Recent interest in sexual addiction has drawn attention to a variation called sexual anorexia. Also called sexual “acting in,” sexual anorexia is characterized by a severe aversion to sexual contact and the obsessive avoidance of sex. Other signs of sexual anorexia include:

• Shame and loathing after sex
• Rigid, judgmental attitudes about sex
• Excessive fear about sexually transmitted disease
• Body distortion
• Obsessive self-doubt
• Self-destructive behaviors to limit, stop, or avoid sex
• Episodes of sexually acting out or sexual “binges”

Deprivation creates the illusion of control. In food anorexia, the person refuses to eat, controlling exactly what goes in her body; in sexual anorexia the person denies access to sexual penetration and emotional contact.  Convinced that “no one can hurt me if I don’t let them in,” sexual anorexics experience an emotional wasting away as they become increasingly isolated.

Much like bulimics, sexual anorexics may enact a “binge and purge” cycle. Individuals may go through periods of extreme deprivation of sex followed by promiscuous sexual behavior. Sexual addicts, in an attempt to control their compulsive behavior, may even enforce an anorexic phase—born out of self-hatred, or as punishment or atonement for sexual acting out. In Ready to Heal: Women Facing Love, Sex, and Relationship Addiction, Kelly McDaniel writes, “Sexual anorexia is an extreme aversion to closeness, and sexual addiction is an objectification of the other person that makes closeness impossible.”

Other compulsive deprivation behaviors such as hoarding, being a workaholic, debting, and saving may accompany sexual anorexia. Sexual anorexics also may be overweight or obese, as eating can soothe their anxiety and protect them from the advances of others by making them appear sexually undesirable.

People who are this terrified of human contact can have sustained serious wounds of abuse. This could be an obvious trauma, such as sexual abuse by a parent or caretaker, or by the more covert injury of a negligent, disinterested parent.  Infants and children need consistent attention and love from their caregivers, and the absence of these can be just as damaging as abuse. It is particularly devastating when a child, wounded at the hands of a parent, realizes there is no one to turn to for solace. This corruption of trust and safety teaches the child to fear their own need to be connected to others.

People with sexual anorexia and other intimacy issues long for affection, but they have learned through trauma that they are undeserving of love and that others cannot be trusted. Because of how horribly they have been wronged by others, rigid isolation appears to be the only way to feel safe.

Reaching out for help can be very difficult for someone who has been unable to depend on others, but it is essential for recovery. Support groups can help a person to feel less alone and can strengthen his or her capacity for intimate connection with others. Individual therapy can help people with sexual anorexia explore their pain and mistrust of others, and can create a corrective, caring relationship with a stable other.

Further reading:

Carnes, Patrick. (1997). Sexual anorexia: Overcoming sexual self-hatred. Center City, MN: Hazelden.

Katehakis, Alexandra. (2010). Erotic intelligence: Igniting hot, healthy sex while in recovery from sex addiction. Deerfield Beach, FL: HCI.

McDaniel, Kelly. (2008). Ready to heal: Women facing love, sex, and relationship addictions. Carefree, AZ: Gentle Path Press.

Why do so many men sabotage relationships and careers? Current cultural stereotypes of men range from bumbling incompetence to aggressive, macho insensitivity. I’ve worked with men in therapy and personal growth workshops for over 25 years, and I’ve identified a type of adult man I call the LATE Men, Lost, Angry Teens, and they are often stuck in an adolescent level of development – literally, LATE to grow into full adult functioning.

We all have four primary internal parts: An Inner Child, a Teenager, an Inner Critic, and a loving, responsible Adult. The Teenager seeks independence, identity, and acceptance with peers. Teens may also become rebellious, angry, confused and withdrawn. Adjustment problems are more likely to occur in distressed or dysfunctional families, where adolescents do not receive the guidance, emotional support, and other resources necessary for healthy maturation and individuation. (more…)

Slow down and listen.

When we communicate, sometimes we ignore what our partner is saying. Instead of focusing on our partner, our thoughts are consumed with what we plan to say next. If you pay attention to your partner’s words, and then you reflect back what you hear them say or feel, then they will feel heard. As a result, you will be on the road to a resolution of the issue. Does someone in your life, maybe yourself, constantly repeat a message over and over? It is probably because said person does not feel heard.

Try reflective listening and see if you can stop that person from repeating. “Reflective listening” means you state back the jest of what you heard or the emotion associated with the communicator’s message. Keep it short. If that is not what the speaker meant for you to hear, then the speaker will say, “No that is not what I wanted you to hear.” The speaker then repeats the statement, trying to change it in a way that the meaning can be more clearly understood. We talk and listen through our life filters. What one person says and intends to be heard may be totally different than what the receiver hears. Reflective listening is an advantageous tool because it confirms if the message was heard in the speaker’s intended manner. (more…)

The question often comes up among LGBT (lesbian, gay, bisexual, transgender) people: should they see a gay therapist, or would they would be comfortable with a gay-friendly therapist? This is a personal decision people need to make for themselves, but as in choosing any therapist, it is important to find a professional who has the education, the empathy, and the ability to understand your individual needs.

