McKinney Counseling & Recovery

Intimacy Anorexia

guarded heart

What is Intimacy Anorexia?

Intimacy anorexia involves a pattern in which one or both members in a relationship, typically the primary committed relationship, put up barriers, avoid, or withhold nurturing the relationship. The pattern is not merely isolated to a single type of behavior but occurs across different spheres of intimacy. So, although "we just don't talk" might be a symptom of intimacy anorexia, this alone would not be sufficient for diagnosing the syndrome.

In intimacy anorexia the lack of "talk" is not compensated by nonverbal communication and serves to weaken the sense of emotional, intellectual, physical, spiritual, and/or sexual closeness and attachment to each other. The intimacy anorexic restricts the free flow of love much the way a food anorexic restricts the intake of food. Because it is not nourished, the relationship withers.

The individuals in the relationship wither as well. Deprivation from the anorexia can result in a sense of emotional isolation that can leave both of you, but particularly the partner, feeling that despite being married, you are alone in this relationship. Given that some researchers contend that emotional isolation is a more dangerous health risk than either cigarettes or high blood pressure, the individual impact of intimacy anorexia can be enormous.

How Do I Know if My Relationship is Anorexic?

You can request an evaluation from me to assess the specific patterns in your relationship. To begin to self-assess the patterns in your relationship, ask yourself the following questions:

For the Partner For the Anorexic
Are you starved for affection in the relationship? Do you feel loved and appreciated, or deprived and neglected? Do you withhold praise or affection?
Do you feel as if you are married but alone in this relationship? Does your behavior communicate you don't need your partner?
Do you feel locked out from her/his feelings or as if yours are unappreciated? Do you guard your heart so your mate can't get in?
Does s/he blame shift to deny responsibility or avoid looking at his/her own issues?

Do you play the blame game?
Has your spirit and self-esteem been systematically chipped away at?

Do you use criticism to push your partner away?
Do you feel rejected, unwanted, or unattractive to your mate?

Do you withhold or sabotage sex?
Is s/he controlling about money? Do you control or use guilt trips or shaming to manipulate your mate about money?
Does s/he clam up when you try to communicate about something important to you? Do you stonewall when your mate tries to communicate with you?
Do you worry about upsetting him/her or feel like you have a walking on eggshells lifestyle? Do you use anger to shut down attempts to connect?
Do you feel more like roommates than lovers?


Is There a Difference Between Intimacy Anorexia, Sexual Anorexia, and Sex Addiction?

The answer is complex because it's both yes and no. There can be a great deal of overlap between these disorders, but they can and do occur independently of each other. Pornography and sexual addiction involves compulsively acting out with sexual behaviors. Sexual anorexia involves compulsively acting in with sexual behaviors, which may or may not include a more widespread withholding in other areas of intimacy. Intimacy anorexia, however, involves acting in across multiple intimacy domains, which may or may not include a withholding of sexual intimacy.

The pioneering work in identifying and treating intimacy anorexia issue was done by sexual recovery expert Doug Weiss. Doug identified a more pervasive pattern of withholding in his sex addicted clients, a pattern that goes beyond the withholding of mere sexual intimacy. In his studies, 29% of male addicts met criteria for intimacy anorexia and 39% of female addicts met criteria. In addition, 39% of partners and spouses of sex addicts also met criteria for intimacy anorexia.

What is the Most Common Pattern You See in Your Practice?

In my own practice I see a lot of overlap between sex addiction and sexual anorexia. The irony is that the same client who is out of control with pornography or sexual behavior outside of the primary relationship, may simultaneously go for weeks, months, or years placing little or no energy into nurturing a sexual relationship with his or her partner. More often than not intimacy anorexia is also present.

Why is Addressing Sex Addiction, Sexual Anorexia, and Intimacy Anorexia an Important Component of Treatment?

A common pattern I see in the recovering community is a recognition of acting out behaviors with little or no recognition of acting in behaviors. For the addict this results in two harmful effects: 1) relapse and 2) a glass ceiling on the depth of his or her recovery.

Just as a severely restrictive food diet sets the dieter up for a sense of deprivation that ultimately fuels a binge, unaddressed sexual and intimacy anorexia sets the addict up for a sense of deprivation that ultimately fuels a relapse. Moreover, accepting a lack of intimacy as the norm, regardless of which sphere of intimacy, is a form of self-abandonment. It's a way tolerating less than what you deserve in a relationship and in life; it's a way of de-valuing yourself and in doing so ensuring that the promises of recovery will not be fulfilled for you.

Ignoring the anorexia has consequences for your relationship as well. It punishes your mate. It dooms your partner to a life of loneliness, it strips away at self-esteem, deprives him or her of being fully loved and of the freedom to fully love in return. The long-term consequences predispose to bitterness and resentment. You both deserve better.

If you are a partner of an intimacy anorexic you may not have had the label but you are probably very aware of the impact of the anorexia on your relationship, on you. You may have survived the trauma of D-Day, the day you discovered or had your addict's acting out disclosed to you. You may have survived the early emotional rollercoaster days of recovery. You may have even been heartened by seeing your addict gain traction in recovery and achieve success in stopping the acting out. But if the anorexia has not been addressed, that is when the full reality your situation hits you — that as painful as the acting out was, the intimacy anorexia is actually much more destructive.

Your addict may be expecting praise for how hard s/he has worked on stopping the acting out and have no understanding of why you may still be angry, or disappointed, or expecting more. But for you, that's when you really get it — that despite his or her progress on the addiction your needs are still not being met. You are still not being cherished!

Is There Hope? Can Relationships Recover?

 Yes. Both individuals and relationships can and do recover, but it takes work from both of you. Since anorexia involves using avoidance withholding as a means of managing fear of being vulnerable, if you wait for the acting in to magically disappear the situation will likely never change — or your relationship will die while you're waiting. You have to work on developing intimacy skills, on deepening the depth of your connection to each other across the intimacy spheres. And you have to do this on purpose, even before you feel like behaving more intimately. If you do the work the feelings will likely follow.

If you are a partner, know that you have a right to set the standard for how you will be treated in a relationship. You have a right to expect respect from your mate; you have a right to establish your boundaries in a relationship, including those that have short-term relational consequences and those that are deal breakers. You have a right to enforce consequences if those boundaries are violated — as long as you enforce them respectfully.

Not all therapists are trained to treat intimacy anorexia. If you would like to learn more, contact me.   You may also contact the American Association for Sex Addiction Therapy to locate a Sexual Recovery Therapist near you.

For more information on intimacy anorexia, check out the intimacy anorexia blog or take the Intimacy Anorexia/Intimacy Deprivation Survey

McKinney, TX Licensed Psychologist and Certified Sex Addiction Therapist
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Dr. Janice Caudill
Certified Clinical Partner Specialist
Licensed Psychologist
Certified Sex Addiction Therapist & Supervisor
Partner Recovery Therapist
Sexual Recovery Therapist
Somatic Experiencing Practitioner (& Supervisor)
Certified Multiple Addictions Therapist

250 Adriatic Parkway, Suite 105
McKinney, Texas 75070