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"1. "'Sex addiction’ and compulsive sexual behaviors are the same thing." Wrong. Whilst the DSM-5 has rejected "sex addiction" as a diagnosis, the ICD-11 has endorsed the term "compulsive sexual behavior disorder" (CSBD). The World Health Organization (WHO) clearly states that CSBD is not, however, an addiction disorder and that those two terms should not be used interchangeably.

I also frequently hear, "It doesn’t matter what we call it. If the client calls it an addiction, it is an addiction." The word "addiction" has become part of the popular lexicon (sex addict, shopping addict, chocolate addict). And the public can describe their problems whichever way they want; it is not their job to be trained in clinical language. Psychotherapists, on the other hand, should stay on the side of science and not perpetuate anecdotal myths. The public may use the word "depression" to say that they feel low, but clinicians don’t take that term lightly and insist on a proper assessment to determine if clients are indeed clinically depressed. The same principle should apply to the assessment of sexual compulsivity.

2. "I’m sex-positive and I recommend 12-steps programs such as SAA or SLAA." This is quite an incongruence. SAA and SLAA programs are sex-negative spaces where there is no knowledge of sexology, and there may be pathologizing of many normative sexual behaviors, with little understanding of gender, sexuality and relationship diversity. In my opinion, you cannot be both "sex-positive" and recommend 12-step programs. These are incompatible. It is like saying "pork meat vegetarian sausage."

3. "Sex addiction is real." Well, no. There has now been a lot of research done in clinical sexology that confirms "sex addiction" is not a valid clinical diagnosis, yet many will still assess it and treat it with old-fashioned methodologies and addiction-oriented thinking. For example, some therapists may still think that one can become addicted to BDSM, which we know is not true. Or they may attempt an addiction treatment such as suggesting that clients avoid sexual stimuli like we would ask someone with substance use disorder to avoid going to the pub.

I also often hear, "The science is lacking, there will be proof of ‘sex addiction’ one day." There is actually plenty of science, including neuroscience, showing that sexual compulsivity is not an addiction. There is plenty of science confirming that pornography is not an addiction, either. In fact, among scientific communities such as the ESSM (European Society for Sexual Medicine), the term "sex addiction" is rapidly fading away.

4. "Porn addiction is real." This sounds more like a personal opinion than a clinical opinion. In the absence of endorsed diagnostic criteria for "sex addiction" or "porn addiction," it leaves the therapist’s assessment open to their own biases rather than informed clinical opinion. If they don’t like the idea of watching pornography, they can very quickly pathologize a client with "pornography addiction."

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