Sexual Addiction Therapists in Nashville, TN

Photo of Kevin Smith, Clinical Social Work/Therapist, LCSW
Kevin Smith
Clinical Social Work/Therapist, LCSW
5 Endorsed
Nashville, TN 37217
I believe that you have the ability to achieve fulfilling life goals and to make healthy life choices for yourself. As a mental health therapist, my job is to be the tool to assist you in the decision-making process and to achieve those goals. I have worked across all levels of care - from outpatient therapy services all the way up to psychiatric hospitals - while treating a variety of issues for teens and adults.
I believe that you have the ability to achieve fulfilling life goals and to make healthy life choices for yourself. As a mental health therapist, my job is to be the tool to assist you in the decision-making process and to achieve those goals. I have worked across all levels of care - from outpatient therapy services all the way up to psychiatric hospitals - while treating a variety of issues for teens and adults.
(615) 499-6899 View (615) 499-6899
Photo of Leah Linn, Licensed Professional Counselor, MA, LPC, MHSP
Leah Linn
Licensed Professional Counselor, MA, LPC, MHSP
Online Only
I have received specialized training in treating both trauma and sexual addiction (sex, porn, and love addiction, sexual shame and trauma, and other intimacy struggles).
I am currently accepting a limited number of new clients living in Tennessee, Florida, Arizona, and Wisconsin for weekday daytime telehealth appointments. My mission is for each client to find their true self and voice and see that so many of our negative storylines and scripts are just programming we have picked up throughout our lives. My heart is to follow each client's lead on where he or she needs to go versus my own agenda and/or preferences. I believe that it is in allowing space for our experiences of our full humanity that we realize that at our most fundamental level our essence is actually good and true.
I have received specialized training in treating both trauma and sexual addiction (sex, porn, and love addiction, sexual shame and trauma, and other intimacy struggles).
I am currently accepting a limited number of new clients living in Tennessee, Florida, Arizona, and Wisconsin for weekday daytime telehealth appointments. My mission is for each client to find their true self and voice and see that so many of our negative storylines and scripts are just programming we have picked up throughout our lives. My heart is to follow each client's lead on where he or she needs to go versus my own agenda and/or preferences. I believe that it is in allowing space for our experiences of our full humanity that we realize that at our most fundamental level our essence is actually good and true.
(615) 502-4130 View (615) 502-4130
Photo of James Trone, Licensed Professional Counselor, LPC, MHSP, CSAT
James Trone
Licensed Professional Counselor, LPC, MHSP, CSAT
1 Endorsed
Nashville, TN 37215
I work with individuals and couples to break old patterns, move through stuck places, and discover new pathways for growth. My approach centers on three key models: the Trauma Model (how unprocessed pain shapes perception), the Patterns Model (the unconscious strategies we use to survive), and the Story Model (the narratives we tell about who we are and what’s possible). We process through emotions, thoughts, and the body to shift out of limiting states and move toward the higher self. I work best with those who are ready to do the work.
I work with individuals and couples to break old patterns, move through stuck places, and discover new pathways for growth. My approach centers on three key models: the Trauma Model (how unprocessed pain shapes perception), the Patterns Model (the unconscious strategies we use to survive), and the Story Model (the narratives we tell about who we are and what’s possible). We process through emotions, thoughts, and the body to shift out of limiting states and move toward the higher self. I work best with those who are ready to do the work.
(615) 239-1130 View (615) 239-1130
Photo of Adam Kohlan, Marriage & Family Therapist, LMFT, BBA
Adam Kohlan
Marriage & Family Therapist, LMFT, BBA
4 Endorsed
Nashville, TN 37203
Many of the men I work with feel like they’re carrying a lot on their own. You may be dealing with anxiety, anger, relationship struggles, or patterns that keep repeating despite your efforts to change. Some men also feel stuck in cycles with pornography or sexual behavior that bring shame, secrecy, or distance in relationships. If you want greater clarity, self-control, and stronger relationships, therapy can help you understand the patterns driving your thoughts, emotions, and behaviors so you can move forward with more stability and purpose.
Many of the men I work with feel like they’re carrying a lot on their own. You may be dealing with anxiety, anger, relationship struggles, or patterns that keep repeating despite your efforts to change. Some men also feel stuck in cycles with pornography or sexual behavior that bring shame, secrecy, or distance in relationships. If you want greater clarity, self-control, and stronger relationships, therapy can help you understand the patterns driving your thoughts, emotions, and behaviors so you can move forward with more stability and purpose.
