Sex, Lies & Trauma

Straight Talk about Sexual Compulsivity

Sexual Anorexia – The Shadow Addiction

The compulsive avoidance of sexual and relational intimacy can be devastating.

Although still stigmatized in our culture, sex addiction has steadily gained recognition in the public consciousness over the past decade, resulting in a host of treatment centers, rehabs, support groups and specialized therapists. What is less talked about, but equally devastating, is 'sexual anorexia,' a concept that refers to the compulsive avoidance of sexual nourishment and intimacy.

The phrase has been floating around since 1975, but it was Dr. Patrick Carnes who is credited with introducing it to the mainstream in his 1997 book of the same title. Much like a food anorexic, a sexual anorexic may refuse all sustenance -- in this case, emotional and sensual sustenance -- in order to keep chaotic feelings, anxiety and unexplored trauma at bay. Where sex addicts 'act out' or ‘binge’ through promiscuity or high-risk behavior, sexual anorectics starve themselves by 'acting in,' denying themselves the pleasure of relationships, dating, loving touch and genuine connection with others.

For the anorexic, the possible rejection he or she might encounter from another human being is just too threatening. It feels safer to remain isolated, no matter how unsatisfying that lifestyle may be. Sometimes this self-imposed exile from sexuality may be the result of sexual abuse or body dysmorphia, or it may have originated in a highly repressive or religious upbringing. Rigidity, judgment and shame dominate the sexual anorexic's emotional landscape, leaving little room for exploration or curiosity. Like an alcoholic or drug addict, the anorexic may go to great lengths to hide the condition, making up excuses in order to decline event invitations, feigning illness, or compulsively switching jobs, apartments or schools to avoid developing community. In all cases, he or she remains an outsider, cut off from the joys of partnership.

What's more, a perplexing dichotomy often exists in those who seem furthest removed from sexually avoidant behaviours, namely the sex addict. He or she may find it easy to be sexual with strangers or one-night stands, but terrifying to attempt any kind of intimate, committed relationship. Thus a cycle of binging and purging occurs, or ‘sexual bulimia,’ if you will. Sexual anorexia can also show up momentarily within long term partnerships, with one party withholding sex, love and affection from the other, either deliberately, or through passive aggressive acts such as staying late at work every night to avoid being alone with a mate. Giving a partner the ‘silent treatment’ or being overly critical can also be telltale signs of intimacy avoidance.

Like sex addiction, sexual anorexia is a symptom of a deeper disconnection from oneself and others and needs to be explored with a qualified professional in a safe, therapeutic setting or in a 12-step group that address the issue in their literature such as Sex and Love Addicts Anonymous (SLAA) or Sex Addicts Anonymous (SAA). By facing their deepest fears about closeness, vulnerability and sex itself, anorexics can begin to move towards the rewarding human interactions that make for a happy and healthy life.

Alexandra Katehakis, M.F.T., is the Founder and Clinical Director of the Center for Healthy Sex in Los Angeles. more...

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