"Sex Addiction" Therapy
Bellevue, WA
Expert Care for Impulsive and Compulsive Sexual Behaviors
Unmatched Therapy for Sexual Behavior Struggles
Discover the PBH Difference
At Pacific Behavioral Healthcare, we provide the most comprehensive and
progressive treatment for impulsive or compulsive sexual behavior,
sometimes called "sex addiction" or "porn addiction"
in the Pacific Northwest
Problematic sexual behaviors (often called "sex addiction") can lead to intense pain and suffering and often undermine the foundations of trust in even healthy, committed relationships. For partners affected by these behaviors, feelings of betrayal, anger, and abandonment can seem inescapable. For the individual struggling with the behaviors, guilt, shame, embarrassment, loss of relationships and more can persist indefinitely if no therapeutic intervention takes place to fully address the underlying causes and to begin the healing process.
We are here to help you heal your life and your relationships, whether in person or via telehealth. Our approach is comprehensive, nuanced, compassionate, and collaborative. The following information (follow the links below) will help to describe our carefully crafted perspective on these very painful problems.
What is Impulsive-Compulsive Sexual Behavior?
What is Included in a Comprehensive Evaluation of Sexual Behavior?
What Does an Effective Treatment Plan Look Like?
What Makes the PBH Treatment Approach Unique?
Is Help Available for Pornography Struggles?
Is There Help Available for Betrayed Partners?
Is Couples Therapy Available for Healing?
Is Therapy Available over Phone or Video?
Can Relationships Really Survive This?
Do I Need a Therapist Who Is a CSAT?
What is Impulsive-Compulsive Sexual Behavior? Is it Sex Addiction?
What people sometimes refer to as "sex addiction" or "porn addiction" is actually a variety of different clinical presentations of problematic sexual behavior that can manifest uniquely across individuals. People who are struggling with their sexual behavior, may feel trapped in their preoccupation with sexual activities and their behaviors may persist despite significant risk or consequences. Many (but not all) individuals experience an escalation in their behavior over time, finding that they were led to a place that they never could have predicted years earlier. They may tell themselves that they will stop, and yet find themselves repeatedly returning to the same behaviors over and over again. Such loss of control can make stopping these behaviors feel daunting and fuels shame and despair. These symptoms and experiences often lead people to feel as though their struggle is a sex addiction. Without help, it is possible that their sexual behaviors may become more intense or damaging to their lives.
Compulsive sexual behavior, and similar difficulties, are not solely explained by someone having a strong sex drive or diverse sexual interests. Many healthy individuals experience an above average drive for sex and having sexual desires that don't fit in the mainstream is generally not a matter of clinical concern. Sexual behaviors are considered to be problematic when they violate well-reasoned values, are dishonest, harmful to others, place people at elevated risk, or diminish joy from the person’s own life.
There is ongoing scholarly debate as to whether these types of struggles are primarily impulsive, compulsive, or addictive in nature. Empirical evidence is emerging that suggests that sexual behavior struggles have multiple causes. The reality is that problematic sexual behavior is a complex phenomenon that cannot be fully accounted for by a single explanation, such as "sex addiction." It is critically important that individuals who struggle with their sexual behavior be evaluated by a clinician who is able to fully account for the complex (and often confusing) intersection of human sexuality and mental health, rather than operating from a simplistic belief that all problematic sexual behaviors can be attributed to "sex addiction" or "porn addiction."
Issues with sexual behavior problems and compulsivity can be hard to identify and understand. Sex is a natural part of the human experience. We are hard wired to emotionally connect and be intimate with others. When this process is not nurtured properly, we are left with maladaptive ways of relating sexually and emotionally to others as well as to ourselves.