(615) 235-6045 View (615) 235-6045
Photo of Michelle Bruning Stanfill, Clinical Social Work/Therapist, LMSW, ASAT
Michelle Bruning Stanfill
Clinical Social Work/Therapist, LMSW, ASAT
Nashville, TN 37212
I firmly believe that everyone holds inherent worth and the capacity for change. At times, addiction, relational stress, and shame can cloud our ability to see this clearly. In my work, I view symptoms not as flaws to be judged, but as meaningful adaptations shaped by your experiences. I take a relational, collaborative, and genuinely curious approach to therapy, helping you make sense of how you show up in your inner world and in your relationships.
I firmly believe that everyone holds inherent worth and the capacity for change. At times, addiction, relational stress, and shame can cloud our ability to see this clearly. In my work, I view symptoms not as flaws to be judged, but as meaningful adaptations shaped by your experiences. I take a relational, collaborative, and genuinely curious approach to therapy, helping you make sense of how you show up in your inner world and in your relationships.
(615) 703-3351 View (615) 703-3351
Photo of Jenn MacMaster, Clinical Social Work/Therapist, LCSW, CSAT, SEP
Jenn MacMaster
Clinical Social Work/Therapist, LCSW, CSAT, SEP
5 Endorsed
Nashville, TN 37203
"Pain is inevitable. Suffering is optional." Haruki Murakami. I will hold a safe space for you to process life and its inevitable pains--change, loss, grief, and trauma. I will join you without judgement: where you are, as you are. Our time together will be collaborative and supportive—a partnership. You will gain an experience of trust and of personal power. You will be equipped with tools and skills relative to the goals that you establish, enabling you to thrive independently. Relationships, "stuckness", trauma, etc. will be addressed and resolved. Together, we will manifest your inherent creativity, purpose, and joy.
"Pain is inevitable. Suffering is optional." Haruki Murakami. I will hold a safe space for you to process life and its inevitable pains--change, loss, grief, and trauma. I will join you without judgement: where you are, as you are. Our time together will be collaborative and supportive—a partnership. You will gain an experience of trust and of personal power. You will be equipped with tools and skills relative to the goals that you establish, enabling you to thrive independently. Relationships, "stuckness", trauma, etc. will be addressed and resolved. Together, we will manifest your inherent creativity, purpose, and joy.
(615) 645-2640 View (615) 645-2640
Photo of Russell Baxter, Licensed Professional Counselor, LPC, MHSP
Russell Baxter
Licensed Professional Counselor, LPC, MHSP
5 Endorsed
Nashville, TN 37206
I’m passionate about working with adults and couples who have experienced trauma, battled depression, faced difficult life transitions, and struggled with compulsive sexuality or other addictions. With couples, I'm deeply committed to helping them rebuild their relationships into something solid, navigate through challenging times, and reconnect. Through my training and experience, I use EMDR, Brainspotting, part’s work, mindfulness, attachment work, and other evidence based approaches in my practice. Each approach is used to process difficult experiences and develop skills to handle life’s challenges and live authentically.
I’m passionate about working with adults and couples who have experienced trauma, battled depression, faced difficult life transitions, and struggled with compulsive sexuality or other addictions. With couples, I'm deeply committed to helping them rebuild their relationships into something solid, navigate through challenging times, and reconnect. Through my training and experience, I use EMDR, Brainspotting, part’s work, mindfulness, attachment work, and other evidence based approaches in my practice. Each approach is used to process difficult experiences and develop skills to handle life’s challenges and live authentically.
(615) 436-8818 View (615) 436-8818
Photo of Tim Kiernon, Marriage & Family Therapist, LMFT, CTT
Tim Kiernon
Marriage & Family Therapist, LMFT, CTT
Online Only
Is your life falling apart? Let me help you make it fall together. Available in Tennessee and Arizona, I help adults and couples struggling with sex addiction, pornography addiction, compulsive sexual behavior, and trauma. Many clients feel trapped in secrecy, shame, betrayal, or relationship crisis. You do not have to face it alone. I provide direct, compassionate therapy focused on uncovering the roots of addictive patterns, healing trauma, rebuilding trust, and creating lasting change. I work with individuals and couples dealing with intimacy issues, betrayal wounds, childhood trauma, and emotional disconnection.
