169: Out of Control Sexual Behavior in Women – Jessica Levith

Summary: Today’s guest Jessica Levith, is a Licensed marriage therapist from California and is here to talk about the “Out of Control Sexual Behavior Model” which is a view of compulsive, out-of-control sexual behavior. A treatment model is developed around this, and Jessica extends it to cisgendered women with challenging and problematic sexual behaviors. She provides treatment for people who think they exhibit out-of-control behavior. The episode also discusses sexual health and its influence on our sexuality. <br><br>Define – Out of Control Sexual Behavior (OCSB) <br><br>Jessica defines Out Control Sexual Behavior as the client’s perception of their sexual behaviors, feelings, and urges being out of their control. What makes OCSB different from the Sex Addiction Model is that OCSB is a sexual health-focused treatment where people establish their vision of sexual health without giving up a part of their sexuality. Jessica mentions a history of conflation of non-consensual sexual behaviors in the OCSB model. She debunks a theory in the Sex Addiction Model that it is believed that when a person’s sex addiction goes untreated they fall more towards non-consensual behaviors. However, in OCSB when a patient presents a sign of non-consensual sexual behaviors, they have to be ruled out as they’re more suitable for specialized treatment from a therapist whose practice deals with non-consensual behaviors. <br><br>In OCSB model treatment, they are on the lookout for patients with a genuine interest in changing how they view their sexuality. This treatment is not for those who may be simply motivated to escape the shame of exposure to their family or partner by labeling their behavior as a disease. This aligns with the perception in the OCSB model where sexual addiction is viewed as a behavioral problem that can be regulated in all parts of life. In contrast to that, the Sex Addiction Model views sexual addiction as a disease that allows the patient to step back from their responsibilities of change. <br><br>How to broaden what people see as out-of-control sexual behavior. <br><br>To broaden the view of what one would consider being an out-of-control sexual behavior, they have to process the cause behind their belief. To explain where some of these beliefs originate from, Jessica explains how women have been socially imprinted through history on how we should look, feel and act. She gives a historical context of parallels of women’s behavior being dictated in religion, art, and even science and the instance where the change started. Through Doug’s book and his model, Jessica points out the concept being based on Human Behavioral Theory which prompts for change and adaptability especially in women. <br><br>Steps in the clinical journey of OCSB model treatment? <br><br>Initial screening​ is the first step in the process of OCSB Model treatment where clients are screened to rule out non-consensual sex, for internal motivation, presence of any acute issue that could disrupt the treatment like being a physical threat to self or others, substance use, and abuse, mental health issues or physical health issues. In the next step, an ​assessment​ is done with a series of courses such as Adverse Child Experience (ACE), Sexual Symptom Assessment Scale (SSAS), Sexual Inhibition Scale (SIS), Sexual Excitation Scale (SES), and semi-structured assessment. During the process, the therapist learns a lot about the client as a person. In the end, the therapist helps the client to use sexual health terms instead of pathology terms, which means, they stop viewing it as a disease. Then the therapist and the client together make a ​sexual health plan​ by using this information. <br><br>Sexual health in OCSB is upheld by ​six principles​ – consensual sexual activity, non-exploitative, honesty, shared values, protection from STIs and STDs and unwanted pregnancies, mutual pleasure, and solo pleasure. When you live within these six...