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Sexual Anorexia: Overcoming Sexual Self-Hatred
A first-time examination of sexual anorexia, an extreme fear of sexual intimacy and obsessive avoidance of sex, by the acknowledged leader in the treatment of compulsive sexual behavior and recovery.
Author Dr. Patrick Carnes begins by defining sexual anorexia and demonstrating how it and its parallel disorder, sexual addiction and compulsivity, often arise from a background of childhood sexual trauma, neglect, and other forms of abuse. Carnes explores the numerous dimensions of sexual health, examining key issues which must be addressed and resolved for recovery to proceed.
Utilizing extensive research and elucidating case studies, Carnes develops concrete tasks and plans for restoring nurturing and sensuality, building fulfilling relationships, exploring intimacy, and creating healthy sexuality. Woven throughout the book are stories of recovery which illustrate sexual healing principles, model new behavior, and support motivation for change. Sexual Anorexia enables those suffering from this disorder to recognize that sex need not be a furtive enemy to be fought and defeated but, instead, a deeply sensual, passionate, fulfilling, and spiritual experience that all human beings are innately entitled to.
Author Dr. Patrick Carnes begins by defining sexual anorexia and demonstrating how it and its parallel disorder, sexual addiction and compulsivity, often arise from a background of childhood sexual trauma, neglect, and other forms of abuse. Carnes explores the numerous dimensions of sexual health, examining key issues which must be addressed and resolved for recovery to proceed.
Utilizing extensive research and elucidating case studies, Carnes develops concrete tasks and plans for restoring nurturing and sensuality, building fulfilling relationships, exploring intimacy, and creating healthy sexuality. Woven throughout the book are stories of recovery which illustrate sexual healing principles, model new behavior, and support motivation for change. Sexual Anorexia enables those suffering from this disorder to recognize that sex need not be a furtive enemy to be fought and defeated but, instead, a deeply sensual, passionate, fulfilling, and spiritual experience that all human beings are innately entitled to.
420 pages, Paperback
First published January 1, 1997
161 people are currently reading
1648 people want to read
About the author
Patrick J. