Silva Neves Specialist Psychotherapy in Central London EC1 & Reading, Berkshire RG1



Sex addiction and out of control sexual behaviours. sex addiction

'Sex Addiction', Out-of-Control Sexual Behaviours and Hypersexual Behaviours: Important information before starting treatment

The field of 'Sex addiction' emerged in the 80’s with Dr Patrick Carnes' publications and treatment centres in the USA. The films Shame (2011), Thanks For Sharing (2012), Nymphomaniac (2013) and Don Jon (2013) brought 'sex addiction' to the awareness of the public.
More recently, the public scandals in the Hollywood film industry brought the sex addiction treatment field into questioning and scrutiny. The field has been criticised to be an easy and comfortable ‘get-out-of-jail’ card for white, rich sexual offenders.

'Sex addiction' is currently the most widely used term describing sexual behaviours that have gone out of control. At the moment, many people are confused as to what sex addiction actually is. If you think you are having problems controlling your sexual behaviours, you might call yourself a sex addict.

There are a few important things for you to know before you engage in treatment:

  • Sex Addiction is only a term coined by some treatment centres in the USA in the 80’s. It is not an approved or recognised mental health diagnosis in the DSM V (Diagnostic and Statistical Manual of Mental Disorders). It is not a recognised condition in the field of psycho-sexology either. The reason for this is that robust clinical research in the field is poor, despite what many books are preaching. These books are based on clinicians’ opinions, not clinical research. Many of these well-meaning clinicians and authors are not adequately trained in the field of human sexuality.

  • The term that I believe is more appropriate for this condition is out-of-control sexual behaviours or hypersexual behaviours. My opinion is based on my extensive knowledge of human sexuality and my experience of working with many clients who present with out-of-control sexual behaviours.

    Some of the issues people with hypersexual behaviours have are:

  • Using sex as a primary way of coping with the unpleasant feelings of life: feeling sad, feeling angry, feeling tired, feeling bored, etc…

  • A sexual behaviour that is compulsive and repetitive. Someone with hypersexual behaviours cannot stop their sexual behaviours despite negative consequences. They feel their sexual behaviours are out of control.

  • It makes the person feel bad. Clients often report that the sexual behaviours they engaged in was unwanted by them, and they feel bad and shame afterwards. They can also feel depressed or worthless.

  • Engaging in sexual behaviours that is against their own values and integrity. For example, having sex outside of the marriage, even though they love their spouse.

  • It is a condition that brings a lot of despair and suffering for the people with out-of-control sexual behaviours, and it has a tremendous traumatizing impact on their partner.


  • Sex addiction and out of control sexual behaviours. loneliness

    The diagnosis of 'sex addiction'

    Although the term ‘sex addiction’ is the most widely used term to describe out-of-control sexual behaviours, it is vital for you to understand the implication of a ‘sex addiction’ diagnosis so that you can make an informed choice on your treatment options:

    If a clinician diagnoses you with ‘sex addiction’, you are likely to be offered an addiction treatment, which rests upon the assumption that sex is addictive and it is a chronic illness. As mentioned above, there is no clinical evidence to support this assumption, despite many books and websites that claim otherwise.
    The typical 'sex addiction' treatment will encourage you to attend SAA meetings (Sex Addicts Anonymous) or SLAA meetings (Sex and Love Addicts Anonymous). The addiction clinician will base their treatment plans on addiction-focused treatment which will include a ‘sobriety contract’ and other addiction behavioural interventions. A sobriety contract and addiction interventions work very well for alcohol and drug addiction. However, in my clinical experience, the addiction model is not efficient with sexual behaviours because human sexuality is a completely different physiological and psychological system. In my professional opinion, in order to treat ‘sex addiction’ effectively, the clinician must have a thorough and specialist training and understanding of human sexuality.

    AASECT (American Association of Sexuality Educators, Counselors and Therapists) issued the following statement:
    1- There is no sufficient empirical evidence to support the classification of sex addiction and porn addiction as a mental health disorder.
    2- The sexual addiction training and treatment methods and education pedagogies are not adequately informed by accurate human sexuality knowledge.

