wanted when it came to sex. They could get away with having mistresses, prostitutes, etc, without facing consequences. But, during this time, people began to speak up and push for fairness so that everyone, no matter their gender, would be treated more equally in sex and relationships. The idea of sex addiction is a social phenomenon; it’s not clinical, medical, or based on any research.
Throughout history, every time we allow social morality to dictate medical and psychological treatment, terrible things happen to people. In the 1800s, when the belief was that masturbation was immoral, it led to horrible things being done to children; women who enjoyed sex were labeled as nymphomaniacs or female hysteria, which led to them being institutionalized and receiving lobotomies, same with gay people being forced to undergo electroconvulsive therapy. We hurt people when we allow social morality to make decisions about our sexual, medical, and mental health treatments.
What Science DOES Tell Us About “Sex Addiction”
Some of the latest research studied what the people involved in “sex addiction” therapy looked like, also known as the demographic. What they found was over 90 percent of the people receiving this type of therapy were men, over half were white men who made over eighty-five thousand dollars a year, and that gay and bisexual men were three times at risk of being labeled as a “sex addict.”
What this tells us is that the sex addiction industry is continuing to label homosexual behaviors as an illness. While offering an excuse for wealthy, white, powerful men who get caught engaging in selfish and harmful sexual behaviors, an excuse of having a “disease” to avoid responsibility for their actions that they do have control over. There is also not a single published study that shows that sex addiction treatment programs help people to make different choices. So, if this is the case, then why do so many mental health professionals struggle to agree on this issue?
A Profession Divided
Unfortunately, mental health therapists receive little training on sexuality issues. Only five percent of mental health professionals have received training beyond how to diagnose sexual disorders that are listed in the DSM-5. This leaves therapists subject to making decisions about their clients’ sexual issues based on their biases-YIKES! In the words of the famous sex researcher Charles Kinsey, “Anyone with the diagnosis of a nymphomaniac is someone who has more sex than the therapist.”
Men Use Sex To Cope
Men, more frequently than women, use sex as a coping strategy for negative emotions. Sadly, our society teaches men that they cannot have emotions, much less talk about them. This makes it difficult for men to understand and process feelings healthily. This can lead them to turn to sex or pornography to cope with stress and other challenging emotions to make them feel better, not the other way around. Pointing the finger at porn and sex is just a distraction from the root of the issue that men are not allowed to express their feelings. Men need safe, nonjudgmental spaces to learn different ways to cope with complicated emotions and life experiences. Sex therapy can help men navigate their emotions and develop more effective coping strategies.
A new way of understanding out-of-control sexual behaviors
Think of sexual behaviors on a spectrum. One end is rigid, and the other is out of control. In the rigid category, we may see men who are in distress because their spouse has labeled them a sex or pornography addict. After a thorough assessment of their behavior, we discover that they are only watching porn and masturbating a couple of times a month, at home, in private. This is an example of a moral incongruence– a mismatched experience between what a person believes is right and what they do. People from religious backgrounds are more likely to label someone as a sex or porn addict and experience a moral incongruence.
On the other side of the spectrum, we have out-of-control sexual behaviors. Men in this category are sexually behaving more recklessly. They may have multiple affairs, may not be careful to use contraceptive methods, and potentially are spending thousands of dollars paying for sex, whether it be sex workers, cam girls, or massage parlors. Men with these behaviors need different interventions, but to help them, we need to look at the problem differently and hold them accountable to their relationship agreements.
Relationship Agreements
Relationship agreements are mutually agreed-upon terms or guidelines between partners in a relationship that help define expectations, roles, boundaries, and the dynamics of how the relationship will work. They can take various forms depending on the needs and desires of the individuals involved. Relationship agreements are often used to clarify communication, prevent misunderstandings, and ensure that both partners are on the same page about important aspects of their relationship.
Here are some examples of elements that might be included in a relationship agreement:
Communication Expectations
How and when partners will communicate, and what kind of communication style is preferred (e.g., frequent check-ins, open and honest discussions about feelings, etc.).
Boundaries
What personal or emotional boundaries are important to each partner? These could include physical space, privacy, or no contact with ex-partners or other relationships.
Monogamy vs. Non-Monogamy
In some relationships, the agreement may outline whether the partners are committed to monogamy or if they are polyamorous, open relationships, or other non-monogamous arrangements.
Financial Responsibilities
How will expenses and financial responsibilities be divided, especially if the partners are cohabiting or sharing resources?
Conflict Resolution
How disagreements or conflicts will be handled, including whether there will be mediation, time-outs, or specific methods for resolving disputes.
Sexual and Intimacy Preferences
Expectations and agreements regarding sexual activities, frequency, boundaries, and intimacy.
Long-Term Goals
Discussions about future aspirations, like marriage, children, career goals, or relocation, and whether both partners are aligned on these critical life decisions.
Time and Space
Agreements about the amount of time spent together versus apart, how much personal space each partner needs, and any other commitments or priorities outside the relationship.
Mutual Support
How partners will support each other emotionally, mentally, and physically through different life challenges or transitions.
Check-ins
Some relationships include regular "relationship check-ins" as part of their agreement, where both partners reflect on how the relationship is going, what is working, and what might need adjustment.
Relationship agreements can be formal or informal, written or verbal, and should be adaptable as needs change over time. They are often seen as a way to build trust and clarity between partners, especially in complex relationships where expectations may need to be more obvious and easily understood.
The key to a healthy relationship agreement is ensuring that both partners feel heard and respected and that the agreement evolves as needed.