A broad range of sexual behaviors can become dysfunctional, impulsive, or compulsive, including:
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Anonymous sex
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Infidelity
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Risky or Unsafe Sex
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Chronic Masturbation
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Cybersex
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Problematic Pornography Use
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Exhibitionism
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Voyeurism
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Massage Parlors
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Sex Buying (soliciting prostitutes)
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Obsessive Dating
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Toxic Relationships
What is Included in a Comprehensive Evaluation of Sexual Behavior?
For those who struggle with problematic or compulsive sexual behaviors (commonly termed "sex addiction" or "porn addiction"), thoroughly assessing for the underlying nature of the struggle, as well as other possibly related mental health struggles, is essential to determine the most effective treatment for them. Each individual is unique, and therapy should be tailored to a client’s particular needs. We offer a number of specialized tests, combined with clinical interview, to help determine underlying personal, sexual, and mental health struggles beyond just a quick label of "sex addiction" or "porn addiction." Evaluation not only serves to highlight necessary treatment areas but can jump start your treatment making it a more efficient and effective process.
We do not promote any "one size fits all" conceptual models
such as "sex addiction" or "porn addiction"
for sexual behavior problems
A thorough sexual behavior evaluation will generally assess for the following:
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Sexual history and behavior patterns
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Sexual functioning
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Exploration of possible functions of the sexual behaviors
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Relationship and attachment patterns
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Personality factors
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Comprehensive screening for mental health struggles
Your PBH therapist can assess for these important areas. However, many individuals who are concerned about their sexual behavior choose to start by scheduling a comprehensive evaluation with Dr. James Olsen, who is a leader in the field of sexual health and sexual behavior problems. Individuals who are evaluated by Dr. Olsen receive ample personalized attention and are able to hear his conceptualization of their struggles as well as his recommendations for effective intervention. Once an evaluation is completed, Dr. Olsen works to fit clients with a treatment provider who has the specialized skills to best address the particular underlying struggles they are facing. Additional recommendations for injured partner therapy as well as couples’ reconciliation therapy can be offered as well.
What Does an Effective Treatment Plan Look Like?
Individuals who exhibit patterns of sexual impulsivity or compulsivity (and related struggles) commonly also struggle with depression, anxiety, trauma, attention deficit difficulties, or substance use problems. There are also many struggles that appear similar to compulsivity that can make sexual behaviors extremely difficult to manage, such as obsessive-compulsive disorder. To ensure that you receive the most successful care possible, it is essential to examine how these factors may be playing a role in your behaviors. Unfortunately, many well-meaning providers fail to thoroughly screen for or address these other very real and often debilitating conditions. Often this comes in the form of a one size fits all prescription for sex addiction therapy. At PBH, we frequently see the aftermath of this when individuals come to us after attempting other, less comprehensive approaches. They are often frustrated that they are not getting better or feel that treatment is hopeless. Together, we can work to figure out how the pieces fit together for you. We can then build an appropriate treatment plan to help you achieve a rich, rewarding, and connected life.
Individual Therapy
Each individual is unique, and therapy should be tailored to their particular needs. A proper individual therapy plan will be based on an assessment of the nature of the sexual behavior struggles, the function the behaviors have played in the individual’s life, underlying personality or mental health concerns, relationship and attachment patterns, and current struggles with intimate relationships. This includes help working to heal relationships from the damage resulting from problematic sexual behaviors. If individual therapy is not tailored to the client’s particular needs, it is likely to be ineffective.
Group Therapy
An important part of healing from problematic or compulsive sexual behavior or porn use is sometimes working alongside others with similar struggles. Engaging in group therapy provides opportunities for self-growth, learning, and connecting with others. Knowing that you are not alone in your struggles and receiving compassionate support and acceptance from others is a powerful experience. Group offers a safe space to heal, gain hope, learn specific tools to gain control over your compulsive behaviors, and provides an opportunity for accountability. Many clients report gaining significant benefits from group therapy that extend beyond the group environment to their relationships with their partner or spouse, family, and friends.
