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Sexual and Intimacy Anorexia

What is Sexual Anorexia?

Sexual anorexia, also known as sexual anorexia nervosa or sexual anorexia disorder, is a term that has been used to describe a pattern of behavior in which individuals have an extreme fear or aversion to sexual activity, intimacy, or sexual relationships. It is not an officially recognized diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) or other widely accepted diagnostic manuals. However, some therapists and clinicians have used the term to describe a range of symptoms and behaviors related to an individual's avoidance or suppression of their sexual desires and needs.


What is Anorexia in S.L.A.A.pdf

Common characteristics or behaviors associated with sexual anorexia may include:

  • Avoidance of sexual activity: Individuals with sexual anorexia often go to great lengths to avoid sexual situations or may engage in sexual activity very infrequently or reluctantly.
  • Fear or anxiety related to sex: They may experience significant anxiety, guilt, or shame related to sexual thoughts, desires, or actions.
  • Negative body image: A poor self-image, dissatisfaction with one's body, or shame about physical appearance can contribute to sexual avoidance.
  • Relationship difficulties: Sexual anorexia can strain relationships, as partners may feel neglected, rejected, or unfulfilled.
  • Strict sexual rules: Individuals with this condition may have rigid beliefs or rules about what is considered "acceptable" sexual behavior, leading to self-imposed restrictions.
  • Low libido: They may have a diminished or absent sexual desire, which can be distressing for both the individual and their partner.
It's important to note that sexual anorexia is a term that has been used by some therapists and authors but is not officially recognized as a mental health diagnosis in mainstream psychiatric or psychological literature. Some mental health professionals may use it to describe a specific cluster of symptoms or behaviors within the context of broader issues related to sexuality, intimacy, and relationships.

What are the symptoms of sexual anorexia? 

  • Avoidance of Sexual Activity: Individuals with sexual anorexia often go to great lengths to avoid engaging in sexual activities. They may actively resist or reject sexual advances from their partner.
  • Fear or Anxiety Related to Sex: A significant amount of anxiety, guilt, or shame may be associated with sexual thoughts, desires, or actions. This fear can make it difficult to engage in or enjoy sexual experiences.
  • Negative Body Image: Poor self-image, dissatisfaction with one's body, or shame related to physical appearance can contribute to sexual avoidance. A person may feel uncomfortable or unattractive in sexual situations.
  • Relationship Difficulties: Sexual anorexia can strain relationships, as partners may feel neglected, rejected, or unfulfilled. This can lead to conflicts and emotional distance.
  • Strict Sexual Rules: Individuals with sexual anorexia may have rigid beliefs or rules about what is considered "acceptable" sexual behavior. They may impose strict limitations on themselves or their partners, making it challenging to have a satisfying sexual relationship.
  • Low Libido: A diminished or absent sexual desire is a common symptom of sexual anorexia. Individuals may have little interest in sex and may actively suppress or deny their sexual desires.
  • Avoidance of Intimacy: Beyond just sexual activity, some individuals with sexual anorexia may also avoid emotional intimacy and closeness in relationships.
  • Depression and Anxiety: The distress and emotional turmoil associated with sexual anorexia can lead to symptoms of depression and anxiety.
  • Isolation: Some individuals with sexual anorexia may withdraw from social and romantic relationships to avoid situations that trigger their anxieties or fears.

What is Emotional Anorexia? 
"Emotional anorexia" is not a recognized clinical diagnosis in mainstream psychiatry or psychology, and it is not included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) or other widely accepted diagnostic manuals. The term is sometimes used informally or in self-help literature to describe a pattern of behavior in which individuals restrict or suppress their emotions, similar to how anorexia nervosa involves restriction of food intake.

In this context, "emotional anorexia" may refer to the following patterns of behavior or emotional experiences:

  • Emotional Suppression: People with emotional anorexia may have difficulty expressing their feelings, whether positive or negative. They may consciously or unconsciously suppress their emotions, leading to a sense of emotional emptiness.
  • Fear of Vulnerability: Like how individuals with anorexia nervosa fear gaining weight, those with emotional anorexia might fear being emotionally vulnerable or opening up to others. This can result in difficulties with forming close and meaningful relationships.
  • Perfectionism: Individuals with emotional anorexia may hold themselves to high standards and feel that they must always appear strong and composed, even when experiencing emotional turmoil.
  • Difficulty Identifying Emotions: Some people may struggle to identify and label their emotions accurately, which can hinder their ability to communicate their feelings effectively.
  • Emotional Avoidance: Emotional anorexia may involve avoiding situations or people that trigger strong emotions, leading to social isolation.
  • Physical Symptoms: Just as anorexia nervosa can have physical consequences, emotional suppression can impact mental and physical well-being, potentially leading to symptoms like anxiety, depression, or somatic complaints.

