Sexual Anorexia
I'm still grappling with "sexual anorexia," what it means and how it impacts a marital relationship.
My husband was acting out with prostitutes as well as engaged in an active sex life with me. And yet, what I now realize is that his sexual contact lacked intimacy. He could not be truly intimate. I've stopped trying to come to an understanding of his illness, but I'm still exploring it from the aspect of how it affected ME. How did his inability to be intimate impair our communications? And why did I not notice?Why did I accept it as okay?
When Sex Addiction is Sexual Avoidance
Updated July 29, 2010
Written or reviewed by a board-certified physician. See About.com's Medical Review Board.
"Sexual anorexia" is a term that was made popular by sex addiction expert Dr. Patrick Carnes. Carnes used the term to describe the compulsive avoidance of sex and sex-related matters, although he was not the first to write on the subject or to use the term. It may surprise you to learn that Carnes presents sexual anorexia as a form of sex addiction in his book, Sexual Anorexia: Overcoming Sexual Self-Hatred.
According to Carnes, the word anorexia means without appetite (anorexia being derived from the Greek word, orexis). So sexual anorexia refers to a lack of sexual appetite. What makes it a form of addiction is the compulsive avoidance of sex that sexual anorexics build their lives around.
They do this in a variety of ways, which can include:
Persistent fear of intimacy, sexual contact, sexual pleasure, sexually transmitted diseases, etc.
Preoccupation, to the point of obsession, with sexual matters, including the sexuality, sexual intentions, and sexual behaviors of others, and their own sexual adequacy.
Negative, rigid, or judgmental attitudes about sex, body appearance, and sexual activity.
Shame and self-loathing over sexual experiences.
Self-destructive behavior in order to avoid, limit or stop sex.
Who Develops Sexual Anorexia?
Sexual anorexia can affect men and women. Carnes states that victims of past sexual abuse or sexual rejection are most often affected, and are often unaware of the reason for their difficulties with sex.
They may have concurrent problems with other addictions, such as food addiction, substance addictions, and other obsessive or anxiety-driven problems.
People who strongly identify with cultural, social or religious groups that involve sexual oppression, repression or other negative approaches to sexuality may be particularly vulnerable to developing the obsessive avoidance of sex that characterizes sexual anorexia.
Do Sexual Anorexics Ever Have Sex?
Carnes describes how sexual anorexics may be prone to occasional periods of sexual promiscuity, or "sleeping around," a bit like bulimics -- people who periodically starve themselves of food, then binge and purge what they have eaten. An example of how this can happen is when a sexual anorexic abstains from sex except when he is intoxicated. The boundaries around sexual expression are excessively rigid, but crumble when inhibitions are lowered.
Despite their aversion to sex, sexual anorexics may be engaged in "sexual" relationships, including marriage, although the quality of the relationship is likely to be impaired by the sex avoidance of one or both partners. Ironically, a sexual anorexic may even form a relationship with an "acting out" sex addict, as one partner loses control over their sexuality while the other has excessive control. In a situation like this, one partner may be promiscuous, while the other abstains from sex.
Help for Sexual Anorexics
Although sexual anorexia is not a recognized disorder, problems of avoidance of sex are well-recognized by sex therapists and many couples counselors and psychologists. If you or your partner are having difficulties with your feelings about sex or sexual expression, you may be able to get a referral to a sex therapist from your doctor.
You can also contact your local psychological association for help finding a psychologist who can help you, or visit the American Psychological Association website. Although sex addiction services are not generally provided by mainstream addiction services, this provision is increasing, so it may be worth making a confidential inquiry –- sometimes these services depend on the interests and training of individual members of staff.
Finally, you may wish to contact the Society for the Advancement of Sexual Health (SASH), who can help you find a therapist with expertise in sex addiction and sexual anorexia.
Sources:
Carnes, Ph.D., Patrick Sexual Anorexia: Overcoming Sexual Self-Hatred. Hazelden, Center City, MN. 1997.
Hardman, R. & Gardner, D. "Sexual anorexia: a look at inhibited sexual desire." Journal of Sex Education & Therapy 12:55-59.