People often live privately with concerns about their sexual behaviour or pornography use for a long time before seeking support. Shame, secrecy, and uncertainty about whether the difficulty is "real" can make that first contact particularly difficult. This article explains who therapy may be helpful for, why people seek it, and how the process works.
"Sex addiction" and "porn addiction" are widely used terms, but they are not formal diagnoses and their use remains contested. The World Health Organization's International Classification of Diseases (ICD-11) instead includes compulsive sexual behaviour disorder (CSBD), which it classifies as an impulse-control disorder (World Health Organization, 2026; Kraus et al., 2018).
ICD-11 describes CSBD as a persistent pattern of failure to control intense, repetitive sexual impulses or urges, resulting in repetitive sexual behaviour. The pattern occurs over an extended period, such as six months or more, and causes marked distress or significant impairment in important areas of life (World Health Organization, 2026).
I use both sets of terms because many people searching for support describe their experience as an addiction. You do not need a diagnosis to attend therapy, and you do not need to decide which term fits your experience.
Who is this therapy for?
I work with adults aged 18 and over, individually and as couples. Therapy may be appropriate if:
Your sexual behaviour or pornography use feels difficult to control or reduce
Repeated attempts to change have not been successful
The behaviour continues despite negative consequences, or brings little or no satisfaction
Sexual activity has become a central focus, at the expense of your health, relationships, work, or other interests
You are experiencing shame, secrecy, anxiety, or isolation in relation to your behaviour
You and your partner are affected by the discovery or disclosure of sexual behaviour
You are a partner experiencing the impact of betrayal, and you wish to explore this in its own right
My practice is gender, sex, and relationship diversity (GSRD) affirming and culturally sensitive. I work with adults of all genders, sexualities, relationship structures, faiths, and cultural backgrounds.
Why do people seek therapy?
People seek therapy for many reasons. Some feel unable to stop a behaviour that conflicts with what they want for their lives. Others make contact after a partner discovers their behaviour, following a change in their mental health, or when the consequences have become difficult to manage.
The factors contributing to these difficulties vary from person to person. Research and clinical literature have identified associations between CSBD and other mental health difficulties. In therapy, we may also consider early relationships, attachment, trauma, emotional regulation, stress, and the wider context of your life. These are possibilities to explore rather than assumptions about your experience.
It is also important to distinguish between a loss of control and distress arising from conflict with personal values. High sexual interest or frequent sexual activity does not in itself indicate a disorder. Under ICD-11, distress that is entirely related to moral judgements or disapproval of sexual impulses, urges, or behaviours is not sufficient for a CSBD diagnosis (World Health Organization, 2026). Research also suggests that moral incongruence can influence how people perceive their own pornography use. Exploring this with care can support a more accurate understanding of your concerns and avoid unnecessary pathologising.
How does therapy work?
Initial conversation. We begin with a brief conversation to discuss what has brought you to therapy, answer any questions, and consider whether working together feels right.
Assessment. We then explore your concerns in more detail, including your sexual behaviour, relationships, personal history, and mental and physical health. We will also discuss confidentiality and its limits. You can choose what you share and when.
Formulation. Together, we develop a shared understanding of what may have contributed to your difficulties and what may be maintaining them. A biopsychosocial perspective is useful here, as it considers biological, psychological, relational, and social influences together.
Ongoing work. We agree therapeutic goals that reflect your values and circumstances. Depending on your needs, our work may include exploring urges and triggers, understanding the function of the behaviour, addressing shame, and considering issues of disclosure and trust. You remain in control of your goals, and they do not need to be defined by abstinence. We review our work regularly, and there is no fixed number of sessions.
Work with couples and partners. Where a relationship is affected, couples therapy can provide a space to consider disclosure, betrayal, and each partner's experience. It may not be appropriate in every situation, including where there is abuse or coercive control. We can discuss which form of support may be most suitable for you.
Taking the next step
I offer sessions in central Leeds and online. Individual sessions last 50 minutes and couples sessions last 60 minutes, with each session costing £65. You do not need a GP referral, or to have stopped the behaviour, before getting in touch.
If you would like to find out more, please read about individual therapy or couples therapy, or contact me to arrange an initial conversation.
If you are in immediate danger, call 999 or attend A&E. For urgent mental health support, contact NHS 111, or call Samaritans free on 116 123 at any time.
Monica Chiorascu MBACP
Integrative psychotherapist I Psychosexual and relationship therapy I Sex and porn addiction
Therapy with Monica I hello@therapywithmonica.com I 07895053117