Couples Reconciliation Therapy
For individuals in a committed relationship where one or more violations of the fidelity expectations of the relationship have occurred, specialized couples therapy is a critical aspect of healing the relationship. Our expert couple’s therapists are trained to help the members of the relationship to work through the pain, connect with empathy for the injured partner, establish healthy boundaries, better understand the factors that contributed to the behaviors, re-establish trust, reconstruct a new relationship designed to thrive, and build meaning out of the suffering. The hurt partner and the relationship deserve an understanding as to why the behavior occurred. This requires a more nuanced approach than simply labeling the problem a sex addiction or a porn addiction without further inquiry.
What Makes the PBH Treatment Approach Unique from Standard Sex Addiction or Porn Addiction Therapy?
PBH is not like other clinics who treat sexual behavior problems. Discover the PBH difference!
Targeted and Thorough
Unlike the one-size-fits all models out there, at PBH, we start by getting a clear sense of who the client is and what difficulties they are facing through a comprehensive assessment. We find that a one-size-fits all approach for treating sexual behavior problems (“sex addiction” or "porn addiction") is ineffective and can contribute to ongoing behavioral struggles, continued relationship hardship, and a lack of overall success in establishing hope and joy. Our group of specialists will design a treatment plan that meets your specific needs and budget. We offer a combination of individual therapy, group therapy, and couples therapy. Our goal is to help you stop the destructive cycle and empower you to live an authentic, intimate, and joyful life.
Collaborative
By receiving treatment at a clinic with a respected team of experts, our clients benefit from a level of collaboration that is rare in the field. Our therapist coordinate client care carefully and thoughtfully with one another. When more than one therapist is involved with a relationship (e.g., individual therapist and couples therapist), our team members take the time to learn from one another about the nature of the struggles, ongoing developments, and each other’s perspectives regarding how to best promote healing and growth. Our clinic is focused on helping one another to learn and perform at our very best. To accomplish this, we have created an environment in which therapists bring their ideas, questions, concerns, and knowledge to team meetings and wrestle with challenging topics. Our team is just that; a team.
Health and Growth Focused
Therapeutic strategies that place excess emphasis on stopping behavior patterns are generally ineffective at achieving thriving outcomes for their clients. This is because they lack the focus on living healthy and learning how to thrive. We certainly work to stop harmful behaviors and have effective strategies to make that happen. However, that is a low bar for therapy. By understanding the underlying nature of the behaviors, we can devise effective strategies to live a more rewarding life that includes joy and meaning. People don’t often find themselves at joy and meaning from focusing intense efforts solely on what to not do.
Rooted in Science
Unfortunately, too few in the mental health community are able to properly dedicate themselves to directly digesting ample scientific research related to their professional practice. Often, we see that professional trainings offer little research-based findings and regress to personal opinions. What results is what is known as the scientist-practitioner gap. Researchers develop vast knowledge that is often poorly understood or utilized by practitioners. At PBH, we find this pattern to be unacceptable. As a result, we have formed our own institute dedicated to consuming, promoting, and disseminating research concerning sexuality and relationships. As a result of our commitment to staying embedded in empirical knowledge and inquiry, we are a key source of knowledge for therapists outside of our clinic.
Respected
At PBH, we provide the most comprehensive and progressive treatment of problematic or compulsive sexual behavior in the Pacific Northwest. Our founders are trusted members of the sexual health community and conduct national level training on how to treat problematic sexual behaviors and foster healing in hurt relationships. We understand the complex nature of sexual struggles and can set you on a path for growth, connection, and success.
Is Help Available for Pornography Struggles?
Problematic or compulsive porn use (sometimes called “porn addiction”) can be distressing to individuals and can cause significant hardship on relationships. Some experience an escalation over time in their pornography use or they feel preoccupied with searching for porn. Some feel that they are "unable to stop" their porn use, despite the havoc it is creating in their lives.
