Compulsive Sexual Behaviours


A Psycho-Sexual Treatment Guide for Clinicians

Compulsive Sexual Behaviours

Release Date: May 11th 2021

Compulsive Sexual Behaviours offers a unique approach to the struggles people face with their out-of-control sexual behaviours.
This comprehensive guide is deeply rooted in the science of sexology and psychotherapy, demonstrating why it is time to re-think the reductive concept of ‘sex addiction’ and move towards a more modern age of evidence-based, pluralistic and sex-positive psychotherapy. It is an important manual for ethical, safe and efficient treatment within a humanistic and relational philosophy.
This book will be an important guide in helping clients stop their compulsive sexual behaviours as well as for therapists to self-reflect on their own morals and ethics so that they can be prepared to explore their clients’ erotic mind.


"Silva Neves brings the understanding of compulsive sexual behaviors into the 21st century with a rigorous review of the past and latest literature and research. His argument that correct language dictates correct treatment is spot on and provides an exhaustive and comprehensive list of action steps for the initial assessment to ensure accurate assessment, diagnosis and treatment. His clinical examples bring all this to life through his clients. His plead for therapists to be not only sex positive but also pleasure positive is timely in a world that is missing proper sex education. I highly recommend this book."

Joe Kort, PhD is a sex and relationship therapist and co-Director of Modern Sex Therapy Institutes.  

"Compulsive Sexual Behaviours is a much-needed book taking a sensible, critical, and pragmatic approach to the topic of 'sex addiction'. Silva's book offers an alternative model which puts pleasure, consent, and self-understanding at the heart of the therapeutic endeavour with people who struggle with their sexual behaviour. It contains everything you need to know about the theory and research in this area, plus a helpful and practical guide for practitioners about how to work around this theme with clients. The book is friendly, accessible, and engaging throughout, drawing pluralistically on relevant therapeutic and sexological approaches, and providing nicely inclusive examples of work with clients from across gender, sex, and relationship diversity."
Meg-John Barker, author of Sexuality: A Graphic Guide, Enjoy Sex, and The Psychology of Sex. 

The problematic thinking of ‘sex addiction’

We are passionate about real information on sexual behaviours. There is so much ‘fake news’ on the topic of sexual desire and sexual behaviours. For example, what is too much sex? Not enough sex? And of course, the erroneous conceptualisation of ‘sex addiction’.

The field of 'Sex addiction' emerged in the 80’s with 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: 

1. 'Sex Addiction' is not an approved or recognised mental health diagnosis in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders). It is not a recognised condition in the field of psycho-sexology.

2. The clinical term that is endorsed by ICD-11 (International Classification of Disease) is Compulsive Sexual Behaviour Disorder (CSBD). Its classification is under Impulse Control Disorder, not Addiction. The clinical criteria to meet the diagnosis for the CSBD are very specific: it is rare for people to fully meet the disorder criteria. Therefore, most people who struggle with their sexual behaviours do not suffer from a disorder, but they struggle with sexual behaviour problems and erotic conflicts (it is the difference between pathology and a problem. A problem is not always pathological).  

Although the term ‘sex addiction’ is the most widely used term to describe compulsive 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), which have no knowledge in sexology and, as a result, are sex-negative and shaming. The addiction clinician will base their treatment plans on addiction-focused treatment which might include a ‘sobriety contract’ and other addiction behavioural interventions. Addiction interventions work very well for alcohol and drug addiction, however the addiction model is not efficient with sexual behaviours because human sexuality is a completely different physiological and psychological system. In order to treat ‘sex addiction’ effectively, the clinician must have a thorough and specialist evidence-based and contemporary 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.

Some of the struggles people with sexual compulsivity face are:

1. Using sex as a primary way of coping with the unpleasant feelings of life: feeling sad, feeling angry, feeling tired, feeling bored, etc…
2. A sexual behaviour that is compulsive and repetitive. They cannot stop their sexual behaviours despite negative consequences. They feel their sexual behaviours are out of control.
3. 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.
4. 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.
5. It is a condition that brings a lot of despair and suffering for the people with compulsive sexual behaviours, and it has a tremendous traumatizing impact on their partner.

WHO (ICD-11)

WHO (ICD-11) clearly states: ‘materials related to the ICD-11 make very clear that CSBD is not intended to be interchangeable with ‘sex addiction’, but rather is a substantially different diagnostic framework’. 

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