Worth being straight about the disagreement, because the treatment landscape is shaped by it.
Compulsive sexual behaviour disorder is in the ICD-11, classified as an impulse-control disorder: a persistent pattern of failure to control intense sexual impulses, resulting in repetitive behaviour, causing marked distress or impairment, over an extended period.
“Sex addiction” isn’t a recognised diagnosis. It was considered and rejected for the DSM, and the addiction model — tolerance, withdrawal, the same mechanism as a substance — isn’t established. Many researchers consider it a poor fit for the evidence.
Which matters practically, because a substantial industry has grown up around the addiction model, including expensive residential programmes and twelve-step frameworks, some of which are helpful for some people and none of which rests on settled science.
What the criteria actually require
The ICD is explicit about something that gets missed: distress arising purely from moral disapproval of one’s own behaviour — from religious teaching, or from a partner’s or a community’s judgment — is not sufficient for the diagnosis.
This exclusion exists deliberately, because a great many people are told they have a disorder when what they have is a conflict between their behaviour and a value system.
The question isn’t whether you feel bad about it. It’s whether the behaviour continues despite consequences you actually care about, and whether attempts to reduce it repeatedly fail.
The markers that matter
Sex or pornography consuming time you would rather spend otherwise. Repeated unsuccessful attempts to reduce it. Continuing despite real consequences — to a relationship, to work, financially, or to health. Escalating intensity or risk to achieve the same effect. Using it primarily to manage mood rather than for pleasure. And concealment that has become substantial.
That mood-regulation item is frequently the most informative. For a great many people this is functioning as an anxiety or distress management strategy rather than as a sexual one.
What’s underneath, usually
Clinicians who work with this consistently find something beneath it: trauma history, depression, anxiety, ADHD, a manic phase, or an attachment pattern where intensity substitutes for closeness.
Treating the behaviour without the driver is why so many people cycle. And in some cases the presentation isn’t this at all — intrusive unwanted sexual thoughts with checking and reassurance-seeking is OCD, and it needs a completely different treatment.
Where to get help
A licensed clinician, and preferably an AASECT certified sex therapist. This is outside any coaching scope, and a coach who takes it on is doing something they shouldn’t.
Approaches with support include CBT adapted for this, ACT, and treating the underlying condition. Medication is sometimes used, particularly where there’s a mood or anxiety component.
Be wary of programmes that require you to accept the addiction framing as a condition of treatment, and of anything sold as a residential package at very high cost. Both exist in volume and neither is evidence-based.
Where behaviour involves other people
Everything here concerns consenting adults. If the behaviour involves anyone who can’t consent, that’s not a compulsion question and it requires specialist professional help urgently rather than a website.