Although there are many gay-affirmative and gay-friendly therapists, sometimes it is important to find a therapist who is a member of the gay community. The process of therapy is a very personal one, and for many people it is vital that their therapist be someone who understands and can directly relate to their life experiences. For many LGBT people, there is an internal process that makes it important for them to work with a therapist who has direct knowledge of what it is like to live as a member of the gay community.

So what should you look for when choosing a therapist who specializes in LGBT issues? First off, if having a gay therapist is important to you as a client, then you should make sure you find a therapist who is open about his or her sexual orientation and is willing to openly discuss yours. A gay therapist who is comfortable with his or her own sexuality will be more open to discussing issues that you may be facing as an LGBT person.

But sexual orientation is not all that one should look for in a therapist. It is also important to ask questions about the therapist’s education, training, and understanding of the issues that can face LGBT clients. Your therapist should be familiar with issues of sexuality, coming out, internalized homophobia, HIV/AIDS, depression, and self-destructive behaviors, as well as more traditional issues like couples, dating, social skills, and relationships as they pertain to the LGBT population. Not all gay therapists will be experts on all of these topics, but you want to find the one who has the knowledge to address your personal needs.

Beware of therapists who promise to treat or “cure” homosexuality, as this type of therapy has been found to be unsuccessful. It can often be damaging and lead to low self-esteem, guilt, self-destructive behavior, and even suicide. A good therapist will assist you in finding your personal comfort with your sexuality and not try to “cure” or “fix” you.

Another issue that can come up for discussion in therapy is sex. For many gay people, it is important to have a forum where they can talk openly about sex and the myriad issues that surround intimacy. Ask your therapist whether he or she will be comfortable talking openly about sex and other personal issues that affect you as a client.

As much as it is important to learn about your therapist’s sexuality and commitment to working with LGBT clients, it is equally important to make sure that your therapist will maintain appropriate boundaries in regard to discussing his or her personal experiences. Under no circumstances should there be sexual contact or behavior between client and therapist.

An excellent way to find an LGBT therapist is to use the Advanced Search function here at GoodTherapy.org and enter the search term “LGBT Issues.” You can also check with your local gay and lesbian center, which will often have a resource list of local therapists who work with the LGBT community. Referrals from friends are another great resource in the search for a good therapist who can address your personal needs.

Finding the right therapist for you is vital in order to create the most beneficial outcome of your commitment to go into therapy. Take the time to interview your therapist, making sure that you find the right person who will be able to assist you in your rediscovery of yourself. Whether the therapist is gay or gay-friendly, the right match of therapist and client is the foundation for an exceptional therapeutic experience.

When is not enough sex too little by far?

When we talk about sex addiction, most of us think of someone who is unable to stop engaging in sexual activity. And most of us can understand that too much sex can be dangerous, due to the potential for acquiring sexually transmitted diseases, losing a committed l relationship, or experiencing a decline in health. But no one ever died from lack of sex, right? Surprisingly, addiction can be described as too much or too little—excess or deprivation.

Sexual deprivation, also known as sexual anorexia, has severe physical and psychological consequences, and many people come to me looking for help in tackling and unraveling this serious problem. By the way, a significant percentage of the people I work with by phone are struggling with sexual anorexia. Often, these people feel more ashamed and embarrassed than those with a more traditional form of sex addiction. Before you think you don’t know anyone like that, remember that they will probably keep their secret, feeling deeply out of sync with a culture that constantly promotes sex but is sadly unconscious about sexuality.

Perhaps you suffer quietly with sexual anorexia, consumed by dread of sexual pleasure yet filled with fears and sexual self-doubts. If so, you may find Dr. Patrick Carnes’ excellent book, Sexual Anorexia helpful. He explains what sexual anorexics are not, “It is not inhibited sexual desire they are experiencing, although often they possess a naïveté, an innocence, or even a prejudice against sex. It is not about being cold and unresponsive although that certainly is a way in which they protect themselves against the hurt.”

