Anorexia and Intimacy

“Intimacy anorexia” is a term coined by psychologist Dr. Doug Weiss to explain why some people “actively withhold emotional, spiritual, and sexual intimacy” from a partner. 

Issues related to emotional or physical intimacy can have a major impact on romantic relationships. Loving someone, after all, generally means you want to share thoughts, feelings, and physical affection. 

When you love your partner but feel unsure whether they still feel the same way toward you, your relationship can begin to feel empty and unfulfilling. As shared intimacy falters, you might worry it will fade completely. 

Mental health professionals have various frameworks for looking at intimacy issues, but few recognize intimacy anorexia as an actual condition. 

Here’s a closer look at intimacy anorexia and how to productively explore intimacy issues. 

Language matters

Before we go any further, it’s worth noting that the term “intimacy anorexia” is a bit misleading for two reasons:

  • Anorexia nervosa is an often life threatening eating disorder. Intimacy issues can be serious, but they’re not life threatening.
  • Weiss suggests people experiencing intimacy anorexia have chosen to withhold intimacy. No one chooses to have an eating disorder or other mental health condition. 

The main characteristics

According to Weiss, people with intimacy anorexia typically:

  • keep themselves busy with child care, household tasks, errands, technology, or work
  • blame you for the loss of intimacy rather than explore potential patterns in their own behavior
  • avoid showing love in ways they know you appreciate
  • stop complimenting or praising you regularly
  • have little to no interest in physical intimacy
  • show little interest in connecting on a spiritual level, which could look like not wanting to attend church or pray together
  • avoid talking about their feelings, making it difficult to connect on an emotional level
  • treat you like a roommate, not a romantic partner
  • put you down, criticize you, or try to make you feel bad about yourself*
  • have angry outbursts, ignore you or give you the silent treatment, and stay angry over minor issues instead of working through anger productively*
  • control money by making you keep track of your purchases, preventing you from accessing funds yourself, or criticizing the amount you spend*

Weiss notes that not every sign will show up for people dealing with this issue. He suggests people with five or more of the above characteristics may need treatment.

*These characteristics are typically forms of abuse, not a sign of intimacy issues. Learn more about how to recognize emotional abuse.

Suggested causes

Weiss offers four possible explanations for intimacy anorexia. 

Sexual trauma

According to Weiss, survivors of sexual trauma often choose to withhold intimacy in order to better control their intimate interactions and cope with the “damage” and “shame” associated with the trauma. 

Survivors often do experience challenges with intimacy after experiencing sexual assault or abuse. And many experience shame or blame themselves for what happened. 

However, survivors are in no way to blame for the assault itself or any intimacy issues they face afterward.

It can take a long time — and extensive professional support — before someone who’s experienced sexual trauma regains interest in intimacy. This is absolutely normal. 

Attachment patterns

Your attachment to your primary childhood caregiver can shape the relationships you develop throughout life. 

You probably have a secure attachment if your parent regularly met your needs and made a habit of being there for you.

People with secure attachments grow up knowing how to get emotional needs met. They usually go on to develop healthy adult relationships. 

If your parent often ignored you or offered irregular support, you might have an insecure attachment. This attachment style can affect your relationship with that parent, but it can also affect emotional well-being and make it harder to develop healthy relationships.

Intimacy issues can also emerge from the need to protect yourself from the vulnerability that developed in the wake of disrupted childhood attachments, explains Dr. Joe Kort, a Michigan-based sex and relationship therapist. 

Someone may not even recognize this self-protective behavior as avoidance. 

Sex addiction

According to Weiss, people experiencing sexual addiction get intimacy needs met outside the relationship, so they stop seeking intimacy from partners. 

But the concept of sex addiction is highly debated. Some experts even question its existence. 

In Kort’s view, the label of “sex addiction” is sometimes applied to any behavior that prompts a disgusted response from others. That might include watching porn, having a high sex drive, or having certain kinks.

These aren’t necessarily problems or a sign of anything that needs to be treated or “fixed.”

While some people do have trouble addressing certain sexual behaviors they want to stop, Kort says, there are other, more helpful ways to address these issues: approaches that take into account factors unrelated to sex, like post-traumatic stress or underlying mental health conditions. 

Finally, keep in mind that sexual coercion and other controlling behaviors are considered to be abuse tactics, not signs of addiction. 

Poor role modeling

People learn how to behave in romantic relationships from watching others around them, like parents, friends, older siblings, even characters in movies or TV shows. 

Anyone can struggle with intimacy if they’ve never had a good model to learn from, as Weiss suggests. 

It stands to reason that someone who rarely sees people sharing intimacy will have trouble opening up. It’s pretty difficult for someone who hasn’t encountered many positive models of intimacy to recognize true intimacy in a relationship without guidance.

All the above issues can certainly affect how people view intimacy and establish connections with others, but this typically happens subconsciously. 

It’s inaccurate to suggest that anyone avoiding intimacy due to these factors is doing so intentionally or by choice. 

Weiss’ recommended treatment

Once you realize you and your partner are struggling to maintain intimacy in your relationship, you might wonder how to resolve the situation. 

Weiss offers little information about self-help strategies or treatment approaches, but he does recommend:

  • joining one of his 3- to 5-day intensive counseling retreats
  • participating in therapy sessions at his counseling center
  • purchasing his DVDs or workbook sets

While these programs and materials might be helpful for some, it’s always wise to proceed with caution when someone calls themselves an expert in a condition that other experts don’t recognize, and suggests their unique (and costly) treatment as the only method of healing. 