    Based on my clinical experience, out-of-control sexual behaviours or hypersexual behaviours are real problems which bring a lot of distress in people's lives. But it is not an addiction or a chronic illness. You can re-organise your sexual behaviours and your relational self in a way that is fulfilling for you, permanently.



    Sex addiction and out of control sexual behaviours. Elaine yellow flower

    My treatment of out-of-control sexual behaviours and hypersexual behaviours: a psycho-sexological, holistic and humanistic approach

    My treatment for out-of-control sexual behaviours and hypersexual behaviours is based on specialist psychosexual training and experience, clinical research on human sexuality, clinical evidence on brain functions and neuropathways, and human psychology. I do not offer an addiction treatment to ‘sex addiction’. It means that I do not encourage clients to attend SAA or SLAA meetings. I do not ask clients to be ‘sober from sexual behaviours’. I do not prescribe clients a ‘right’ way to be sexual.

    Instead, I help my clients understand where their sexual behaviours come from, explore their sexual and relational landscape to gain a better understanding of their own individual sexual and relational system. Together, we make sense of their desires, their needs, their wanting, their longing. We also explore values and what their integrity is made of. With this deep understanding, clients are then able to change many different areas of their life to support a fulfilling and vibrant sex life in stable relationships. My approach is humanistic and holistic: it is a non-shaming, respectful and sex-positive approach. In my clinical experience, this approach is very effective, and supports a sustainable long-term fulfilling lifestyle.

    My treatment of hypersexual behaviours and out-of-control sexual behaviours includes:
  • Behavioural approach to help identifying the sexual behaviours that are wanted from those that are unwanted.
  • Learning new ways to self-soothe and cope with the negative feelings about life: stress, anxiety, feeling low, feeling bored, feeling unfulfilled, feeling bad.
  • A deep exploration of the sexual landscape.
  • A deep exploration of the emotional world and core beliefs.
  • A examination of cognitive processes.
  • Re-instating balance in life: hobbies, positive connections with friends and loved ones, a deep sense of self, finding meaning, higher self-esteem.
  • Healing the possible trauma(s) underlying the roots of out-of-control sexual behaviours.
  • Treating the possible psychosexual dysfunctions underlying the roots of out-of-control sexual behaviours.
  • Healing the relationship that has been devastated by hypersexual behaviours, if appropriate.
  • Re-integrating vibrant, diverse and fulfilling sexuality with self and others.

    My approach of the treatment of hypersexual behaviours and out-of-control sexual behaviours is non-moralistic, non-judgmental, empathic and holistic.

    The treatment for hypersexual behaviours is challenging. But I do not believe in ‘once an addict, always an addict’. Using specific classic humanistic, evidence-based psychological interventions and modern psychosexual interventions, people can truly leave their out-of-control sexual behaviours behind and change their lives positively and permanently.

    The aim of the treatment of hypersexual behaviours is based on the six principles of sexual health (Pan America Health Organisation):
    1- Consent
    2- Non-exploitation
    3- Protection from HIV, STI and unwanted pregnancy
    4- Honesty
    5- Shared values
    6- Mutual pleasure


    Sexual Health is the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence. (WHO 2006)



  • Sex addiction and out of control sexual behaviours. Sex addiction

    Therapy for partners

    The discovery or disclosure of out-of-control sexual behaviours and hypersexual behaviours brings devastating and traumatizing consequences to the partner.

    The most common impacts on the partner are:
  • Emotional turmoil, depression and feelings of despair
  • Acting like a detective
  • Obsessing about the sexual acting out which can make like hard to manage
  • Avoiding thinking or discussing the traumatizing consequences
  • Sleeplessness and nightmares
  • Feeling stupid for believing the addict's lies
  • Emotional numbness
  • Feelings of victimization
  • Fear about future relapse
  • Trust is shattered
  • Anger and hostility
  • Loss of the dream of the relationship
  • Loss of self
  • Loss of emotional and sexual safety

    It is important for the partner to engage in therapy to help with healing the trauma of out-of-control sexual behaviours and the restore balance in the emotional and practical life.

    I do not offer therapy for both the person with hypersexual behaviours and the partner. If I engage in therapy with the partner, I refer the person with hypersexual behaviours to one of my trusted colleagues, and vice versa.
    I do offer couples therapy for couples who have been wounded by hypersexual behaviours.







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