Sexual anorexia: understanding and dealing with a growing problem

Sexual anorexia is a really important topic, and isn’t getting the attention it deserves. Sexual anorexia is the unhealthy fixation on avoiding sex out of fear and shame. It can appear on the surface like a commitment to sexual purity (just as food anorexia can appear on the surface to be healthy self-discipline around eating). But under the surface sexual anorexia is very different than it appears. It’s not about healthy self-control, it’s about fear, self-hatred, and (very often) unresolved trauma from sexual abuse.

Just like sex addiction, sexual anorexia is often misunderstood. It’s not simply a matter of having a low sex drive. It has to do with anxiety and repulsion towards sex. Wikipedia describes it as: “A loss of ‘appetite’ for romantic-sexual interaction. However, the term is used broadly and can be better defined as a fear of intimacy to the point that the person has severe anxiety surrounding sex with emotional content i.e. in an intimate relationship.”

Patrick Carnes has written the book on this topic, with the title “Sexual Anorexia: Overcoming Sexual Self-Hatred.” Here are a few quotes from an article which features a reprint of the introduction to the book:

Sexual anorexia is an obsessive state in which the physical, mental, and emotional task of avoiding sex dominates one’s life. Like self-starvation with food or compulsive dieting or hoarding with money, deprivation with sex can make one feel powerful and defended against all hurts.

When referring to food appetite, anorexia means the obsessive state of food avoidance that translates into self-starvation. Weight concerns and fear of fat transform into a hatred of food and a hatred of the body because the body demands the nurturance of food. food anorexics perceive bodily cravings for sustenance as a failure of self-discipline. The refusal to eat also becomes a way for food anorexics to reassert power against others, particularly those who may be perceived as trying to control the anorexic, trying in some manner to prevent the anorexic from being his or her “true” self.

Many professionals have observed how food anorexia and sexual anorexia share common characteristics. In both cases, the sufferers starve themselves in the midst of plenty. Both types of anorexia feature the essential loss of self, the same distortions of thought, and the agonizing struggle for control over the self and others. Both share the same extreme self-hatred and sense of profound alienation. But while the food anorexic is obsessed with the self-denial of physical nourishment, the sexual anorexic focuses his or her anxiety on sex. As a result, the sexual anorexic will typically experience the following:

* a dread of sexual pleasure
* a morbid and persistent fear of sexual contact
* obsession and hyper vigilance around sexual matters
* avoidance of anything connected with sex
* preoccupation with others being sexual
* distortions of body appearance
* extreme loathing of body functions
* obsessional self-doubt about sexual adequacy
* rigid, judgmental attitudes about sexual
* excessive fear and preoccupation with sexual diseases
* obsessive concern or worry about the sexual activity of others
* shame and self-loathing over sexual experiences
* depression about sexual adequacy and functioning
* intimacy avoidance because of sexual fear
* self-destructive behavior to limit, stop, or avoid sex

Here are a couple more good quotes on this subject from Joe Kort:

“Negative associations about sexuality are usually formed by some sexual trauma or abuse – possibly incest by a family member, an older neighborhood boy or girl, a clergyman, teacher, or anyone older who imposes their adult sexuality on the child – leaving them feeling terrified, powerless, angry and often blaming themselves.”

“Children should not be exposed to sexual contact for many reasons, one of which is that they are not ready, physically or developmentally, to handle it. In adulthood, many trauma survivors become sexually anorexic or sexually addicted. But neither disorder is really about sex: it arises from the initial loss of control over what happened to them as children. Adult sexuality imposed on a child impedes the child’s own sexual development, so they either act out (in sexual addiction) or act in (become sexually anorexic).”



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16 thoughts on “Sexual anorexia: understanding and dealing with a growing problem”

  1. Oops … I apologize for the spam that got into the system there (in the comment above). Over the years I’ve gotten more careful about the comments in here. Please feel free to comment on this article … do you think sexual anorexia is really a big deal, or is it overblown? I’d love to hear your thoughts on this.

    – Mark

  2. Wondering what is the difference between the extreme aversion to sex described here and having trouble establishing a loving sexual relationship after many years of addiction. When acting out has been present, we realize that our whole sexual relationship has been tainted and there is much confusion about how to move forward in a healthy way.

  3. That’s a great question Susie … and I think there is a difference between sexual anorexia that stems from childhood trauma, and the kind of sexual aversion/struggle that stems from the sexual addiction fallout. Dealing with adult issues is often easier (at one level anyway), because these issues are more understandable to us. The things that stem from early life trauma (like sexual anorexia) manifest themselves as vague feelings (preferences, fears, shame, etc) that are often hard to make sense of on a cognitive level.

    Many couples whose sexual relationship has been tainted by addiction find it challenging to move forward in a healthy way together. But they’re not alone. Marriage therapists who’ve been to our trainings tell me that many – if not most – couples struggle at some points in their relationship to maintain a positive and mutually satisfying sex life … even those where sex addiction is not a factor. In other words, even in the BEST of circumstances, establishing and maintaining healthy sex is not easy. When sex addiction is present, the sexual relationship has become associated with shame, pain, and suspicion, thus making it ever more challenging.

