What is Compulsive Sexual Behavior Disorder?
Compulsive sexual behavior disorder (CSBD) has been known by a number of different names over the years, including hypersexuality, sexual addiction, and excessive sexual desire disorder.
Although there has been considerable debate among experts regarding whether or not compulsive sexual behavior should be classified as a mental health condition, it has been included in the International Classification of Diseases, 11th Revision (ICD-11).
The ICD-11 defines CSBD as a condition “characterized by a persistent pattern of failure to control intense, repetitive sexual impulses or urges, resulting in repetitive sexual behavior over an extended period (e.g., six months or more) that causes marked distress or impairment in personal, family, social, educational, occupational, or other important areas of functioning.”
What types of sexual behaviors might become compulsive for people with CSBD?
Often, the sexual behaviors and urges that individuals with CSBD experience are not problematic in and of themselves. For example, CSBD patients may engage in common sexual behaviors such as masturbation, viewing porn, having multiple partners, and/or cybersex. When this is the case, the issue arises from the patient’s inability to control their impulses, even when the behaviors are having a negative effect on their life. This situation can lead to a loss of time, productivity, and self-esteem, as well as potential damage to the individual’s relationships, career, and overall health.
However, there are times when a person’s sexual compulsions are illegal or fundamentally harmful to themselves or others. For example, individuals with paraphilic disorders experience repeated, distressing impulses that may harm others.
What are the symptoms of CSBD?
People with CSBD may have the following symptoms:
- Frequent intense sexual fantasies and urges that are involuntary/out of control
- A strong drive to repeatedly engage in certain sexual behaviors
- A feeling of a lack of control when it comes to engaging in sexual behaviors, often marked by unsuccessful attempts to stop the behaviors
- Guilt, shame, or remorse after engaging in said behaviors
- The use of sexual behaviors as a means to deal with other problems in life
- The inability to stop engaging in sexual behaviors despite serious negative repercussions such as contracting or spreading a sexually transmitted infection, damaging or losing important relationships, losing a job, draining one’s finances, or facing imprisonment for sexual offenses
What treatments are available for people with CSBD?
It is important for individuals with CSBD to seek professional help as soon as possible, especially if they have thoughts of causing harm to themselves or others. Psychotherapy and medications can be used to control compulsive sexual behavior. These treatment options can be particularly effective when patients also address other mental health conditions and/or substance abuse issues that they may have, as these factors can aggravate CSBD symptoms.
Cognitive behavioral therapy (CBT) is a type of psychotherapy that helps an individual identify negative, unhealthy patterns in their life and consciously opt to use productive approaches instead. Other types of therapy that may be useful for CSBD focus on increasing a person’s awareness of their thoughts and urges and replacing behaviors that do not align with their values with behaviors that do.
Medications that affect the brain’s chemistry (e.g., antidepressants, naltrexone, mood stabilizers, and anti-androgens) may also improve CSBD symptoms. CSBD patients should speak with their health care providers to determine the best course of action when it comes to treatment.
Fong, T.W. (2006). Understanding and managing compulsive sexual behaviors. Psychiatry (Edgmont), 3(11), 51. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2945841/
Kraus, S.W., Krueger, R.B., Briken, P., First, M.B., Stein, D.J., Kaplan, M.S., Voon, V., Abdo, C.H., Grant, J.E., Atalla, E., & Reed, G.M. (2018). Compulsive sexual behaviour disorder in the ICD‐11. World Psychiatry, 17(1), 109. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5775124/
Mayo Clinic. (2020, February 7). Compulsive sexual behavior. https://www.mayoclinic.org/diseases-conditions/compulsive-sexual-behavior/symptoms-causes/syc-20360434