Help, My Sexual Behaviors are Out of Control!
Out of Control Sexual Behavior vs. “Sex Addiction”:
What’s the Difference?
When conversations about sex get tricky, two terms often pop up: sex addiction and out of control sexual behavior (OCSB). They sound similar, but they actually come from different frameworks, and the distinction matters.
What People Mean by “Sex Addiction”
The term sex addiction has been around for decades and is often used in popular media to describe people who feel compelled to seek sex, porn, or sexual activity despite negative consequences. It’s modeled after substance addiction, where the behavior is seen as compulsive and harmful.
But here’s the catch: sex addiction is not officially recognized as a diagnosis in the DSM-5 (the manual used by mental health professionals in the U.S.) or by the World Health Organization. Some clinicians use it, but it’s controversial because:
Sexual desire varies widely and labeling someone as “addicted” can pathologize normal sexuality.
The term can be influenced by moral, cultural, or religious values around sex.
The addiction model doesn’t always capture the complexity of why people struggle with sexual behaviors.
What Is Out of Control Sexual Behavior (OCSB)?
OCSB is a term that’s gaining traction in clinical settings. Instead of framing the issue as an “addiction,” it focuses on the experience of distress and loss of control around sexual behavior.
The American Association of Sexuality Educators, Counselors, and Therapists (AASECT) defines OCSB as when someone:
Feels their sexual behavior is inconsistent with their values or goals.
Repeatedly fails to control the behavior.
Experiences significant distress or consequences in their life because of it.
This approach emphasizes the person’s subjective distress and the mismatch between their actions and their personal values, rather than labeling them as “addicted.”
Key Differences
Sex Addiction is based on an addiction model (like drugs or alcohol), where as Out of Control Sexual Behavior (OCSB) is based on a behavioral and values conflict model. Sex addiction is not an official diagnosis in DSM-5 or ICD-11. However, the ICD-11 includes “Compulsive Sexual Behavior Disorder,” which aligns more closely with OCSB than “addiction.” We believe that Sex Addiction can pathologize high sexual desire even if it’s healthy. In contrast, OCSB focuses on distress and loss of control, not desire itself. A final key difference is that Sex addiction is often linked to 12-step or abstinence-based treatment models. OCSB emphasizes therapy that addresses triggers, shame, values, and regulation skills. Sexuality and desire are inherent and important part of ourselves that we can’t remove or cut off; therefore OCSB supports sexual health approaches to establish a relationship to your sexuality that allows for flexibility, acceptance, and changes in behavior.
Why Language Matters
How we frame the problem shapes how we treat it.
“Sex addiction” may resonate with some people, but it risks stigmatizing sexuality itself and 12 step models may feel uncomfortable for non-religious persons.
“OCSB” shifts the focus: the issue isn’t sex, but the lack of alignment between behavior and personal well-being.
By moving away from moralizing language, OCSB allows space for healthier, shame-free conversations about sexuality and self-control.
Getting Support
If you or someone you know struggles with sexual behavior that feels out of control:
A qualified sex therapist (ideally AASECT-certified) can help unpack what’s happening.
Therapy might explore underlying issues like stress, trauma, relationship challenges, or coping strategies.
The goal isn’t to eliminate sexuality—it’s to find a healthier, more fulfilling relationship with it.
Final Thoughts
Whether you call it “sex addiction” or “out of control sexual behavior,” the important part is that people struggling deserve compassionate, evidence-based care. Sexuality is complex, personal, and deeply human—so the language we use should honor that complexity without shame. Whether you or someone you love experiences challenges with sexual behavior, S.H.A.G can support you toward experiencing more joy, pleasure, and alignment between your sexual behavior and values.
