Addiction – Dr. White & Associates, P.C.

Rethinking Sex Addiction Terminology

Mark White — Mon, 27 Apr 2026 14:00:56 +0000

I used to use the term sex addiction, but that seems too condemning now. I prefer the terms compulsive sexual behavior, problematic sexual behavior, or unwanted sexual behavior.

The shift from the term “sex addiction” to phrases like “compulsive sexual behavior,” “problematic sexual behavior,” or “unwanted sexual behavior,” reflects more than just a change in vocabulary—it signals a broader evolution in how trained therapists, researchers, and individuals understand human sexuality, agency, and relational distress. Language tends to shape perception, and in this case, it can either reinforce negative stigma or create space for nuance, compassion, and effective care.

“Sex addiction” emerged as a popular term in both media and some clinical circles to describe patterns of sexual behavior that felt out of control or harmful. While it provided a shorthand that resonated with some people’s lived experiences of compulsion, it also carried heavy connotations. The word “addiction” often implies a disease model similar to substance use disorders, suggesting physiological dependence, loss of control, and, in some cases, moral failure. For some, this framing felt validating—it acknowledged the intensity of their struggle. But for others, it felt pathologizing or overly rigid, reducing complex relational and psychological dynamics to a single label.

In contrast, terms like “compulsive sexual behavior” attempt to describe the experience more precisely without prematurely assigning a specific explanatory model. “Compulsive” highlights the repetitive, difficult-to-control nature of the behavior, aligning it with other compulsive patterns seen in anxiety or obsessive-compulsive related conditions. This framing invites clinicians to explore underlying mechanisms such as emotional regulation, trauma, learned arousal patterns, attachment issues, or cognitive patterns, rather than assuming a one-size-fits-all addiction paradigm.

Similarly, “problematic sexual behavior” shifts the focus toward behavioral impact rather than inherent pathology. It asks: in what ways is this behavior creating problems in a person’s life—interpersonally, emotionally, or functionally? This perspective allows for a more individualized assessment and treatment. What is “problematic” for one person may not be for another, depending on values, relationship agreements, and context. It opens the door to collaborative meaning-making between clinician and client, rather than imposing an external label.

The phrase “unwanted sexual behavior” even goes a step further by centering the individual’s subjective experience. It emphasizes agency and consent—not in the interpersonal sense, but intrapersonally. The key issue becomes the mismatch between what a person wants and what they find themselves doing, maybe even in a compulsive way. This language can feel less shaming and more empowering, as it validates the person’s desire for change without defining them by the behavior itself.

This shift in terminology also reflects ongoing debates within the mental health field. Notably, “compulsive sexual behavior disorder” has been included in the ICD-11, but it is not categorized as an addiction. This distinction underscores the field’s caution about overextending the addiction model and highlights the importance of continued research.

Ultimately, moving away from “sex addiction” toward more descriptive and less moralizing language supports a more compassionate and flexible approach. It reduces stigma, encourages people to seek help, and allows for treatment that is tailored to the individual’s needs rather than constrained by a single conceptual framework. Language does not just describe reality— it shapes it, and in this case, it may help create a more humane and effective path forward.

At Dr. White and Associates, we want to provide compassionate care and treatment that meets your needs without shaming language. If you are struggling with problematic sexual behavior, you can schedule an appointment to begin your journey of healing by calling 806-780-0003 or by going to the DWA scheduling portal here: https://dwatherapy.com/schedule-an-appointment/

Accountability Relationships for Compulsive Sexual Behavior

Tim White — Wed, 22 Jan 2025 15:00:30 +0000

In my therapy practice, I often hear about personal experiences of accountability. Usually, though, it’s a description of failed accountability, especially when the accountability issue is compulsive sexual behavior. Let’s explore accountability from the perspective of being set up for success. Accountability can be defined as “an obligation or willingness to accept responsibility or to account for one’s actions” (Webster), and as “acknowledgment and assumption of responsibility for actions, . . . (Wikipedia). Further, accountability for husbands in a marriage is set up for success by considering the following elements:

Intentional/voluntary – Husbands, enter an accountability relationship by your own personal intention, not just at the request or insistence of your spouse.
Purposeful – The purpose of accountability is not to catch a man violating agreed-upon behavior boundaries. The purpose is to assist in maintaining proper/agreed-upon behaviors and to assist in maintaining integrity.
Specific and comprehensive – Men, typically we know when we are most likely to act outside of our agreed-upon behavior boundaries; when we are most at risk for actions that we will end up regretting. Successful accountability identifies specific questions to be asked that determine if personal standards of integrity are being met, if specific behaviors are being avoided. Successful accountability is also comprehensive enough to ask if there is anything else occurring that produces shame or guilt, or that a husband thinks would cause emotional pain in his spouse.
Scheduled/repeating/random – Successful accountability isn’t a one-time event; it’s scheduled, it’s regularly repeating, and sometimes even random. Schedule your accountability to occur on some repeating basis that works for managing behavior and for scheduling busy people.
Personal/transparent/vulnerable – Accountability requires a man to discuss very personal matters. Many men are acculturated toward privacy, avoidance, and superficiality. Choosing an accountability partner is an intentional choice to be deeply vulnerable. Further, successful accountability requires choosing someone who can effectively hear a deep level of personal vulnerability.
Not for everybody – When an accountability relationship becomes ineffective it needs to end or simply needs to be recognized as a friendship that no longer functions as accountability. Then another relationship needs to be established that does include accountability elements.
Hierarchical – Holding someone accountable, and speaking encouragingly about responsibility creates a sense of reporting to a higher authority. For this reason, successful accountability cannot be a man’s spouse. A committed, intimate marriage relationship is a relationship between two equals.
Honest – Successful accountability requires a commitment to be honest with the accountability partner. A lack of honesty is disrespecting of the accountability partner’s time, effort, and commitment.
Trusting/confidential – Submitting to accountability questions requires a relationship of trust that is committed to keeping the vulnerable information confidential.
Motivating – Living in a context of regularly scheduled accountability questions is motivation to maintain standards of behavioral integrity.
Foundational for informed consent – In the case of couples in recovery from some breach of fidelity, her husband’s accountability partnership can contribute to her ability to consent to efforts of healing and recovery. However, this does not mean that an accountability partner should report specifics to the wife. I recommend that at the most, accountability partners simply state to wives that they are holding the husbands accountable. It is the husband’s responsibility to be honest with his wife about breaches of agreed-upon behavior boundaries. Accountability produces increments of trust and security.These elements, when implemented and maintained over time, generally result in success. We are designed for success, let’s use what we have been given. If you want an accountability relationship that is set up for success, inquire at a local church if a staff member can aim you in the direction of someone who would be willing to fill the role. Discussing this list from the very beginning will help in making accountability successful.

Created for Connection but Susceptible to Alternatives

Mark White — Tue, 24 Mar 2020 21:19:51 +0000

Dr. White – I recently reviewed some addiction debate among professionals regarding a YouTube video titled Addiction, by Kurzgesagt:

https://www.youtube.com/watch?v=C8AHODc6phg

And a TED Talk titled Everything You Think You Know About Addiction is Wrong, by Johann Hari:

Their point being made is that a potential underlying cause of addiction that has been undervalued in research and treatment is disconnection; addicts often suffer varying degrees of disconnection in their important relationships. Hari concludes that “the opposite of addiction is not sobriety. It is human connection.” I don’t want to enter the debate by taking a stand in far left or far right views. But I do want to emphasize Hari’s point about human connection. In my treatment of recovering addicts, most tell of experiences ranging from ineffective connectedness to debilitating disconnection.

God’s design tells us that we were designed for success (we have been given everything we need for life and Godliness, 2 Pet. 1:3). We have been given the principles of oneness, unity, and like-mindedness; principles that require connection. We could define oneness as 1) knowing what your partner feels and caring about what you know in a way that is effective for your partner, and 2) knowing what your partner thinks and caring about what you know in a way that is effective for your partner.

So why do so many of us experience disconnection; a disconnection that can contribute to eventual compulsion and addiction? I think it is because the practice of these principles requires taking the risk to be vulnerable. And further, the vulnerability risks we do take sometimes teach us not to risk it again. When a marriage partner asks “honey, what are you feeling,” answering honestly requires vulnerability.

Whether we are recovering from compulsion/addiction or simply trying to become more connected in our intimate relationships, we can set ourselves and our partners up for success by practicing vulnerability. Here are some practical ideas for connection success in a oneness relationship:

set aside daily, uninterrupted, couple connection time
disarm your partner by stating that revelation of any emotion is ok and that you want to know the feelings
ask “honey, what’s on your heart today,” or “what are you feeling”
accept the feeling by simply not asking why, or not stating that they shouldn’t feel that way
validate the one who experiences the feeling by responding with words of concern that include the revealed emotion, “honey, I really care about you feeling disappointed”
provide comfort (words of encouragement, touch). If you don’t know what is comforting, ask “what’s the most compassionate thing I can do right now to comfort you?”

Practicing these simple steps every day for several weeks creates a new normal that provides self reinforcement for its continuation. Let’s let this become part of the fabric of daily relationship life in order to live the abundant life we were created for.