Is your life falling apart? Let me help you make it fall together. Available in Tennessee and Arizona, I help adults and couples struggling with sex addiction, pornography addiction, compulsive sexual behavior, and trauma. Many clients feel trapped in secrecy, shame, betrayal, or relationship crisis. You do not have to face it alone. I provide direct, compassionate therapy focused on uncovering the roots of addictive patterns, healing trauma, rebuilding trust, and creating lasting change. I work with individuals and couples dealing with intimacy issues, betrayal wounds, childhood trauma, and emotional disconnection.
(629) 302-2640 View (629) 302-2640
Photo of Candi R Kaatz, Marriage & Family Therapist, PhD
Candi R Kaatz
Marriage & Family Therapist, PhD
4 Endorsed
Nashville, TN 37215
It can be embarrassing, painful and debilitating to have intimacy or sexual problems. It may be due to physical problems, aging, sexual abuse, strict upbringing, assault or for an unknown reason. You or someone you love may live with out of control pornography or sexual behavior or addiction. You may have difficulty forming a long term intimate relationship with someone and not understand why. You may be looking for solutions and believe no one will understand or you may believe your situation is hopeless. You are looking for healthy intimacy and sexuality in your relationship and may not be sure why this is so difficult.
It can be embarrassing, painful and debilitating to have intimacy or sexual problems. It may be due to physical problems, aging, sexual abuse, strict upbringing, assault or for an unknown reason. You or someone you love may live with out of control pornography or sexual behavior or addiction. You may have difficulty forming a long term intimate relationship with someone and not understand why. You may be looking for solutions and believe no one will understand or you may believe your situation is hopeless. You are looking for healthy intimacy and sexuality in your relationship and may not be sure why this is so difficult.
(615) 235-6066 View (615) 235-6066
Photo of Jason Hancock, Marriage & Family Therapist, LMFT
Jason Hancock
Marriage & Family Therapist, LMFT
9 Endorsed
Nashville, TN 37215
Fear. Shame. Pain. Stigma. Just thinking about therapy can stir these emotions—especially if you're struggling with addiction, relationship or parenting issues, caregiving, abuse, or infidelity. Thankfully, times are changing. Mental health is being prioritized, and it's OK to not be OK. I'm a licensed Marriage and Family Therapist with a master’s from Lipscomb University. I offer in-person and telehealth sessions. If you’re struggling, help is available. Call me at 615-414-6210.
Fear. Shame. Pain. Stigma. Just thinking about therapy can stir these emotions—especially if you're struggling with addiction, relationship or parenting issues, caregiving, abuse, or infidelity. Thankfully, times are changing. Mental health is being prioritized, and it's OK to not be OK. I'm a licensed Marriage and Family Therapist with a master’s from Lipscomb University. I offer in-person and telehealth sessions. If you’re struggling, help is available. Call me at 615-414-6210.
(615) 751-6163 View (615) 751-6163
Photo of Steve Riser, Licensed Professional Counselor, LPC, MHSP, MDiv
Steve Riser
Licensed Professional Counselor, LPC, MHSP, MDiv
1 Endorsed
Nashville, TN 37220
My specialty is working in a variety of areas including sexual addiction, marriage conflict, divorce, family conflict, sexual abuse, grief, affair recovery, depression, anxiety, anger management, adult transitional issues, teen sexuality, parenting and spirituality among many other areas of relational brokenness helping people achieve wholeness.
I enjoy working with clients seeking to grow emotionally, spiritually and relationally. I believe therapy is an opportunity to journey deeper areas of self awareness and a greater understanding of who we have been created to be. I am relational in my approach to counseling. I believe that we have been broken in relationships and that we are therefore healed in the context of relationships. I have had many clients who have had success and experienced transformation throughout the counseling process. Evening and weekend appointments available. Contact me via phone, email, or text. New clients can register at therapyappointment.com
My specialty is working in a variety of areas including sexual addiction, marriage conflict, divorce, family conflict, sexual abuse, grief, affair recovery, depression, anxiety, anger management, adult transitional issues, teen sexuality, parenting and spirituality among many other areas of relational brokenness helping people achieve wholeness.
