Feeling out of control in your sexual life can take many forms. It might be about how much sex you’re having, or who with, or where. It might be about apps, porn, or the drugs used in sex. It might be about the number of partners, the risks taken, the use of sex workers. The list goes on.
It usually starts as something fun. Something that brings relief, enjoyment, pleasure.
The sex can be great.
Until, over time, it isn’t.
Over time, the behaviour starts to have impacts you never imagined: on work, on the relationships you care about, on your health, on your finances, on the things in life you actually want to be present for.
The feeling of being out of control brings its own weight. Shame, anxiety, low mood, exhaustion. It can be very hard to talk to anyone about it. There may be nowhere obvious to go. And the pattern repeats.
We start by naming it clearly, honestly, openly. We take time to map the problem and to understand where it has come from, what drives it, and what keeps it going. There is no position of shame or blame here. These problems arise from many different factors across a lifetime.
This is not addiction treatment in the twelve-step sense.
Often, the behaviour is a response to something overwhelming. In that sense it makes sense. It has been there to help you cope, to provide escape or relief. We work to understand that, and to find other ways of responding to difficult feelings. We also map out what your sexual life could look like in a way that fits your own values and preferences.
Over time, things shift. Recognising the patterns makes it possible to choose differently. People find ways of increasing a sense of control over how they approach sex and the experiences they have. It takes time. People move forward in a direction that suits their own sexual life, and the harms reduce.
Turning up. Naming it as a problem. From there, we unpick the rest together.
Sex addiction is not a formal diagnosis. The ICD-11 (the World Health Organization's main diagnostic manual, used by clinicians in the UK and internationally) frames the clinical picture as Compulsive Sexual Behaviour Disorder. Many people who arrive describing themselves as sex addicts find this clinical frame helpful, but you do not need to accept any particular label to do this work.
The "addiction" model frames compulsive sex as a behavioural addiction. CSBD (Compulsive Sexual Behaviour Disorder, ICD-11) frames it as a disorder of impulse control and emotional regulation. The work in this practice does not require choosing between these; it focuses on the pattern, what it is doing for the person, and what changes when it stops.
Many men present primarily with compulsive porn use rather than partner-based sexual behaviour. The same clinical approach applies. Some develop porn-induced erectile difficulties; that strand is worked on alongside.
No. The work is not abstinence-based. It focuses on understanding the pattern and rebuilding a relationship to sex that the person actually wants.
Outcomes from the NHS group programme Dr Yates designed are published in peer-reviewed research, with a large effect size (d=2.51) on the primary measure for compulsive behaviours.