He continues, describing a number of other reasons that people contact sex therapists, “It is not about religious belief, although religious sexual oppression may have been a place to hide. It is not about guilt and shame, although those feelings are powerfully experienced.” Nor, I might add, is it about sexual betrayal or rejection, though these are themes I hear quite often. It is simply the emptiness of profound deprivation, the silent suffering known as sexual anorexia.[fat_widget_sex_left]

The word anorexia comes from the Greek word orexis, meaning appetite. Thus an-orexis translates as ‘denial of appetite.’ And most of us associate it with the obsessive avoidance of food, or self-starvation. The steadfast refusal to eat can become a way for food anorexics to assert a kind of power over others, especially those they feel are trying to control them in some way. Many food anorexics are driven by a powerful need to achieve a Barbie-doll figure. The terror of sexual rejection is the primary force behind this striving for impossible thinness. Sexual anorexics often share these same fears and distortion of thought. Dr. Carnes notes that in both cases, the sufferers starve themselves in the midst of plenty. That’s been true in my experience too—the majority of sexual anorexics that I’ve worked with have had partners or spouses who were more than willing to engage sexually.

There are striking parallels between food anorexia and sexual anorexia: the essential loss of self, the same thought distortions, the same extreme self-hatred and isolation. Both types struggle for some kind of control over themselves and others, usually the people closest to them. Food anorexics will sometimes become “bulimic,” bingeing with compulsive overeating, and then purging by self-induced vomiting. In a similar fashion sexual anorexics often “act out” with periods of sexual promiscuity or exaggerated frequency. One woman I worked with reported that she only approached her boyfriend for sex twice per year, but when she did she demanded nonstop intercourse or would masturbate to the point that she bled.

Sexual anorexics can be men or women, heterosexual or homosexual. Many have histories of childhood abuse and neglect, sexual and otherwise, what one person I worked with called “my dark secrets.” At some point, they experienced profound loss of trust, causing their “wires to cross,” or their sexual arousal template to be affected. The more frightened you are, the stronger your need to maintain some semblance of control.

Since most sexual anorexics are unaware of the hidden trauma driving them, I’ve found therapy can be very helpful. One man I worked with expressed amazement that “there’s actually a name for this horrible suffering.”

Editor’s note: Content in this article and comment thread may be sexual or graphic in nature and may not be appropriate for all audiences.

Believe it or not, almost everyone has some secret desire, fantasy, or fetish that turns them on in the bedroom (or elsewhere). Some choose to keep their fantasies to themselves and think about them when alone. They consider this part of their sexuality not necessary to share. Others have a strong urge to share their fantasy or fetish, desiring to act it out with partners. Finally, there are those of us who have trouble swallowing the content of our desires, are confused or unsure about its meaning, and feel conflicted about our fantasies and fetishes.

Reflecting Childhood

Feelings of guilt, shame, and confusion about our fantasies and what turns us on are common in our society. We want to know, “Why do I feel this way and where does this come from?” The short answer is our sexual fantasies are likely a reflection of the stimuli we were exposed to during our sexual awakening, much like classical conditioning. For example, the boy who experiences his first erection in the bathtub may then pair arousal with water and bathing. He might have fantasies involving water. The girl who has a domineering mother or who feels ostracized by her peers may have fantasies in her adulthood about being dominated (Dixit, 2010, p. 47).

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What is often difficult for people to understand is that sexual awakening happens when we are children. Although childhood sexuality is a natural part of development, it is often ignored in our culture, shunned, or brushed under the rug as wrong. The child is made to feel ashamed or guilty for having sexual thoughts and desires. No explanations are given, and nothing is talked about.

By remembering that sexual curiosity and the desire to feel pleasure is a normal part of a child’s development, we can eradicate much of the shame and guilt we have about our early sexual experiences. It is this shame and guilt that may lead to our current state of confusion regarding our desires.

Reflecting Anxieties

Sexual fantasies may also be a reflection of our daily anxieties. For example, the individual who worries about having too many responsibilities in daily life may fantasize about being completely dominated and controlled in bed. The woman who feels small and unattractive may fantasize about being a dominatrix.

The key is to remember that we are creatures of balance. What we present to the world and feel on a daily basis often needs to be countered by its polar opposite, which could be manifesting in our sexual fantasies and fetishes. In other words, if an individual fantasizes about being sexually dominated in bed, it does not mean they are weak and helpless in real life. Frequently, the opposite is true.

Sexual fantasies are often representations of parts of our lives, whether past or present. When we break them down and take a closer look, we will see that they are normal reactions to our life experiences.

Reference:
Dixit, J. (April 2010). Psychology Today, p. 47.

At the very core of our lives is sexuality. Though, as a society, we are not trained to talk openly and honestly about sex. Nonetheless, we grow up recognizing and knowing, intrinsically, the need we have for sex and the roles it plays; with one of it’s main functions being procreation. And, what is the other function of sex? Well, and pleasure, of course.