It's important to note that while "emotional anorexia" is a term that some people use to describe these patterns of emotional suppression, it is not a recognized mental health disorder. If you or someone you know is struggling with emotional difficulties, it's advisable to seek help from a mental health professional who can provide a proper assessment and appropriate interventions to address emotional challenges. Therapy, such as cognitive-behavioral therapy (CBT) or dialectical behavior therapy (DBT), can be helpful for individuals dealing with emotional regulation issues.

Resources on Intimacy and Emotional Anorexia 

  1. Intimacy Anorexia by Dr. Doug Weiss 
  1. Healing Abandonment with Susan Anderson - Emotional Anorexia and Abandonment 
  1. S.L.A.A. - Anorexia -Sexual, Social, Emotional
  1. Brazen Women - What is Emotional Anorexia and How Do You Know if You Have it? 
  1. Center for Healthy Sex - Sexual Anorexia And Sexual Aversion
  1. S.LA.A. - Sexual Anorexia
9. HealthySex.com - An educational website dedicated to promoting love-based, healthy sexualilty.

Articles and Publications:
1. What effect has emotional anorexia had on your life - SLAA publication .pdf
2.Patrick Carnes - The Case for Sexual Anorexia
3. Intimacy-Anorexia-collected-documents.pdf
4. Characteristics-of-Sexual-Anorexia.pdf
5. CACAmIAnorexic_ 50Questions.pdf
6. 12_characteristics_of_anorexia.pdf
7. 62-Understanding-Intimacy-Anorexia.pdf

8. Trauma-Bonds-by-Patrick-Carnes-.pdf

  1. Sexual Anorexia: Overcoming Sexual Self-Hatred by Dr. Patrick Carnes - Author Dr. Patrick Carnes begins by defining sexual anorexia and demonstrating how it and its parallel disorder, sexual addiction and compulsivity, often arise from a background of childhood sexual trauma, neglect, and other forms of abuse. Utilizing extensive research and elucidating case studies, Carnes develops concrete tasks and plans for restoring nurturing and sensuality, building fulfilling relationships, exploring intimacy, and creating healthy sexuality. Woven throughout the book are stories of recovery which illustrate sexual healing principles, model new behavior, and support motivation for change. Sexual Anorexia enables those suffering from this disorder to recognize that sex need not be a furtive enemy to be fought and defeated but, instead, a deeply sensual, passionate, fulfilling, and spiritual experience that all human beings are innately entitled to.
  2. Intimacy Anorexia: The Book by Douglas Weiss, Ph.D - Feeling lonely, disconnected, or unloved in your marriage because your partner has stopped being intimate with you? Has your dream of a sacred union turned out to be married and alone? Intimacy Anorexia, the active withholding of emotional, spiritual and sexual intimacy, maybe the underlying pattern in your marriage. However, you can have hope again. Once Intimacy Anorexia is identified, it can be treated. You and your husband or wife will learn: The four causes of Intimacy Anorexia, The ten characteristics of Intimacy Anorexia, The addiction process of Intimacy Anorexia, The strategies an Intimacy Anorexic employs to create and maintain distance in the marriage, The tools to stop withholding intimacy, productively build an environment where intimacy thrives, and start being passionate and giving intimacy. This book contains excerpts from other couples struggling with Intimacy Anorexia. Their stories help to communicate hope and healing for Intimacy Anorexics and their spouses. Part of the Intimacy Anorexia Book Set along with the Intimacy Anorexia Workbook and the Intimacy Anorexia Steps Guide, this book includes up-to-date information on sexual, emotional and spiritual anorexia and provides new insights for couples to reignite intimacy.
  3. The Truth about Being Full by Dr. Robin L. Smith - In this powerful new work, Dr. Robin painstakingly chronicles a time when she felt at the end of her rope, unable to truly see herself or escape the unrelenting craving in her heart. Throughout her life, she had always focused on living up to everyone else’s expectations, doing everything they asked—everything they recommended—in the hopes that by pleasing others she would find fulfillment and success. Instead she found herself spiritually and emotionally starved with a hungry soul begging for change. Through vivid descriptions of the symptoms of her hunger, the gnawing emptiness in her soul, and her courageous journey to discovering herself, Dr. Robin opens a window into her own experiences in order to provide insight into yours. With clarity and empathy she starts you on a path to uncovering the real you—the you that lays beneath all the doubt, superficiality, and life crises. 
  4. Coming Home to Passion: Restoring Loving Sexuality in Couples with Histories of Childhood Trauma and Neglect by Ruth Cohn - Coming Home to Passion: Restoring Loving Sexuality in Couples with Histories of Childhood Trauma and Neglect explores the enduring impacts―physiological, psychological, and behavioral―of childhood trauma and neglect. Author Ruth Cohn, drawing on 25 years of experience working with trauma survivors and their partners and families, lays out a practical and actionable course for recovery in clear, accessible language.
  5. Intimacy Anorexia and Pornography Addiction And How I Stayed Married: Through The Eye Of A Needle To Save My Marriage by Jill Jameson -Searching for someone who has actually been there and survived? I found plenty of books describing my situation out there, but none that really were by a wife that survived and stayed. Here is my story. I hope it saves you the years of questions I had, and the strain of not knowing what to do. This book will detail candidly every obstacle and every solution I found. My heart goes out to the newlyweds that make the discovery I did. I want to help. 25 years of marriage after discovering pornography and sexual anorexia in our early years of marriage, gives me the merit badge to be in this club no one wants to be in.
  1. The Stressless Eating Podcast with Leanne Ellington - S02E05: The Truth About “ Emotional Anorexia” and Knowing Your Value ( With Kate Mansfield) - "Have you ever heard of ‘Emotional Anorexia’? Well yes – it’s a ‘thing’! Just like the food version –- you can have ‘Emotional Anorexia’, and it's a lot more common than you think. Not only is it super-common, but it can be really UNhealthy for your mind, your body, your heart, your soul, and yes....your relationship with food. On today's episode of the Podcast, I've invited one of my besties and the UK's leading dating coach to have a chat about how it impacts you and how you value yourself (and trust me, it’s not what you think!) If you're stuck in a pattern of avoidance, procrastination, numbing out, soothing, or avoiding your life (or parts of your life), these might be symptoms of 'Emotional Anorexia'. And that's why we decided to shed some light on this rarely-talked-about (and highly avoided) subject on this episode of the Stressless Eating Podcast."
  2. Impactus Podcast - Intimacy Anorexia with Dr. Douglas Weiss - You’ve heard of someone having anorexia, but have you ever heard of intimacy anorexia? Our guest for this edition of the podcast is Dr. Douglas Weiss from Heart to Heart Counseling in Colorado Springs. We will be exploring the topic of intimacy anorexia and how it results in relationships that are marked by pain and loneliness.
