Sexual anorexia and the challenge of social isolation

Social isolation in the current COVID-19 pandemic presents sexual anorexics with particular challenges. On one level the increased solitary living may feed an avoidant desire to stay away from sexual and emotional liaisons whilst on the other hand it may trigger further anxiety and depression from the increased isolation. People who suffer from sexual anorexia will typically avoid, fear, or even dread situations that might involve sexual intimacy. With enforced social isolation the risk is that an avoidance strategy and self protection schemes might become more embedded thereby creating deeper and deeper introspection.

Sexual anorexia, whilst not a recognised psychiatric condition, can also be referred to as sexual avoidance, or sexual aversion, and can affect men as well as women. Hypoactive sexual desire disorder (HSDD) is a recognised psychiatric condition but differs in that sexual anorexics will often enjoy an active sexual fantasy life. Regardless of gender, there might be a disgust of genitalia when it comes to sexual thoughts of interacting with intimate body parts. 

People who suffer a chronic fear of abandonment may retreat from all intimate and emotional involvement with others for a period of time. This often has noble goals, such as seeking to avoid feeling emotional pain and vulnerability. The trouble is this often mistakes sexual and emotional anorexia for recovery and healthy functioning. Sexual and emotional anorexia can be seen as the compulsive avoidance of giving or receiving social, sexual, or emotional nourishment. Deprivation with love and sex can make one feel powerful and defended against past emotional hurts. This perceived sense of control guards against feeling vulnerable and powerless and compounds loneliness and shame.

Sexual anorexics often refer to a fear of sexual pleasure and sexual self-doubt and have a number of fears about starting, or staying in, relationships. These include the fear of intimacy and of truly connecting with another, fear of having intense feelings and of being visible, fear of one’s own sexuality and fear of engulfment and emotional suffocation by another.

Sexual anorexia is often seen as the flip side of sexual addiction (itself the subject of much debate amongst clinicians) as it is elusive, and often operates in the background behind other compulsive behaviours. However, there is commonality in each condition such as the need to be in control, feelings of despair, and the preoccupation with sex. Sex addicts can be extremely compulsive and promiscuous as a way of taking control in their lives. Sexual anorexics, on the other hand, typically gain the control they crave by rejecting sexual and emotional closeness.

The avoidance schemes or self-protective mechanisms can be wide-ranging and can include the following:

• Using isolation for self-comfort.
• Engaging in a vivid fantasy life in private.
• Getting sexual satisfaction exclusively from porn.
• Engaging in cross addictions such as shopping, gambling, food, drugs, alcohol and hoarding.
• Sexual promiscuity with emotionally unavailable people.

The seeds of the condition can be in childhood trauma, during a fearful and threatening period or episode with no control.  Sexual anorexics may have learned to become adverse to sex and their own sexuality in order to lessen their fear and their experiences of trauma.  Traumatic events may have been serious boundary violations, sexual shaming, sexual and physical abuse, bereavement or emotional neglect and abuse.

Seeking help

Sexual anorexics will be well versed in using a form of social distancing as strategies and ways to avoid intimacy. This is when they will avoid dating, intimate friendships, behave in a grandiose (or an inferior) manner, avoid others and withdraw or isolate from their partner. That is why this current public health crisis presents particular challenges for them as the enforced isolation risks further embedding avoidance strategies.

Due to a chronic fear of abandonment sexual anorexics can be reluctant to engage with therapists and often wait until they feel desperate. Psychotherapy could explore whether your loss of libido stems from sexual trauma, or sexual negativity learned as a child or whether your current relationship is needing a review. A path of recovery could be to identify past traumas and their impacts and to heal past wounds in order to ultimately have nourishing social, sexual and emotional relationships. The work could also involve addressing the impact of internalised negativity associated with sexuality when growing up as well as what intimacy means to you. The stages of therapy could explore whether the built-up avoidance strategies and self-protection mechanisms are still relevant and appropriate for your current lifestyle and whether they are still serving you.

Your GP could undertake medical tests to check for any possible underlying health conditions if you are worried about your physical health such as hormone imbalances. 

To speak to a professional counsellor use the Counselling Directory's search tool. Many therapists now offer online and telephone support.