Compulsive sexual behaviour
We find that most men do not describe themselves as having a problem with sex. They describe themselves as having a problem with control. Something that started as pleasurable, exciting, or simply part of how they understood themselves sexually has, over time, started to feel less like a choice and more like a pattern they cannot step outside of.
Published
Dr Michael Yates, Clinical Psychologist and Psychosexual Specialist
The scales have tipped. What once felt liberating, or at least manageable, now costs more than it gives back. This is the starting point for almost everyone who comes through the programme: not moral failure, not something inherently broken in them, but a gradual shift in a pattern that once worked and now does not. Understanding that shift is the first piece of the work, and it is what we want to set out clearly on this page.
When the scales tip
Imagine a set of scales. On one side sits everything the behaviour has given: the pleasure, the freedom, the relief, the excitement, the sense of being sexual in a way that felt fully alive. For most men, that side has been genuinely heavy. No one engages in what eventually becomes compulsive sexual behaviour without it having brought something fun and pleasurable at some point. To ignore that would be dishonest, and it would make the work worthless.
On the other side of the scales sit the consequences. The relationships strained or lost. The hours swallowed up by apps or pornography or arrangements that took much more time and energy than planned. The infections, the financial costs, the narrowing of life outside the behaviour. The sense of shame that arrived somewhere along the way, even when the pleasure was still there. The ways these behaviours have taken us away from the values we thought we had for ourselves and others. Eventually, the feeling that the thing is happening to you rather than being chosen by you.
For men who are in that position, the scales have tipped.
The weight of what the behaviour costs has exceeded the weight of what it gives. That is when most men first reach out for support.
The arc matters. Almost always, the behaviour started somewhere reasonable. Apps, pornography, sex with multiple partners, drugs and sex, paid sex, online sex: these things tend to enter someone's life at a point when they feel congruent with who that person is and what their life is like. For many gay and bisexual men, sexual exploration is interwoven with coming out, with finding community, with the particular freedom of moving into gay spaces for the first time after years of feeling invisible or constrained. For younger straight men, pornography is often where the first template of sexuality was laid down, long before any lived experience. For older men, the behaviour may have run quietly alongside a long-term relationship for years before circumstances brought it into the open.
The escalation is also real. Behaviours tend to become more frequent, more time-consuming, more risky, and more difficult to interrupt over time. This is not a character flaw. It reflects how patterns that are tied to pleasure and relief tend to entrench. The brain, shaped by repeated reward, starts to ask for more. And the behaviour that once brought the relief needs to be done more often, more intensely, or for longer to produce the same effect.
What the behaviour is doing
The important question is not what the behaviour is, but what it is doing for you. Every behaviour has a job. Something it has been doing over time that felt useful enough to keep reaching for. Understanding that job is how change becomes possible.
Inside all of us, there are three ways our feelings work.
The first is the alarm. What switches on when something feels dangerous, or when a feeling gets too big to handle. It puts us on edge, ready to fight, run, or freeze. (In therapy this is called the threat system.)
The second is the drive. What pulls us toward reward, motivation, and excitement. The wanting side of us that goes out looking for the things we care about. (In therapy this is called the drive system.)
The third is a system that helps us manage our feelings and calm ourselves, which we call the soothing system. It is the quieter part of us that can rest, feel safe, and feel connected, without needing anything from outside to produce that feeling. It is what lets a person sit still and not have to fix, escape, or achieve anything. It is the part that is often least developed in the men who come to this work.
Not because of anything wrong with them. Men are not, in our culture, given many tools for handling what comes up around sex. Sex is treated as a physical thing, cut off from what is happening emotionally underneath. Gay and bisexual men have often grown up with explicit messages that being sexual the way they want is wrong, dangerous, or shameful. Straight men have grown up with equally strong but differently shaped pressure: sex is a performance, emotional needs are not admitted, and the only acceptable way to handle feeling overwhelmed is to handle it alone. Almost none of the men I meet have ever been shown how to sit with the difficult feelings that come with navigating sex and relationships as we get older.
The behaviour arrives as an emergency exit: fast, reliable, repeatable.
In that context, what the behaviour is often doing is this: fixing, escaping, or getting away from a feeling that a man has no other tools to face. The alarm inside him has fired, and the behaviour is the fastest way he knows to switch it off. That fear might be inside the sexual space itself, fear of intimacy, fear of rejection, fear of what vulnerability would expose. It might be in the wider life: work pressure, financial strain, family difficulty, loneliness, uncertainty about who you are or where you are going. The behaviour arrives as an emergency exit: fast, reliable, repeatable. It works, at first. Over time, as the consequences build up, the behaviour starts to generate its own difficult feelings, and the loop tightens.
Who comes in, and what they bring
The men we work with are a genuinely mixed group. Gay and bisexual men make up a substantial proportion, as does the straight population.