The time spent by some gathering and viewing pornography can have devastating effects on relationships, work productivity, finances, and can help prevent individuals from achieving the sexual intimacy they truly desire.
We will work alongside our clients to understand the real nature of their problematic or compulsive porn use. We help our clients to find better tools to communicate their desires and achieve the sexual intimacy they want in an honest way. We help them to achieve healthy sexuality filled with intimacy and connection and to lead a full life.
Have You Been Hurt by Your Partner's Porn Use?
It can be confusing to try and make sense of a partner’s porn use. Often times hurt partners report feelings of anger, confusion, poor self-image, loneliness, and emotional and sexual withdrawal. We help couples have open and honest sexual conversations about sexuality — so they don’t feel blindsided, hurt, and left out of sexual intimacy in their relationship.
Is There Help Available for Betrayed Partners?
Discovering that your significant other had a secret sexual life is often one of the most devastating betrayals a person can face. If this has happened to you, you deserve support. You may feel like your entire world has been destroyed overnight. At PBH, we understand this level of pain and are pioneers at help hurting partners & spouses establish safety and stability and reclaim their lives.
Everything you believed about your relationship may now seem like a lie. You may wonder who this person is? Or why they would do this to you? You are probably questioning everything. You realize that your significant other is not safe and has abused your trust. You may feel violated and taken advantage of. You may fear that others will not understand what you are going through and then isolate yourself because it's just easier.
The traumatic impact of infidelity may leave you unsure of what to do next. To move forward, it's essential for your pain to be understood and validated. Having your questions answered and having transparency will help create emotional safety for you to heal. The hurt partner often craves information to help them understand why this happened and how they were deceived, this is natural following betrayal. We will help support you through the discovery and meaning making process. Your trauma symptoms (hypervigilance, intrusive thoughts, intense waves of emotion) are a natural response to intimate betrayal and can subside with trauma-specific interventions.
We understand the pain and profound sense of loss that you are experiencing. The betrayal from your partner's sexual or emotional infidelities is traumatic. To stop the pain, you need to heal the areas of your life that have been broken. You may now feel "less than," avoid intimacy, question your intuition, and be flooded with anger and grief. One of the most noticeable and distressing symptoms is extreme vigilance or being overly watchful, anxious and on guard for fear of getting blindsided again. This will leave you feeling exhausted.
This is not the relationship you signed up for. Now you are left to pick up the pieces of your life. It's not fair.
Learn more about our betrayal trauma services here
Is Couples Therapy Available for Healing?
The pain of infidelity, impulsive or compulsive sexual behavior ("sex addiction" or "porn addiction"), or pornography conflict strike at the very foundation of the relationship. When betrayal is present, there is a fracture of trust that will not heal on its own.
When a relationship is harmed by sexual behaviors or infidelity, connection, safety, and trust must be rebuilt. Couples must learn to build emotional closeness, restore trust, effectively communicate, and increase their own and each other’s satisfaction in the relationship. The skills couples learn will help them with potential conflicts in the future so they can feel confident and prepared to address issues as they arise.
Rebuilding trust requires transparency, honesty, consistency, emotional authenticity, and genuine growth and change. Having empathy for your partners pain is crucial to healing the relationship. Your partner needs to know that you understand the trauma that your behaviors have caused them and feel remorse.
At PBH, we understand the complexity of issues surrounding the disclosure of sexual secrets, the damage of lost trust, the struggle to develop true intimacy, and the pain and isolation stemming from the shame of sexual betrayal.
The benefits gained during treatment are immense and often pay vast dividends throughout the couple’s relationship.
Is Therapy Available over Phone or Video?
Recovery from infidelity and
problematic sexual behaviors ("sex addiction or "porn addiction")
for clients throughout Washington State
Access to the best care available regardless of where you are located!
Washington State defines "telehealth" as “the delivery of health care services through the use of interactive audio and video technology, permitting real-time communication between the patient at the originating site and the provider, for the purpose of diagnosis, consultation, or treatment" (WA State Legislature, 2016).