I enjoy working with clients seeking to grow emotionally, spiritually and relationally. I believe therapy is an opportunity to journey deeper areas of self awareness and a greater understanding of who we have been created to be. I am relational in my approach to counseling. I believe that we have been broken in relationships and that we are therefore healed in the context of relationships. I have had many clients who have had success and experienced transformation throughout the counseling process. Evening and weekend appointments available. Contact me via phone, email, or text. New clients can register at therapyappointment.com
(615) 489-4416 View (615) 489-4416
Photo of Hunter Braden, Pre-Licensed Professional, LPCA
Hunter Braden
Pre-Licensed Professional, LPCA
Nashville, TN 37203
Originally from Georgia, Hunter moved to Nashville in 2020 and brings with him nearly a decade of experience working in church settings in roles ranging from discipleship ministry to pastoral support. His initial pursuit of vocational ministry was rooted in a desire to understand how people grow and change—an interest that eventually led him toward professional counseling.
Originally from Georgia, Hunter moved to Nashville in 2020 and brings with him nearly a decade of experience working in church settings in roles ranging from discipleship ministry to pastoral support. His initial pursuit of vocational ministry was rooted in a desire to understand how people grow and change—an interest that eventually led him toward professional counseling.
(629) 276-5606 View (629) 276-5606
Photo of Nicole Otis, Marriage & Family Therapist, MA, LMFT, CAST
Nicole Otis
Marriage & Family Therapist, MA, LMFT, CAST
Nashville, TN 37215
Are you struggling with pornography or sexual compulsivity? Is secrecy, broken trust or loss of intimacy hurting your relationship? Or maybe you’re not in crisis, but you know your marriage could be stronger, more connected, more alive? You’re not alone–we have been through these issues personally and know what it’s like. I’m a Certified Sex Addiction Therapist (CSAT), and Hunter is a Certified Mentor Coach in long-term recovery. Together, we help men break free (porn, sexting, affairs, prostitution, etc) and we help couples rebuild trust and real intimacy.
Are you struggling with pornography or sexual compulsivity? Is secrecy, broken trust or loss of intimacy hurting your relationship? Or maybe you’re not in crisis, but you know your marriage could be stronger, more connected, more alive? You’re not alone–we have been through these issues personally and know what it’s like. I’m a Certified Sex Addiction Therapist (CSAT), and Hunter is a Certified Mentor Coach in long-term recovery. Together, we help men break free (porn, sexting, affairs, prostitution, etc) and we help couples rebuild trust and real intimacy.
(320) 339-0830 View (320) 339-0830
Photo of Alex Wright, LPC, MHSP, CSAT
Alex Wright
Verified Verified
Online Only
Are you exhausted from living with substance misuse, pornography addiction, or the pain of trauma? Do you feel like no matter how hard you try, nothing seems to work? Having an experienced guide to help navigate the challenges in your healing journey can make all the difference. No matter the trauma or the shape addiction takes (drugs, alcohol, sex, porn, etc.), healing depends on addressing the underlying issues and restoring connection to our bodies, ourselves, others, and the world. As you begin to heal, the need to engage in addictive behavior lessens, ultimately resulting in natural, lifelong recovery.
Are you exhausted from living with substance misuse, pornography addiction, or the pain of trauma? Do you feel like no matter how hard you try, nothing seems to work? Having an experienced guide to help navigate the challenges in your healing journey can make all the difference. No matter the trauma or the shape addiction takes (drugs, alcohol, sex, porn, etc.), healing depends on addressing the underlying issues and restoring connection to our bodies, ourselves, others, and the world. As you begin to heal, the need to engage in addictive behavior lessens, ultimately resulting in natural, lifelong recovery.
(423) 436-8210 View (423) 436-8210
Photo of Nicole Otis, Marriage & Family Therapist, MA, LMFT, CSAT
Nicole Otis
Marriage & Family Therapist, MA, LMFT, CSAT
Online Only
Are you struggling with pornography or sexual compulsivity? Is secrecy, broken trust or loss of intimacy hurting your relationship? Or maybe you’re not in crisis, but you know your marriage could be stronger, more connected, more alive? You’re not alone–we have been through these issues personally and know what it’s like. I’m a Certified Sex Addiction Therapist (CSAT), and Hunter is a Certified Mentor Coach in long-term recovery. Together, we help men break free (porn, sexting, affairs, prostitution, etc) and we help couples rebuild trust and real intimacy.