Gay and bisexual men often arrive through a sexual health route: repeated sexually transmitted infections (STIs), physical injuries, a conversation with a nurse or doctor who noticed a pattern. The behaviour they name might be app use that has become compulsive, pornography, drugs and sex (including chemsex), sex workers, or repeated high-risk sexual encounters. For younger gay men, the situation can be particularly acute: some have no reference point for what safe, connected, pleasurable sex looks like. The only template they have ever had is harm-coded sex, and they face a genuinely difficult realisation: that this is what they were taught sex was, but it is hurting them. For older gay men, the arc is different. They often had other forms of sex earlier in life and have arrived at a point where they are comparing what they have now with what they used to have, and cannot see a way back.
Bisexual men carry specific pressures. They often feel invisible or uncertain in gay spaces, and the easiest entry point into those spaces is often the most liberated and the most drug-adjacent. The behaviour can become entangled with simply trying to find a place to belong.
Straight men present with broadly similar patterns, though the specific behaviours lean more towards extramarital affairs, paid sex, and platforms such as OnlyFans and live cam sites. They tend to present later than gay men. Often, a relationship is at breaking point, or a disclosure has happened, and the man arrives in crisis. The behaviour has been running for years, kept manageable, kept compartmentalised, until the weight of maintaining it became too great. What these men carry, almost universally, is confusion, anger, sadness, and a sense of loss. Something they believed was in their control has turned out not to be.
Younger straight men occupy a similar position to younger gay men: pornography has been the only template. For men whose entire sexual development has been shaped by high-stimulation online pornography, the gap between that template and what real sexual contact involves can be genuinely disorienting.
The words men often use and how we respond
Many men arrive describing themselves as having a sex addiction or porn addiction. The language is understandable: it captures the loss of control, the compulsive quality, the feeling that something has got a grip on them. It is also the way millions of men describe this experience when they search for help. If you have been looking for support using those terms, you are in the right place.
The way we work is different from the addiction model. In this programme we do not ask you to identify as addicted, and we do not treat the problem as one that requires total abstinence.
Shame drives the very behaviour a man is trying to interrupt.
That distinction matters, because if the goal is framed as never doing the behaviour again, the whole treatment tips toward stopping at all costs. In practice, that approach rarely produces lasting change. When abstinence becomes the measure of success, every slip becomes evidence of failure. Shame builds. Shame drives the very behaviour a man is trying to interrupt. The cycle tightens instead of loosening. That is why this programme is not a twelve-step or abstinence-prescribed programme. The work is about understanding what has been happening, and then building a different relationship with sex that a man can actually live with.
It is not just about you
The problem is not located solely inside the man. It is not evidence of a broken character or a diseased brain. It sits, most often, in the world around him: in the way our culture goes silent about the emotional side of sex, in the absence of any useful language for managing what sexual experience brings up, in the specific pressures of being a gay or bisexual man in a world that has not made that experience safe, or in the specific pressures of being a straight man in a culture that confuses shutting down with strength.
It is very difficult to change a behaviour you are still using to punish yourself for.
When the men I work with come to understand this, something shifts. It becomes possible to see the behaviour not as evidence that they are fundamentally flawed, but as an understandable response to threat and to a gap in resources. That shift is what makes it possible to change.
What the programme offers
Time To Talk About Sex is a six-month group therapy programme for men whose sex lives have started to feel out of control. It is designed around the work described on this page: understanding what the behaviour has been doing before trying to change it.
The programme runs across twenty-four sessions in two phases. The first phase, New Chapter, is about understanding. Mapping the pattern. Recognising the emotional systems underneath it. Beginning to see the behaviour in its full context rather than as simply a source of shame. The second phase, New Direction, is where the harder work happens. Sitting with the shame, the loneliness, and the inner critic. Building the self-compassion that makes it possible to change. Working out what a sexual life you actually want looks like, and how to move towards it.
The group is part of the work, not just the setting for it. Shame thrives in private. A room of other men working on the same material does something that no amount of individual work can replicate. Men who have done group work in this territory describe it the same way: not alone. Not having to explain themselves before they can begin.
The programme is open to gay, bisexual and straight men across the UK. Groups are organised by sexual orientation so that men work alongside others whose experiences are most similar to their own. Each cohort takes up to ten men.
Questions men often ask
What is compulsive sexual behaviour?
Compulsive sexual behaviour describes any pattern of sexual behaviour that has started to feel out of control. Officially, it refers to behaviour that has persisted for six months or longer, feels repetitive and difficult to stop, and continues despite negative outcomes. In our work we often simply talk about sex starting to feel out of control, behaviour you are engaging in more than you want to, in ways you didn't plan, and that is starting to impact you in ways you didn't anticipate.
How do I know if my sex life has become compulsive?
One of the clearest signs is that the behaviour is producing outcomes you didn't expect and didn't want, across relationships, work, health, or your sense of yourself. Another is that you have tried to stop or slow down, and found that you can't, or that you stop for a while and then find yourself back in the same place. If sex is continuing despite consequences you are aware of and would prefer to avoid, that is worth paying attention to.
Is compulsive sexual behaviour the same as sex addiction?