At Pacific Behavioral Healthcare, we provide the most comprehensive and progressive treatment of problematic or compulsive sexual behavior in the Pacific Northwest and are now able to expand to other areas in Washington via our telehealth platform. Telehealth care includes video sessions or phone. Video sessions are available through a user friendly and HIPAA compliant platform to ensure your confidentiality and easy access to the care that you deserve. However, for clients who are uncomfortable with or unable to use video, or have limited computer access, telephone sessions are also available.
Can Relationships Really Survive This?
The discovery of affairs or other infidelities is one of the most painful problems a couple can face. With the relationship in crisis, it can be hard to know what to do to move forward. This is a difficult and fragile time and requires a skilled therapist who is knowledgeable on infidelity to help you navigate the pain of betrayal and rebuild your relationship. Healing from infidelity or sexual behavior problems takes guidance from a therapist who understands the complexity and depth of pain and who is able to delicately work through the many potential factors, psychological and otherwise, that precipitated the infidelity.
With the right approach, many couples are able to come out the other side more joyful, connected, and healthy than they thought possible. Deep pain can become transformed into a relationship that is beautiful and inspiring to others.
If you or a loved one is suffering from problematic sexual behaviors, reach out today.
Do I Need a Therapist Who is a CSAT?
We believe that recovery from infidelity and problematic sexual behaviors
is best accomplished with a therapist who is trained in advanced models of
sexual behavior problems and who has a deep understanding of human sexuality.
It is common to read online or hear from a therapist that individuals who are struggling with sexual behavior problems, who may or may not believe that they have a "sex addiction" or "porn addiction," need to be seen by a therapist who is a Certified Sex Addiction Therapist (or CSAT). Indeed, our team has even heard it suggested that only a Certified Sex Addiction Therapist is qualified to work on these cases. We do not agree.
The Certified Sex Addiction Therapist model is based on the sex addiction and porn addiction model developed by Patrick Carnes. Indeed, the certifying company for CSATs was founded and is owned by Dr. Carnes. Beginning in the 1980s, Dr. Carnes promotion of his sex addiction and porn addiction model helped to bring attention to sexual behavior struggles and the loss of control many people experience in this area. However, there are other very important advanced conceptual models of sexual behavior problems that offer alternative nuanced explanations for sexual behavior problems beyond the sex addiction and porn addiction model. These include the Out-of-Control Sexual Behavior Model developed by Doug Braun-Harvey and Michael Vigorito, the Impulsive-Compulsive Sexual Behavior (ICSB) model developed by Dr. Eli Coleman (University of Minnesota), the Dual Control and Sexual Tipping Point Model developed by Dr. Peer Briken (University Medical Center Hamburg), or the Integrative Problematic Sexual Behavior Model currently in development by Dr. James Olsen, among others. The Certified Sex Addiction Therapist credential is for the Carnes sex addiction and porn addiction model and is not a certification for any of the other clinical models of problematic sexual behaviors.
There are many important nuances between these models and the sex addiction and porn addiction model. In our view, these models each offer important conceptual distinctions that have extremely important treatment implications.
Our founders were trained and credentialed as Certified Sex Addiction Therapists prior to completing advanced training in human sexuality to become Certified Sex Therapists. In addition to the sex addiction and porn addiction model, they have also completed extensive advanced study of the other above-mentioned models of sexual behavior problems. They train licensed clinicians and doctoral students on the nuances of sexuality and sexual behavior struggles and host professional training events in an effort to advance care for all.
We respect and appreciate the contributions that were made by the sex addiction and porn addiction model as promoted by Dr. Carnes. However, we also believe that the best training for a therapist to address sexual behavior problems is for extensive training as a sex therapist along with additional advanced training and supervision on multiple theoretical models of problematic sexual behavior, not just the sex addiction and porn addiction model.