Are you struggling with pornography or sexual compulsivity? Is secrecy, broken trust or loss of intimacy hurting your relationship? Or maybe you’re not in crisis, but you know your marriage could be stronger, more connected, more alive? You’re not alone–we have been through these issues personally and know what it’s like. I’m a Certified Sex Addiction Therapist (CSAT), and Hunter is a Certified Mentor Coach in long-term recovery. Together, we help men break free (porn, sexting, affairs, prostitution, etc) and we help couples rebuild trust and real intimacy.
(302) 467-2053 View (302) 467-2053
Photo of Ashley Smart Fleming, Licensed Professional Counselor, LPCMHSP, CDWF, CSAT
Ashley Smart Fleming
Licensed Professional Counselor, LPCMHSP, CDWF, CSAT
2 Endorsed
Serves Area
My focus is on sexual addiction and trauma.
My client base is focused on the addict and those close to them who have been affected by the addict's behaviors. Clients entering the practice have found themselves caught in a destructive cycle of behaviors; often wishing they could stop, but find themselves continuing the behaviors. Then, there are those the addict has betrayed and hurt deeply through his or her behaviors. The affect of the behaviors have often left the loved ones traumatized and in need of support through the healing process.
My focus is on sexual addiction and trauma.
My client base is focused on the addict and those close to them who have been affected by the addict's behaviors. Clients entering the practice have found themselves caught in a destructive cycle of behaviors; often wishing they could stop, but find themselves continuing the behaviors. Then, there are those the addict has betrayed and hurt deeply through his or her behaviors. The affect of the behaviors have often left the loved ones traumatized and in need of support through the healing process.
(615) 645-1394 View (615) 645-1394
Photo of Rick Underwood - Dr. Rick Underwood Counseling, Licensed Professional Counselor, PhD, LPC, MHSP, NCC, SATP
Dr. Rick Underwood Counseling
Licensed Professional Counselor, PhD, LPC, MHSP, NCC, SATP
1 Endorsed
Serves Area
As a certified sexual addiction therapist I walk alongside those who struggle with issues of compulsive addiction behaviors.
I am honored to work with individuals, and couples in an emotionally safe, caring, and confidential environment where trust and authentic communication are experienced. I am privileged to walk with clients on their journey if they are seeking to explore solutions to a specific concern of life, or of if they have a desire to move past the "state of survival" or complacency to "living fully" and experience life as we are designed to live. I am available weekdays, evenings, and occasionally weekends. For more information please go to my website.
As a certified sexual addiction therapist I walk alongside those who struggle with issues of compulsive addiction behaviors.
I am honored to work with individuals, and couples in an emotionally safe, caring, and confidential environment where trust and authentic communication are experienced. I am privileged to walk with clients on their journey if they are seeking to explore solutions to a specific concern of life, or of if they have a desire to move past the "state of survival" or complacency to "living fully" and experience life as we are designed to live. I am available weekdays, evenings, and occasionally weekends. For more information please go to my website.
(615) 601-3537 View (615) 601-3537
Photo of Nicole Otis, Marriage & Family Therapist, MA, LMFT, CSAT
Nicole Otis
Marriage & Family Therapist, MA, LMFT, CSAT
Online Only
Are you struggling with pornography or sexual compulsivity? Is secrecy, broken trust or loss of intimacy hurting your relationship? Or maybe you’re not in crisis, but you know your marriage could be stronger, more connected, more alive? You’re not alone–we have been through these issues personally and know what it’s like. I’m a Certified Sex Addiction Therapist (CSAT), and Hunter is a Certified Mentor Coach in long-term recovery. Together, we help men break free (porn, sexting, affairs, prostitution, etc) and we help couples rebuild trust and real intimacy.
Are you struggling with pornography or sexual compulsivity? Is secrecy, broken trust or loss of intimacy hurting your relationship? Or maybe you’re not in crisis, but you know your marriage could be stronger, more connected, more alive? You’re not alone–we have been through these issues personally and know what it’s like. I’m a Certified Sex Addiction Therapist (CSAT), and Hunter is a Certified Mentor Coach in long-term recovery. Together, we help men break free (porn, sexting, affairs, prostitution, etc) and we help couples rebuild trust and real intimacy.
