Sex addiction and porn addiction remain controversial topics. While the term “addiction” is widely used by the general public, some health professionals object to it, arguing that it can pathologise aspects of normal human sexuality.
In 2019, the latest edition of the International Classification of Diseases (ICD-11), published by the World Health Organisation (WHO), did not include sex addiction as a diagnosis due to insufficient evidence at the time. Instead, it introduced the term Compulsive Sexual Behaviour Disorder (CSBD), classifying it as an impulse control disorder. The ICD is a diagnostic manual used by health professionals worldwide. When introducing CSBD, the WHO working group emphasised that this classification reflects a “watch and see” approach, acknowledging that research in this area is ongoing and continues to evolve.
At the time of writing, much of the research is moving toward an addiction-based understanding – particularly in relation to pornography use. Some academics group pornography alongside behaviours such as gambling, gaming, shopping, and social media use under the umbrella of ‘Internet Use Disorder’ or ‘Internet Addiction Disorder’, while arguing that compulsive sexual behaviours should be categorised separately. Others view pornography use as a subtype of sex addiction, suggesting both should be classified together as behavioural addictions. Within the field of sexology, there have also been proposals to position CSBD as a ‘Condition Related to Sexual Health’.
As this shows, the picture is still evolving, and no single framework has been universally accepted.
So, does the terminology matter? At the Laurel Centre, we believe in speaking your language. Whether you prefer the term addiction, compulsion, or simply problem, we respect your perspective. More importantly, we tailor our treatment to your individual needs, using the latest evidence-based approaches.
It is important to note that one key criticism of the term “addiction” is the assumption that it requires a disease-model approach, similar to treatment for substance dependence, focused on abstinence, behaviour change, and relapse prevention. At the Laurel Centre, we take a different approach. We use a biopsychosocial model, addressing both the conscious and unconscious drivers of unwanted behaviours, not just the behaviours themselves.
Crucially, we work collaboratively with you to define what healthy sexuality means in your life. Together, we explore which behaviours you want to leave behind and which you wish to retain as a positive part of your sexuality.
The Biopsychosocial Perspective
Today, most health professionals, across disciplines such as addiction and sexology, use a biopsychosocial framework. At the Laurel Centre, we see this as essential, and we have expanded it to include cultural and relational perspectives.
The BERSC Model, developed by Dr Paula Hall and introduced in the first edition of her book in 2012, ‘Understanding and Treating Sex Addiction’, builds on the biopsychosocial approach. It incorporates:
- Biology – the physiological aspects of behaviour and addiction
- Emotions – internal emotional experiences and regulation
- Relationships – interpersonal dynamics and attachment patterns
- Social context – environmental and societal influences
- Culture – identity factors such as gender, sexual orientation, race, and faith, as well as communities individuals identify with (e.g. kink, polyamorous, or open relationships)
This broader framework allows for a more holistic understanding of each individual’s experience.
A Changing Field
As a society, our understanding of sex addiction, porn addiction, and CSBD continues to evolve. It remains a relatively new area of clinical practice and research. At the Laurel Centre, we are committed to staying open to emerging evidence and continuously adapting our work in line with new insights.
If you are considering therapy or training in this field, it is important to choose a provider who remains up to date with research from multiple perspectives and offers a client-centred, integrative, and sex-positive approach.
