Why I Don't Use the Term "Sex Addiction" - and What I Do Instead

If you've ever felt out of control with your sexual behavior, compulsively watching porn, pursuing affairs, engaging in risky encounters, or feeling unable to stop despite real consequences, you've probably come across the term "sex addiction."

Maybe you've even used it to describe yourself.

But here's the thing: I don't use that term in my practice. Not because your struggle isn't real, it absolutely is, but because the label itself can actually get in the way of real healing.

The Problem with "Sex Addiction"

The concept of sex addiction suggests that sex itself is the problem, like alcohol or drugs. But sex isn't an external substance. It's a normal, healthy part of being human. When we pathologize sexuality itself, we layer on more shame—and shame is usually what's driving the behavior in the first place.

The term also doesn't account for what's really happening beneath the surface: unmet needs, trauma responses, anxiety, loneliness, disconnection, or a nervous system that's learned to regulate through sexual behavior.

What Is OCSB?

Instead, I work with what's called Out of Control Sexual Behavior (OCSB)—a framework that focuses on the loss of control and the distress it causes, not on demonizing sexuality.

OCSB recognizes that these behaviors often serve a purpose:

• They soothe anxiety or emotional pain

• They provide a sense of connection (even if fleeting or false)

• They offer escape from stress, boredom, or trauma

• They've become a deeply ingrained coping mechanism

The behavior isn't the enemy. It's a symptom. And symptoms are trying to tell us something.

How I Treat and Support OCSB

My approach isn't about shaming you into stopping or white-knuckling your way through abstinence. It's about understanding what's driving the behavior and building healthier, more sustainable ways to meet your needs.

Here's what that looks like:

1. We explore the "why" beneath the behavior What are you really seeking when you turn to sex or porn? Connection? Relief? Control? Numbness? Understanding the function helps us find alternatives that actually work.

2. We address shame head-on Shame keeps you stuck in cycles. We'll work to separate your worth from your behavior and build self-compassion, which is essential for real change.

3. We look at patterns and triggers When does the behavior happen? What feelings, situations, or thoughts precede it? Awareness is the first step toward choice.

4. We rebuild emotional regulation skills If sex has been your primary way to manage difficult emotions, we'll develop new tools, mindfulness, somatic practices, healthy outlets, so you have options.

5. We examine relationships and intimacy Often, OCSB is tangled up with deeper relational wounds or unmet needs for closeness. We'll explore how you connect (or avoid connecting) with others and yourself.

6. We redefine your relationship with sexuality The goal isn't to eliminate sexuality from your life, it's to help you engage with it in ways that feel aligned, intentional, and healthy.

You're Not Broken

If you're struggling with out of control sexual behavior, it doesn't mean you're broken, weak, or morally flawed. It means you're human—and you've been doing the best you can with the tools you had. Healing is possible. Not through shame or deprivation, but through understanding, compassion, and building a life where you don't need to escape anymore.

If this resonates and you're ready to explore what's really going on, I'm here. Reach out, and let's talk.

Dr. Adrian Scharfetter PhD, LMFT, CST