Six Sexual Health Principles
Rather than making clinical and medical decisions based on social morality, let’s discuss what makes sexual behavior problematic in a way that is sex-positive, holds people accountable to their relationship agreements, and respects sexual and erotic diversity. Doug Braun-Harvey created the six principles of sexual health. These principles are the foundation for fostering healthy, respectful, and safe sexual relationships.
First Principle
All sexual activity should be consensual, with clear and enthusiastic agreement from all parties involved.
Second Principle
Non-exploitation, which means sexual relations are free from coercion, manipulation, and exploitation.
Third Principle
Protection from harm. This means sexual activity should involve taking steps to protect oneself and others from harm, including protection from unwanted pregnancies and sexually transmitted infections (STIs).
Fourth Principle
Honesty includes open and honest communication about sexual intentions, desires, and expectations.
Fifth Principle
Shared values. Sexual relationships should be based on shared values and respect.
Sixth Principle
Mutual pleasure. Sexual activity should be mutually satisfying, with the needs and desires of all parties being considered and respected.
The thing I love the most about the six sexual health principles is how much they account for the diversity of sexual or gender orientation and erotic expression.
Putting it all together
Now, let's apply different relationship agreements and the 6th principles of sexual health to out-of-control sexual behaviors.
Relationship A
Let’s say we have a married heterosexual man who likes to occasionally sleep with women when he is out of town for work WITHOUT his wife’s knowledge or consent. This behavior is problematic because he is engaging in sexual activity that is not a part of his current relationship agreements and could potentially expose his partner to unwanted STIs and pregnancy.
Relationship B
Now, let’s say we have a heterosexual man, but this time, he is not married. He chooses to sleep with women on the weekends casually, and when he does, he is careful and implements safe sex practices to protect himself and his sexual partners from STIs. He is honest with his sexual partners that he is not looking for anything serious and allows the people he is sleeping with to make physically and emotionally safe decisions for themselves.
Relationship C
For our third, we have a gay man who is married, but he and his husband are in an open relationship practicing ethical non-monogamy. He and his spouse have honestly and transparently agreed that when either one of them is out of town and the opportunity arises, they are allowed to casually sleep with a person of the same sex as long as they practice safe sex to protect from STIs.
These three examples show similar sexual behaviors but are operating under different relationship agreements. Relationship A is harmful because he is being dishonest and is engaging in sexual activity that is not a part of his current relationship agreements and could potentially expose his partner to unwanted STIs and pregnancy. Relationships B and C, whether they would work for you or not, are open, honest, and based on the individual and couple's values that work for their unique relationship rather than what society told them is and is not ok regarding sex and relationships. What is ok in one relationship may not be ok in another. What one relationship may consider as too much sex and porn may not be enough or a problem in another relationship.
Another way to look at this is: What are your current relationship agreements? Are you keeping them? Why or why not? Are you okay with what you are doing? Why or why not? Is your partner(s) aware of what you are doing? Why or why not? Are you protecting others? Either the person’s behavior needs to change, or their values and relationship agreements need to change to make the sexual behavior okay.
Thoughts From a Paradise Valley Sex Therapist
From my experience as a mental health professional and AASECT sex therapist in training, working with men who are struggling with out-of-control sexual behaviors, those who want to stop can do so because their sexual actions don’t match their values and beliefs. They learn and find new, healthier ways to cope with difficult emotions and challenges. The ones who don’t stop continue because they feel like they are following society’s rules about sex, even though those rules don’t work for them. Some of these men who choose not to stop their sexual behaviors will leave their relationships and start new ones where they can make agreements that better fit their needs. Others stay because they’re afraid to speak up, fear starting over, or want to have their cake and eat it too.
At The Connection Couch in Paradise Valley, we pride ourselves on creating a safe, nonjudgmental space for men to find healthier ways of processing and coping with their emotions while holding them accountable to their relationship agreements. We are also qualified and offer support to the partners and relationships impacted by infidelity.
Begin Your Journey With Sex Therapy In Scottsdale, AZ
We understand how overwhelming and distressing out-of-control sexual behaviors can feel. You are not broken. As experienced sex therapists in Paradise Valley, we are here to provide nonjudgmental, evidence-based support to help you develop a healthier relationship with your sexuality. Your journey toward balance and self-acceptance starts here. Begin your healing journey with The Connection Couch by following these steps:
Gain the tools and support to understand your sexual behaviors, build healthier coping strategies, and strengthen your relationships.
ADDitional Therapy Services Available In The Scottsdale Area
As a sex therapist in Paradise Valley, I provide therapy for individuals and couples looking to improve their intimacy. I also help couples heal from betrayal and infidelity and offer guidance for those recovering from sexual trauma.
Resources From a Sex Therapist
Blakemore, E. (2023). Gay conversion therapy’s disturbing 19th-century origins. https://www.history.com/news/gay-conversion-therapy-origins-19th-century
Braun-Harvey, D., Vigorito, M. (2013). Treating out of control sexual behavior: Rethinking sex addiction. Springer Publishing Company.
Groneman, C. (1994). Nymphomania: The historical construction of female sexuality. Signs: Journal of Women in Culture and Society, 19(2), 337-367.
Helfer, N. (2021). The myth of sex addiction (No. 20) Healing Sols Podcast.
Hunt, A. ‘The Great Masturbation Panic and the Discourses of Moral Regulation in Nineteenth and Early Twentieth-Century Britain’ Journal of the History of Sexuality, Vol. 8, No. 4 (April, 1998) pp. 575 – 615
Klein, M. (2012) America’s war on sex: The attack on law, lust, and liberty (2nd ed.). Praeger. Ley, D. J. (2012). The myth of sex addiction. Rowman & Littlefield.