Simon Wilson
Therapy for Compulsive Sexual Behaviour
Compulsive sexual behaviour and “sex addiction”
“Sex addiction” is a commonly used term for sexual behaviour that feels repetitive, difficult to control or harmful. I use compulsive sexual behaviour as the broader clinical term. The ICD-11 recognises Compulsive Sexual Behaviour Disorder as an impulse-control disorder, but not everyone seeking therapy will meet its diagnostic requirements.
My current research develops the concept of Compulsive Sexual Spectrum Disorder: a proposed framework for understanding compulsive sexual behaviour across a spectrum of severity, complexity and impact. It is a developing conceptual model rather than a separately recognised diagnostic category.
Understanding what drives and maintains the cycle
Compulsive sexual behaviour rarely has one simple cause. Assessment explores how the behaviour developed, what triggers it and what continues to reinforce it. Relevant factors may include:
Trauma and adverse experiences
Attachment difficulties and fear of intimacy
Shame, secrecy and difficulties with self-worth
Impulsivity and emotional dysregulation
Anxiety, depression, loneliness or stress
Neurodivergence and differences in attention, sensory regulation or impulse control
Relationship conflict, betrayal or emotional disconnection
The immediate relief, stimulation or escape provided by the behaviour
The aim is to develop an individual psychological and relational formulation rather than applying the same explanation or treatment model to everyone.
What therapy involves
Therapy begins with a careful assessment of the behaviour, its history, triggers, consequences and psychological or relational context. We then develop a shared formulation and agree realistic goals for change.
Depending on your needs, the work may include:
Identifying triggers and interrupting established behavioural cycles
Developing emotional regulation and alternatives to sexualised coping
Addressing shame, secrecy, avoidance and distorted thinking
Strengthening impulse control and decision-making
Establishing practical boundaries and strategies for reducing harm
Preparing for setbacks and developing a sustainable relapse-prevention plan
Exploring trauma, attachment and underlying emotional difficulties
Addressing the effects of the behaviour on partners and relationships
Supporting honesty, accountability and meaningful behavioural change
The aim is not simply to suppress sexual behaviour, but to help you develop greater choice, responsibility and a healthier relationship with sexuality.
Partners, disclosure and betrayal
Compulsive sexual behaviour can have a profound effect on partners and relationships, particularly where there has been secrecy, repeated infidelity, financial impact or an unexpected discovery.
Individual therapy may include understanding the effect of the behaviour on others, preparing for honest and responsible disclosure, developing accountability and considering how trust might be rebuilt. This does not make a partner responsible for the behaviour or assume that reconciliation will always be possible or appropriate.
Where joint work is needed, Relationship Therapy or separate support for the affected partner may be recommended. The boundaries between individual and relationship therapy are considered carefully to protect confidentiality and avoid conflicts of interest.
Working with men and high-responsibility roles
I work predominantly with men, including those in senior, regulated, high-responsibility or public-facing roles. Concerns about reputation, employment, family relationships or professional consequences can make seeking help particularly difficult.
Therapy provides a confidential and non-shaming setting in which to understand the behaviour and its underlying psychological and relational context. The work also maintains clear attention to accountability, potential harm and the realistic consequences of behaviour.
When behaviour may be harmful, high-risk or potentially illegal
Some people seek help because they are concerned that aspects of their sexual behaviour or interests may be harmful, high-risk or could cross legal boundaries. These concerns require careful clinical assessment, clear confidentiality boundaries and appropriate attention to safeguarding and potential harm.
Therapy can support greater honest reflection, responsibility and and meaningful change. Where a specialist evaluation of sexual behaviour, psychological complexity or risk is required, Forensic Sexology may be more appropriate.
Therapy, forensic assessment and risk management
Therapy is confidential within the usual ethical, legal and safeguarding limits. Its purpose is to support understanding, responsibility and psychological or behavioural change.
Therapy is not a formal forensic assessment, an expert opinion for legal proceedings or statutory risk management. Where a legal or forensic assessment is required, it is considered separately and is not combined with an ongoing therapeutic relationship.
Assessment therefore considers the pattern of behaviour, the person’s sense of control, its consequences and the wider psychological, sexual and relational context. Therapy may still be appropriate when a formal diagnosis is neither present nor required.
This may include pornography use, repeated infidelity, or sexual behaviours that impact relationships, work, or wellbeing. Therapy offers a confidential space to understand what is happening and begin to regain a sense of control.
You may be struggling with compulsive sexual behaviour if you notice:
Feeling unable to stop or reduce sexual behaviour
Repeated pornography use despite wanting to stop
Secrecy, shame, or living a double life
Repeated infidelity or sexual behaviours that feel out of control
Escalation in behaviour over time
Impact on relationships, trust, or self-esteem
Understanding the pattern
Compulsive sexual behaviour is rarely just about sex. It often develops as a way of managing difficult internal states, including anxiety, shame, loneliness, or unresolved trauma.
Over time, the behaviour can become habitual and difficult to interrupt, even when it no longer brings relief. Therapy focuses on understanding these patterns and creating the conditions for change.
How therapy can help
Therapy provides a structured and confidential space to explore the underlying drivers of compulsive sexual behaviour.
This includes developing awareness of triggers, understanding patterns, and building alternative ways of responding. The work is paced carefully, without judgement, and focused on long-term change rather than short-term control.
A specialist, psychosexual approach
My work is grounded in psychosexual and relational psychotherapy, integrating psychological, behavioural, and relational perspectives.
I work with individuals at different stages, whether you are beginning to question your behaviour, or have been struggling with it for some time.
The focus is not simply on stopping behaviour, but on understanding and addressing the underlying dynamics that sustain it.
Sessions and availability
Professional experience
I am a UKCP-registered psychotherapist and COSRT-accredited psychosexual and relationship psychotherapist and clinical sexologist. I am Chair of COSRT and Founder and Director of the Institute of Psychosexual Psychotherapy, with senior clinical, service-leadership and teaching experience.
Practical information
Sessions are available in Central London and online. Individual sessions normally last 50 minutes and cost £120.
The initial consultation provides an opportunity to discuss the behaviour, its effects and what you would like to change. We can then consider whether my experience and therapeutic approach are appropriate for your needs.
Related specialist services
Psychotherapy for broader individual work involving trauma, emotional distress, shame and psychological complexity
Relationship Therapy for joint work involving betrayal, disclosure, intimacy and recurring relationship patterns
Forensic Sexology for specialist assessment where sexual behaviour, risk or legal questions require separate consideration
Sessions are available in London and online across the UK.
Initial consultations provide an opportunity to discuss your situation and consider whether this approach feels right for you.
All enquiries are handled confidentially.