  3. The Living Truth Podcast - Freedom From Unwanted Sexual Behavior, Hope & Healing For the Betrayed - Intimacy Anorexia with Janice Caudill - Intimacy Anorexia (IA) is the deliberate withholding of emotional, sexual, and/or spiritual intimacy from one’s partner. This deeply painful condition within a marriage is not uncommon but rarely correctly diagnosed as IA is a newly recognized condition that many people helpers don’t yet recognize.. Join Kristin as she interviews Dr. Janice Caudill whose expertise is in working with sexual addiction, partner trauma, and Intimacy Anorexia. Even through the devastation of these three issues there IS hope to overcome and heal! The Living Truth Podcast is conversations that shed light on the deeper issues beneath porn addiction, sex addiction, & help for those enduring the devastation of sexual betrayal this causes. 
  4. A Date with Darkness Podcast - The Love Junkie: Understanding Love Addiction, Intimacy Disorders, and Sexual Anorexia, featuring Shena Tubbs, LPC - A Date With Darkness Podcast is hosted by Dr. Natalie Jones, Psyd., LPCC, a licensed psychotherapist in Oakland and Sacramento CA. Join Dr. Jones for an intimate discussion about the effects of abuse dynamics and healing from relationship trauma.
    Shena Tubbs, LPC, CSAT-C, trauma recovery coach, host of the Love Junkie podcast, and owner of Black Girls Heal in Houston, TX joins us today to discuss love addiction, problems with intimacy, and sexual anorexia. Shena Tubbs specializes in working with African American women and helping them understand how their early childhood experiences have shaped their ideas about love, intimacy, and sex.
  5. Secret Life Podcast - Episode 137: I'm a sex and love addict and I struggle with sexual anorexia - Ruby shares her story of struggle and hope as she overcomes anorexia, sex and love addiction, and fear of intimacy. Listen as she shares her journey through twelve step programs, therapy and support from family and friends. Gain insight into her challenges and victories as she opens up to discuss her experiences and share her wisdom. Ruby’s story will inspire you to face your own challenges and find the courage to heal.
  6. Sex Addicts Recovery Podcast - Episode 20: Deb W. Shares about Intimacy Avoidance - Sex addiction is often described as an intimacy disorder. Sexual anorexia,  intimacy avoidance, or “sexually acting in” can be seen as the flip side of “sexually acting out”.  Join us in this episode as Deb W shares her experience, strength & hope around Intimacy and Sexual Avoidance as well as ISA awareness and helping SAA telemeetings move to Zoom.
  7. Beyond Theory Podcast - Season 1 Episode 8: Dr. Stefanie Carnes on the Impact of Intimacy Issues - Meadows Senior Fellow Dr. Stefanie Carnes joins host David Condos for the conclusion of their two-part conversation. In this episode, she unpacks how intimacy issues develop, how sex addiction hurts partners and families, and how everyone involved can find healing.
  8. Fit for Joy Podcast - Intimacy Anorexia: A Hidden Addiction - Intimacy is a hugely important part of human life. Intimacy allows us to develop deep connections with other people, and can significantly enhance and propel our relationships forward.
    Unfortunately, not everyone is able to easily develop intimate relationships with people. Those who have extreme difficulty maintaining or experiencing intimacy may have a condition known as intimacy anorexia. In this episode, we’re going to discuss intimacy anorexia, its potential causes, and some treatments. Intimacy is key for a happy lifetime and as a holistic coach, Michael Roth helps people to address any causes, triggers, or issues that arise in the entire mind-body system by fully acknowledging and addressing the problem.
  9. Beyond Theory Podcast - Season 4 Episode 20: Patrick Carnes on Sex Addiction - Technology’s purpose is to improve the quality of life for humanity. But unfortunately, in many ways, it has provided unintended consequences, for example, serving as stimuli for sex addiction. Dr. Patrick Carnes says that as technologies evolve, we must remain vigilant about this issue, especially when it comes to adolescents. But can vigilance and treatment practices evolve just as rapidly as technology?
  10. Love and Sex Today W/ Dr. Doug Weiss - Married and Alone - Intimacy Anorexia - EP3 - Welcome to “Love and Sex Today.” I’m Dr. Doug Weiss, and today in volume three we will be discussing “Married and Alone and Intimacy Anorexia.” Now, if you feel married and alone, you’re going to want to listen to this podcast or read this transcript for sure. If you’re feeling unwanted or disconnected, if you feel starved in your marriage, if you feel like you have to beg to be praised, to be touched, to be wanted, if you feel like you are more of a roommate than a lover, you’re probably married to someone who has Intimacy Anorexia.
  11. The Shoot your Shot Podcast - Sexual Anorexia -  C. Diddy (@cdiddy513) & Steph (@bobeaubreaux) discuss mental health of the younger homies, sexual anorexia, Valentine's Day & the expectations for men & women on this day & much more on this episode.

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Susan Zola, LCSW, CCPS, CSAT

T: 631-332-2213
E: suezola@me.com
Licensed In: Arizona, Connecticut, Florida, Maine, Massachusetts, New Hampshire, New Jersey, New York, South Carolina Out-of-State Independent Social Worker Telehealth Provider, Texas, and Virginia


Bachelor of Arts, Psychology – SUNY Binghamton, 1980
Master of Social Work – Adelphi University School of Social Work, 1982.
Private Practice – "Mind Over Matters," 2006.
LCSW License #078530-1
APSATS The Association of Partners of Sex Addicts Trauma Specialists
Certified Sex Addiction Therapist
The International Institute for Trauma and Addiction Professionals
Certified Clinical Partner Specialist

Couples Therapy Sexual and Itimacy Anorexia

Susan Zola, LCSW, CCPS, CSAT
Licensed In: Arizona, Connecticut, Florida, Maine, Massachusetts, New Hampshire, New Jersey, New York, South Carolina Out-of-State Independent Social Worker Telehealth Provider, Texas, and Virginia

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