(507) 519-4921 View (507) 519-4921
Photo of Chelsea Gilbert - Chelsea Gilbert LMFT, CSAT, Marriage & Family Therapist, LMFT, CSAT
Chelsea Gilbert LMFT, CSAT
Marriage & Family Therapist, LMFT, CSAT
10 Endorsed
Serves Area
Something about your life is nagging at you. It has been begging for your attention for a while.. Part of you has started to think, “life doesn’t have to be like this”. You’re right. You notice your connections just don’t feel as fulfilling as they could be. You find yourself wishing you and the people you care about spent less time on your phones and more time truly connecting. Maybe you feel troubled by something that has happened in your past. You’ve tried to get over it, but but it still has a hold on you. You feel like you’re going through life on high alert for any impending harm or you feel completely shut down and numb.
Something about your life is nagging at you. It has been begging for your attention for a while.. Part of you has started to think, “life doesn’t have to be like this”. You’re right. You notice your connections just don’t feel as fulfilling as they could be. You find yourself wishing you and the people you care about spent less time on your phones and more time truly connecting. Maybe you feel troubled by something that has happened in your past. You’ve tried to get over it, but but it still has a hold on you. You feel like you’re going through life on high alert for any impending harm or you feel completely shut down and numb.
(629) 247-3855 View (629) 247-3855
Photo of Dr. Robert B. Weiss, Clinical Social Work/Therapist, LCSW, CSAT
Dr. Robert B. Weiss
Clinical Social Work/Therapist, LCSW, CSAT
7 Endorsed
Serves Area
Dr. Robert Weiss LCSW, CSAT is Chief Clinical Officer of Seeking Integrity LLC, which provides residential and online treatment, education, and support for male sexual addicts and their families. Seeking Integrity also offers specialized residential treatment for men with sex/porn addiction/intimacy disorders or those with co-occurring sexual and substance abuse disorders. Expert holistic treatment provided in 14, 21 or 28 day length of stay. Separately: Online workgroups provide psychoeducation in a 6 week, 90 minutes per week format. Many free resources provided also.
Dr. Robert Weiss LCSW, CSAT is Chief Clinical Officer of Seeking Integrity LLC, which provides residential and online treatment, education, and support for male sexual addicts and their families. Seeking Integrity also offers specialized residential treatment for men with sex/porn addiction/intimacy disorders or those with co-occurring sexual and substance abuse disorders. Expert holistic treatment provided in 14, 21 or 28 day length of stay. Separately: Online workgroups provide psychoeducation in a 6 week, 90 minutes per week format. Many free resources provided also.
(747) 998-0517 View (747) 998-0517

See more therapy options for Nashville

Sexual Addiction Therapists
When should someone seek treatment for sex addiction?
People should seek treatment for sex addiction if they cannot control their sexual thoughts or behaviours to the point that it disrupts their ability to function in daily life, for example by threatening their finances, career, or relationships. This may include spending an excessive amount of time obsessing over sex, planning sex, watching pornography, or masturbating, as well as consistently engaging in risky sexual activities, using sex to escape distressing feelings, or attempting yet failing to control sexual behavior.

What are the most common treatment options for sex addiction?
Psychotherapy is the most common treatment for sex addiction; therapy helps patients better understand their compulsive thoughts and behaviors and develop strategies to manage their desires. Therapy may be supplemented by medications, such as antidepressants, mood stabilizers, anti-androgens, and the alcohol and substance use medication Naltrexone, as well as support groups, such as 12-step programs.

How long does therapy take for sex addiction?
Recovering from compulsive behavior takes time and effort. There’s no precise timeline for treatment, but research suggests 12 therapy sessions may be enough to see change. Treatment for sexual compulsions requires honesty in therapy, a commitment to understanding triggers and developing coping skills, and potential lifestyle changes such as cutting out alcohol or drugs.

What if sex addiction is left untreated?
Compulsive sexual behavior can have serious repercussions if left unaddressed. For example, if sexual obsessions consume the vast majority of a person’s time, they may lose their job. If they can’t stop paying for sex, their finances may suffer. If they’re dishonest in their relationships, their partner may leave them. If they consistently feel shame, they may struggle with anxiety, depression, or loneliness. Therapy can help people develop the tools to manage sexual thoughts and behaviors that feel uncontrollable.