    But the good news here is that this sexual relationship can be rebuilt, with time, attention, and open discussion among partners about what they like, what feels good, when they’re triggered, etc. When the sexual aversion is related to the pain of addiction and sexual sin, it can at least be dealt with in the open, and ongoing conversation and intimate experiences can bring healing.

    But when sexual anorexia is present, it’s more complicated, because the feelings of shame and uneasiness about sex run deep (at the unconscious level), and so it’s harder to work through. Here’s one way to think about this: if we find a very strong attraction or aversion to something sexually that we don’t understand and can’t put into words, it may be tied to unresolved early life experiences that we might want to take a look at.

    One final thought … couples who’ve dealt with sexual addiction often have such a history of pain and frustration around their sexual relationship that it’s hard to talk about the subject. It has a “charge” to it that we can’t really talk sanely. So it’s often helpful to spend a session or two with a seasoned therapist to help deal with this. I’m getting ready to interview Wendy Maltz, who is an example of someone with this expertise. This teleseminar will be recorded, so people can purchase the recording if they want to. Contact me if you’d like to hear more about this.

    – Mark

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  5. Hi I’m new here. I am sorry if this this is the wrong place for this post but I was wondering If some one here on this would be able to help me to choose the right choice.


    I have been trying to work out a way to get my ex boyfriend back for a couple of days. He really is a excellent person and he has never ever implemented anything to blatantly cause harm to me, but the previous time we spoken about some really small-scale private challenges we have both been undergoing just came to a face and before we both knew it we had been each claiming things neither of us intended.

    Ex-Husband back

  7. I have been several times to a therapist with my wife. At those times I did not know about sexual anorexia. It was me who insisted to go to a therapist and my wife did not like it. But I wanted to safe my marriage for our children. Yes, all the things I noticed by my wife, I told. A good therapist should know immediately it had all to do with sexual anorexia, but it seems that no therapist in Holland ever heard about that. Okay, I think that psychology in Holland is still at a very low level, so I can’t blame those so called professional Dutch psychologs, who have an university degree. Anyway, there are also no good articles about that topic in Holland. But reading your American articles and that bloody good book about sexual anorexia, makes everything very clear to me. But, I know if I would go with my wife to a therapist again, that person will again not know anything about the real problem. It would only be a waist of time and money. May be some American specialists about that topic should educate the Dutch public and write Dutch articles and Dutch book about sexual anorexia. Since I know about that topic, I also know that may marriages suffer from that problem and many divorces should not be necessary.

    1. Peter, thanks for your comments. It’s sad to hear about your experiences with therapists there in the Netherlands. I would say that here in the US there is certainly a range of competency about sexual issues. My wife has recently completed a master’s program in Counseling and Psychotherapy, with a specialty in Marriage and Family Therapy. Even though most MFT’s will tell you that sexual issues are a huge part of their practice, to get a master’s degree in this area does NOT require a class on sexuality! That seems crazy to me. The good news is that many therapists get specialized training on their own from other sources, but still … it’s unfortunate to see that this core issue (sexuality) does not get the treatment it deserves in the training and certification of therapists.

  8. Mark, you are right. Nowadays there is a lot of talk about “unwanted intimacy” during worktime. The misunderstanding is that most people confuse intimacy with sex. Intimacy means looking through you and find a kind of spiritual bonding between people, without fearing each other. Not being strangers to each other. To open each others mind and have true communication. The brains are involved in intimacy
    and are connected to each other. An anorectic person will after a very short time, always completely shut down. He or she will immediately built huge walls around him or her. And after that the sex will decline till something boring and mechanical. An anorectic person will do anything not to look through him or her
    and is very afraid for this. An anorectic person is not afraid for sex, because he or she can do this with
    anyone, except his or her own partner. This normally means very short relations. In fact only having sex with strangers and not with theirs own wifes or husbands. Intimacy and sex can not be combined.
    So an anorectic person makes himself or herself open to very multiple sex partners. In fact just strangers ! Sex without intimacy. But I find out that an anorectic person also wants to be humiliated by such a stranger, while having sex. I even think that some anorectics kick not so much on sex, but the humiliation. Mark, do you think I am right ?

  9. I’ve been sober in aa 35 yrs thank God—–also I’m a sex addict.used to go to prostitues peep shows,a lot of other acting out,I go to saa,now,,,,,,I’m doing better,,,,,,,,but now I’m still dealing with sex addiction and sexual anorexic both…….to me sex is about a rush like I passed out… my anorexic is like terror driven to act in help

    1. Mario, thanks for writing. Sorry to hear about the ongoing struggle. As I’m sure you’re aware, it’s quite common for people who struggle with sexual addiction to also struggle with sexual anorexia at various times and in various ways as well. I hope you’re able to get good help through SAA … that’s a great program. Sometimes our challenges require the help of a therapist, especially to sort out early life trauma that started us down this path. One final thought … if you are struggling with getting and staying sober, I would strongly recommend that you look into an intensive workshop with Mark Laaser at Blessings!

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