For many people it can feel like an addiction, something they can't stop despite wanting to, something that overrides their intentions. But officially, compulsive sexual behaviour is not classified as an addiction. It is described as an impulse control disorder, which means it is a behaviour we have learned to use to cope with difficult feelings, and which can become overused to the point where we find it very hard to stop. That is not quite the same as addiction, even if the lived experience can feel similar. We don't ask you to use or accept any particular label in this work.
Why does it feel out of control even when I want to stop?
Because the behaviour is almost always serving a function. At some point it worked, it helped you escape something, feel something, manage something that felt overwhelming. The brain learns very quickly that this is an effective and accessible way of coping with difficult feelings. So every time those feelings arise, the brain reaches for the same solution, even when you consciously want to do something different. The more the behaviour is used as a coping tool, the more entrenched it becomes, and often the more intensity or frequency is needed to produce the same effect. Wanting to stop is not enough on its own if there is nothing in place to cope with the feelings and experiences that the behaviour was originally designed to manage.
Could this be happening to me?
If a sexual behaviour has started to feel difficult to control, if it is having an impact on areas of your life you didn't foresee, if it is taking up more time, energy, or emotional space than you wanted, and if you have tried to change it but keep finding yourself back in the same place, then yes, it could be. These patterns can happen to anyone, at any point in life, and the fact that something feels off is worth taking seriously rather than waiting for it to become undeniable.
Why do I keep doing something I don't want to?
Because at some point, the behaviour gave you something important. It helped you feel good, escape something difficult, connect with your body or your sexuality in a way that wasn't possible elsewhere, or manage feelings that felt unmanageable. The brain learns that this works, and it keeps reaching for it. Over time, the behaviour becomes the default response to a whole range of difficult experiences, not because you are weak, but because no alternative has been built. Understanding what the behaviour has been doing is where the work begins.
I don't think I'm addicted, but something feels off. Is this for me?
Yes. We don't use the language of addiction in this programme, and you don't need to identify as addicted to access support. What matters is whether sex has started to feel like it isn't working for you, whether it is producing outcomes you didn't want, or you are using it in ways that have moved away from what you actually value. If something feels off and you have tried to address it and found it hard to shift, that is enough. We will work with you to understand what is happening and what needs to change.
I can stop when I want to. Does that mean I don't have a problem?
Not necessarily. The question is not only whether you can stop, but what happens when you do. Many of the men we work with can stop, sometimes for long periods. But they find that stopping leaves them without any alternative: either avoiding sex altogether, or living with the pressure of knowing the behaviour is one difficult moment away from returning. If stopping is creating its own problems, or if the behaviour keeps reasserting itself when life gets harder, that is worth exploring, even if you can technically stop when you choose to.
How do I know when it's time to seek help?
When the behaviour is no longer in your control, or is producing consequences you didn't foresee and don't want. That can mean different things for different people, a relationship in difficulty, a pattern that has been discovered, a financial or health impact, or simply a quiet recognition that you have moved a long way from how you want to live. If you have tried to change and it hasn't held, that is a clear sign. There is no minimum threshold to meet. Coming sooner rather than later almost always makes the work easier.
What is my sexual behaviour actually doing for me?
This is one of the first things we explore together. These behaviours do not come out of nowhere, and often they made some sense to us, at least initially. They have given you something: pleasure, relief, validation, a way of escaping difficult feelings, a sense of being desired, access to your sexuality in spaces where that felt possible. Understanding what the behaviour has been giving you is not about justifying it, it is about understanding what needs to be in place instead. No one keeps doing something that has never worked.
What need is this behaviour trying to meet?
It varies between individuals, but the most common needs are around feeling good, feeling liberated, feeling sexually confident, or escaping, switching off from stress, avoiding difficult feelings, or finding connection with others. These are real and legitimate human needs. The behaviour has simply become the primary way of meeting them, often in the absence of better alternatives. We will work with you to understand your specific needs and begin to think about how they might be met in ways that are more sustainable and less costly.
Why does understanding the behaviour matter more than simply stopping it?
Because if you stop without understanding what the behaviour has been doing, you leave a gap, and nothing to fill it with. The emotional states the behaviour was managing do not disappear when the behaviour stops. They press for a solution, and the most available solution is usually the same behaviour. Understanding the function first allows us to think about what alternatives might genuinely work for you, and what a different relationship with sex might look like. For some people that eventually means stopping entirely. For others it means changing the relationship rather than ending it. That decision is yours, and it becomes possible to make honestly only once the function is understood.
What is the ICD-11 diagnosis for compulsive sexual behaviour?
The International Classification of Diseases (ICD-11), the World Health Organisation's main diagnostic framework used by clinicians in the UK, classifies compulsive sexual behaviour as an impulse control disorder rather than an addiction. The formal definition is a persistent pattern of failure to control intense, repetitive sexual impulses or urges, resulting in repeated sexual behaviour that causes significant distress or impairment across important areas of life. Repeated attempts to stop have usually been made. The behaviour continues despite its consequences.
If what you have read here feels familiar, this is what the programme was built for.
A six-month group therapy programme for men whose sex lives have started to feel out of control. Available across the UK.
See how the programme works