Sexual anorexia is a pathological loss of "appetite" for romantic-sexual interaction, often the result of a fear of intimacy to the point that the person has severe anxiety surrounding sexual activity and emotional aspects. It is not a recognized pathology included in the Diagnostic and Statistical Manual of Mental Disorders. In comparing sexual anorexia to anorexia nervosa, some psychologists suggest that the two disorders share four main characteristics: Control, fear, anger, and justification.
Empirical data
Very few studies have been conducted to investigate the specific diagnostic patterns or criteria regarding sexual anorexia. However, one study conducted by Dr. Patrick Carnes found that many of his patients diagnosed with sexual anorexia also had a history of sexual, physical, or emotional abuse, other compulsive or addictive problems such as substance abuse, or a family history of addiction. However, only early treatment data was used, and sample size was very limited.
Sexual addiction and sexual anorexia
In the view of some practitioners, corroborating the work of Patrick Carnes, there are people who appear to have a sexual addiction which is expressed through a variety of behaviors such as the compulsive use of strip clubs, prostitutes, porn sites, etc. but fit the definition of sexual anorexic in that they seem to lack the ability to have a relationship of a sexual nature beyond a paid-for or anonymous experience. Nonetheless, the data for sex addicts and sexual anorexics draw many similarities in terms of family, abuse, and medical history.
History of the term
The concept of sexual anorexia was first mentioned by psychologist Nathan Hare in his 1975 dissertation at the California School of Professional Psychology. Ellen Goodman, the nationally syndicated columnist, wrote about psychiatrist Sylvia Kaplan's use of the concept in 1981 and this was noted in the editor's "Notes" in the journal Black Male/Female Relationships. Nathan and Julia Hare's "Sexual Anorexia" in Crisis in Black Sexual Politics was published in 1989. The term was widely popularized in psychologist Patrick Carnes's book Sexual Anorexia: Overcoming Sexual Self-Hatred, published in 1997. More recently, Julia Hare has used it in the book The Sexual and Political Anorexia of the Black Woman in June 2008.
Causes
Physical problems such as exhaustion, hormone imbalances, medication use and emotional problems such as rape, sexual abuse, power imbalances between partners can cause sexual anorexia.
Treatment
A sex addict is more likely to be capable of being in a more intimate relationship and is often married or in a committed relationship when deciding to get treatment for their addiction. A sexual anorexic may have a social phobia or be so fragile emotionally that the risk of rejection or criticism is far more frightening than being isolated. Narcissistic traits are often seen in both sexual anorexics and sex addicts, but in the sexual anorexic, the traits are considered far more "brittle" and the pain of rejection and criticism is far more deeply felt than for the sex addict. Treatment is aimed at helping the person see where their fears lie and to see the world in less black and white terms. The patient is encouraged to take calculated risks with social activities and distorted thinking is gently challenged with facts and reality. The goals for both sex addicts and sexual anorexics is to learn to have healthy sex and get emotional needs met in direct ways, and to set healthy boundaries. This is an issue that requires ongoing treatment in planned stages with the end goal of autonomy, independence, and improved social relationships.
