Intimacy anorexia

Intimacy anorexia is a relationship disorder that occurs mostly in the context of marriage or long-term romantic partnerships. This relationship disorder is defined by the American Association for Sex Addiction Therapy as “The active withholding of emotional, spiritual and sexual intimacy from the spouse or partner.”^[1]

Sexual anorexia vs. emotional anorexia vs. intimacy anorexia

Sexual anorexia is based around the physical part of intimacy and is related to sexually intimate interactions and the associated emotional connections. It includes being fearful of opening up to partners on an intimate level to the point where sexual anorexics become anxious thinking about being close to others in that manner. This fear often stems from social phobias and is related to fears of being rejected or criticized.^[2] It is different from intimacy anorexia in that sexual anorexia is more about a person's inner feelings and anxiety about intimacy while intimacy anorexia concerns individuals who want to control a relationship through limiting intimacy.

Emotional anorexia is the compulsive avoidance of establishing and maintaining emotional connections and relationships. This includes giving or receiving social, sexual or emotional nourishment. This can take the form of suppressing personal needs to be loved, desired and wanted. Often times, emotional anorexics suppress their own needs and give into their partner's needs or needs of other parties in their relationships. This usually is caused by emotions of worry and anxiety while trying to avoid conflict.^[3] It is different from intimacy anorexia in that emotional anorexia is a psychological mode of thought that affects all of a person's relationships and relational connections while intimacy anorexia is a relationship disorder primarily affecting a person's closest intimate relationships.

History of the term

The concept of intimacy anorexia was first mentioned by psychologist Douglas Weiss, Ph.D. in 1998 in Sexual Anorexia, Beyond Sexual, Emotional and Spiritual Withholding. In this film, he developed the idea that intimacy disorders were prevalent in relationships where couples and partners suffered from mental distress and control issues.^[4] People who presented with these disorders embodied one of two identities. The first identity type engaged in behaviors where they placed their own needs under those of their partner or spouse at the emotional cost of themselves. This is similar to our current understanding of sexual anorexia. The second identity type engaged in behaviors where they controlled the relationship through manipulation and control of intimate behaviors. With these new findings, Douglas Weiss published a book called Intimacy Anorexia in 2010, which details the condition, related behaviors and treatment for intimacy anorexia.^[5]

Causes

The causes of intimacy anorexia are the result of several sources which typically become contributing factors to each other – creating a spiral of emotions and control needs.

• Sexual trauma is at the root of many addiction and mental disorders. It is one’s sexuality being ravaged, shamed and damaged by strangers, friends, or family members. Whether it is one time or hundreds of times by one or more person(s), it creates pain for the entire being of its victim. This pain will have to be addressed by the soul in some manner which leads to survivor attributes. These attributes can translate in to need for control and intimate behavior consequently in an effort to cope.^[6]
• Attachment issues with the opposite gender parent and family origin issues. Attachments to father figures have an important influence on their children's lives because of their roles as protectors, providers and role models. On the other hand, motherly figures provide emotional, relational and social support and models to children.^[7] These paternal influences begin to have an affect on their children's intimacy with other genders when a parent's behavior communicates that they are not safe or trustworthy. This stigma is carried over to relationships with the same gender. Also, the parent's act of being emotionally distant, unavailable or abandoning children does not allow for children to develop a framework to understand what intimacy looks like and leads to intimacy disorders later in the children's lives.^[8]
• Sexual addiction is often seen as a cause for mental disorders and psychological conditions. This is because people use the addiction to meet otherwise unfulfilled needs which in turn fuel the addiction. The addiction can become so strong that it turns into a driving force which can overrule what would otherwise be rational notions of relational behavior.^[9]
• Role modeling neglect is a lesser contributing factor but still substantial nonetheless. Not having role models leads early in life leaves youth to figure things out for themselves. Stunted emotional development, lack of intimacy and managing relationships (rather than participating in them as active members) are related outcomes to this type of neglect.^[10]

Behavior characteristics

Intimacy anorexia has 11 characteristics. These characteristics are related to how partners control levels of intimacy with their spouses and a resulting pattern of behavior forms.

1. Busy: The first characteristic of an intimacy anorexia is being so busy that the anorexic has little time for their spouse. This is a very common characteristic of most intimacy anorexics.
2. Blame: As an anorexic characteristic, blame is almost universal. Blame comes to life when an issue comes up in the marriage and the anorexic blames or puts responsibility on the spouse for the issue, instead of acknowledging their contribution to the problem or issue.^[11]
3. Withholding love: The anorexic often has a difficult time perceiving the intangible nature of withholding love. To withhold love is to not give love to their spouse the way the anorexic knows how to, or how they have asked to be loved.
4. Withholding praise: The withholding of praise is also a significantly recurring behavior for intimacy anorexics. To withhold praise is to not share with the spouse about their positive qualities as a person and their positive impact on the anorexic's life.
5. Withholding sex: By far, of all the behaviors that are characteristics of intimacy anorexia, withholding of sex is probably the easiest to measure. Withholding sex from their spouse is avoiding having sex, sabotaging sexual encounters, or not connecting emotionally during sex.
6. Withholding spiritually: The characteristic of withholding spiritually is also only noticed by the spouse. Spiritual leaders, pastors, rabbis, and medicine men are all capable of disconnecting spiritually with their spouse. Withholding spiritually is withholding spiritual connectedness from the spouse.
7. Feelings: This characteristic can be described as being unwilling or unable to share feelings with their spouse. Having difficulty sharing feelings is a universal characteristic of the intimacy anorexic.
8. Criticism: Having ongoing or ungrounded criticism which leads to distance in the marriage is also a characteristic of intimacy anorexia. This can be the low grade put downs toward the spouse, noticing what they do wrong, or just regularly pointing out their bad ideas.
9. Anger/silence: Not all intimacy anorexics use silence or anger as a characteristic of their intimacy anorexia. However, those who use anger or silence as a characteristic use it with a vengeance. This intimacy anorexia characteristic can be described as any use of anger or silence to push away, punish, or control the spouse.
10. Money: The characteristic of controlling or shaming the spouse about financial issues is probably the least common among intimacy anorexics. Most of the anorexics who control or shame with money do so by keeping the spouse ignorant of the finances, give their spouse an allowance, make the spouse ask for money, and won’t allow the spouse to have a credit card or checkbook.
11. Roommate: A vast majority of those living in intimacy anorexics’ marriage relationships relate to the "roommate" characteristic. The spouse of the anorexic feels like, or has stated feeling like a "roommate."^[5]

Treatment

An anorexic can recover through awareness of their behavior and by wanting to change how they give and receive intimacy. It is best for them to decide to get treatment for their anorexia on their own or with suggestions to get help from their partner. It is critical that their partner support them in this process since they are the other influential voice in the relationship. The treatment for intimacy anorexia, according to the American Association for Sex Addiction Therapy, will most likely be a multiple modality approach which may include individual therapy, marital therapy, therapy for the spouse of the intimacy anorexic, group therapy, twelve-step type groups, education materials or educational groups.^[12]

Intimacy anorexia manifests mostly in marriage or a long-term romantic partnership therefore it can also be impactful on the spouse or partner. Some of the impacts of living with an intimacy anorexic as a spouse can be, but is not limited to: comorbid considerations such as schizoid personality disorder, major depressive disorder or autism spectrum disorder.^[13] Research and clinical trials have proven that individuals and couples can return to a healthy intimacy life both emotionally and sexually.^[14]

References