When Sexual Behavior Feels Out of Control: Understanding and Treating Compulsive Sexual Behavior Disorder

Written by Pebble Kranz, MD, FECSM, IF, MSCP

Two people in black shirts laying in the grass.

Image by Jupi Lu from Pixabay

In recent years, more mental health and medical professionals have encountered clients who feel “out of control” with their sexual behavior—engaging in pornography, hookups, or masturbation they later regret, sometimes without understanding why. Some experience shame and isolation; others struggle to reconcile values and desires. The clinical challenge lies not only in understanding these experiences but in knowing when to normalize, when to identify a problem, and when to refer for specialist evaluation.

Compulsive Sexual Behavior Disorder (CSBD), now recognized in the ICD-11, provides a new diagnostic framework but also raises important questions. Unlike older models that used addiction language, the ICD-11 defines CSBD by the experience of losing control and the impact on one’s life. Crucially, it cautions against labeling sexual behavior as disordered if distress is solely rooted in moral judgment or societal disapproval.

Interested in learning more? Attend the September 19, 2025 workshop Decoding Compulsive Sexual Behavior Disorder: Medical Insights and Therapeutic Strategies. NYSED LMSW/LCSW, LMHC, LMFT, LCAT, OASAS and CMEs are provided. 

This two-hour session helps health professionals move beyond simplistic notions of “sex addiction,” encouraging a nuanced, biopsychosocial understanding of out-of-control sexual behavior. Participants will:

  • Explore physiological, psychological, and cultural factors that contribute to CSBD, as well as controversies and diagnostic limitations.
  • Review critical differential diagnoses, such as neurological conditions (e.g., Parkinson’s disease, frontal lobe injuries), genitourinary issues, and effects of psychiatric medications or substances.
  • Understand internal mechanisms that sustain distress—like emotion dysregulation, shame, and moral incongruence, where behavior clashes with personal or cultural values.
  • Learn to disentangle shame from pathology and help clients clarify what they want, what aligns with their values, and what drives their behavior.

Practical Tools and Approach

Participants will leave with concrete tools for assessment and treatment planning, including:

  • Identifying when to refer to medical or specialist providers.
  • Screening for comorbid conditions.
  • Offering interventions that prioritize emotional regulation and self-compassion over shame or behavioral suppression.
  • The session emphasizes a nonjudgmental, client-centered approach grounded in cultural awareness, sexual health principles, and trauma-informed care.

Who Should Attend?

This training is ideal for clinicians in mental health or medical settings who want to strengthen their competence in sexual health and gain practical tools for navigating CSBD. Whether you’re new to the topic or seeking a research-based refresher, you’ll leave better prepared to meet clients with clarity, humility, and confidence.

Join us for this essential training and gain the skills to support clients when sexual behavior becomes a source of suffering—and to help them find a path forward.

Published 8/14/25