If only pleasure were such an easy thing for us to comprehend. As a society, not only are we discouraged from talking about the pleasure that sex brings us, we are also led to recognize the detriments of deriving too much pleasure. The lack of ability to openly acknowledge things which bring us pleasure, may also cause us to abuse those same things.

It is known as hedonistic to throw oneself into pleasure all the way, to be unable to find a happy medium. When we begin to neglect our responsibilities—work, family, friends—in search of personal pleasure, we then call this phenomenon an addiction. And, when someone comes to the end of the rope with addiction, they often recognize that the only way to undo the damage is to go into what we call sobriety, or recovery.

When an alcoholic or drug addict goes through recovery, it is possible that sex is at the core; however, it is one topic that often gets neglected. Much of recovery is spent addressing the relationships, which affected and were affected by the addiction, coming to terms with our addictions and understanding ourselves in relation to our higher spirit. All of these are, indeed, important items on the road of recovery. However, it is not every day that the role sex plays in an addiction is explored.

It is important to mention that drug and drinking problems can be sexual problems in disguise. Sex plays a major role for some individuals who become chemically dependent. And, to break down its walls, it’s necessary to understand the effects of sex addiction.

Sexuality is often one of the most fragile areas of a recovering individual’s torn self-esteem. Many of the issues of love and relationships, that come up for addicts in recovery from alcohol/chemical dependency, have something to do with sexuality, once the walls are broken down.

Sexual fears and insecurities may be the force that drives a user to drinking or use drugs in the first place. For example, many professionals point to early sexual abuse as the place where some anxieties began. It has been recognized that childhood sexual abuse is a risk factor in drug dependence. Research indicates that, of all the people in treatment, about half have been raped or abused, while a third are victims of incest. So, as practitioners, we have to recognize that sexual abuse may be damaging to feelings of self-worth, which, in and of itself, is a risk factor for drug use and abuse.

Not only is sexual abuse is a major contributor to addiction. Sexual and gender stereotypes are another. Some of the tried and true gender roles still hold in our society, even though we are seeing progress and change. Many women are still the primary home caregivers, putting the needs of men and children ahead of their own, neglecting their own need for support and intimacy. And, men are often still expected to be the initiators, the aggressors, and the breadwinners forgetting to express their emotions and feelings. Ignoring needs and feelings are risk factors for addiction.

In treatment we learn that preserving sobriety involves more than merely reshaping the habits of drug or chemical use, it also requires throwing away stereotypes and reshaping old attitudes that have been hammered in over the years. In treatment the addict learns to start taking care of his/her own needs. The addict learns that their recovery depends upon addressing feelings and emotions. The individual in recovery must talk about things like sexual abuse, sexual gender roles and stereotypes. And, likewise, must also talk openly talk about his/her sex life.

The key is to deal with sex after sobriety. Avoiding sex may leave an individual poorly prepared to cultivate relationships that don’t revolve around, for example, singles bars and drinking, causing an addict to lose that hard-earned sobriety within months or weeks. Unless treatment addresses both the dependency and sexuality, recovering addicts risk relapse with every close romantic encounter. Most treatment programs do recognize that it takes two to repair a relationship strained by chemical abuse, and will incorporate the partner of the addict in the treatment process.

Though many addicts may feel like doing so in recovery, running away from sex is not realistic; it’s better to put sex in the context of feelings and factors that make up the whole person. Here are some things for the addict to remember when it comes to sex:

1. Talk about sexual feelings of guilt and anger in order to heal. Addicts need to learn to recognize the patterns of feelings, sexual or otherwise, that drive them to drink or abuse substances. Only then are they ready for new relationships, or of rekindling an old one.

2. A recovering addict also needs to move slowly, whether in a new or old relationship. Concentrate on building self-confidence and self-image, first, before building up a sex life. For many, it may be a good idea to wait six months, or even a year, before beginning a new sexual relationship. Couples should focus, first, on sharing time and feelings together before jumping back into bed and into their old, unstable, erratic sex life. Sex therapy is also a good starting point.

3. Start over by focusing on really learning about your own body and feelings. The goal here is to help ease fears that sexual feelings are abnormal or strange. It is important to take the time to really learn (or re-learn) what one likes, sexually. Couples should focus on sensuality and should take the pressure off of sex and orgasm for a while and, instead, do things like take bubble baths, sensual massage, and mutual masturbation, and openly communicate with each other about sex. It is important to recognize that, just like there’s more to alcoholism recovery than not drinking, there’s more to sexuality than just sex.

An addict will very likely need to rewire his/her ideas about sex. Taking time and talking openly about sex are the keys. The addict who discovers that sex can be a bridge to intimacy, satisfaction, and a strong self-image, is likely to find deeper, more honest and satisfying relationships—sexual and otherwise.