Why this approach might be worth rethinking

Before you seek intimacy anorexia treatment for yourself or your partner, you may find it helpful to consider the following.

Most experts don’t recognize this condition

You won’t find intimacy anorexia (or sex addiction, for that matter) in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which mental health professionals use to make diagnoses. 

You’ll also find that very few mental health professionals list it as a condition they treat. 

Most of the available information about this condition ties back to Weiss. In fact, the one organization that recognizes intimacy anorexia is the American Association for Sex Addiction Therapy, a for-profit organization founded and operated by Weiss. 

As noted above, many mental health professionals don’t diagnose sex addiction or consider it a mental health issue.

Rather, therapists and counselors increasingly recognize the complexity of human sexuality and acknowledge that many of the sexual behaviors some people consider problematic, immoral, or harmful — including BDSM, role-playing, and group sex — are, in fact, perfectly healthy when practiced safely and with consent. 

It has religious underpinnings

Treatment approaches that align with religious doctrine aren’t necessarily flawed, but they won’t work for everyone. 

Many of Weiss’ offerings are grounded in Christian ideas around marriage and sexual purity. If you don’t follow the Christian faith, you may not get much benefit from this approach.

It may overlook abusive or toxic behavior

Most of Weiss’ signs of intimacy anorexia have little to do with an actual fear of intimacy. 

Remember, the following characteristics all point more toward abuse, not intimacy issues:

  • frequent put-downs and unkind language
  • regularly criticizing you when you’ve done nothing wrong
  • controlling your finances
  • intentionally denying you affection
  • showing extreme anger, but only to you

Relationships characterized by frequent criticism or controlling behavior are toxic at best. Many of them are abusive.

Therapists generally don’t recommend couples counseling for abusive relationships. They also don’t encourage the person experiencing abuse to change their behavior for the abusive partner. 

Find help now

For more information about domestic abuse and how to find support, check out the National Domestic Violence Hotline, which provides free, confidential telephone and chat support 24/7.

It may reinforce unequal relationship patterns

Weiss explains that someone with intimacy anorexia often keeps busy with chores, child care, and other activities until they have no time or energy left for their partner. 

Yet someone who spends most of their day handling housework, errands, and other tasks could easily feel too exhausted to share emotions or connect sexually, especially if they also hold a job outside the home. 

In that case, reconsidering the distribution of household responsibilities may go a long way toward rekindling intimacy.

Other ways to start exploring intimacy issues

Whether you’re seeking support for yourself or your partner, it’s important to understand these issues often trace back to childhood and may not improve without professional help.

People who struggle with intimacy are often trying to avoid pain, Kort explains. But acknowledging the lack of intimacy is a significant first step toward improvement.

Seeking support from an experienced sex and relationship therapist is often the most helpful way to begin addressing intimacy issues. 

Look for counselors who offer evidence-based approaches, such as the Gottman method, imago therapy, or emotionally focused couples therapy. 

Start your search for a therapist with the American Association of Sexuality Educators, Counselors and Therapists (AASECT) directory.

One final note: Decreased intimacy isn’t always solvable, or even a problem.

People have varying intimacy needs, and these needs can change over time. If you feel less connected to your partner than you did early in the relationship, one or both of you may simply want less connection. 

Everyone needs time to themselves, and some people need more space and distance over time. 

Sometimes you can rebuild intimacy, but it’s also possible you may no longer be compatible. 

Bottom Line:

Intimacy doesn’t come easily to everyone. It requires vulnerability and trust, both of which can be hard to develop and maintain. If you’re trying to figure out why your relationship lacks intimacy, the idea of intimacy anorexia may feel like the explanation you’ve been looking for. But it’s important to keep in mind that this isn’t a formally recognized condition, and the proposed treatments may do more harm than good for some. 

References:
https://www.healthline.com/reviewers/janet-brito
Addiction to sex and/or pornography: A position statement from the Center for Positive Sexuality (CPS), The Alternative Sexualities Health Research Alliance (TASHRA), and the
National Coalition for Sexual Freedom (NCSF). (2017).
journalofpositivesexuality.org/wp-content/uploads/2017/10/Addiction-to-Sex-Porn-Position-Statement-from-CPS-TASHRA-NCSF.pdf
Davoodvandi M, et al. (2018). Examining the effectiveness of Gottman couple therapy on improving marital adjustment and couples' intimacy.
ncbi.nlm.nih.gov/pmc/articles/PMC6037577
Kort J. (2020). Personal interview.
Parenting children and youth who have experienced abuse or neglect. (2018).
childwelfare.gov/pubPDFs/parenting_CAN.pdf
Ullman SE, et al. (2014). Coping, emotion regulation, and self-blame as mediators of sexual abuse and psychological symptoms in adult sexual assault.
ncbi.nlm.nih.gov/pmc/articles/PMC3884218/
Wiebe SA, et al. (2016). A review of the research in emotionally focused therapy for couples.
onlinelibrary.wiley.com/doi/abs/10.1111/famp.12229
Written by Crystal Raypoleon December 21, 2020
https://www.healthline.com/health/relationships/intimacy-anorexia
Photo Credit: Annie Spratt

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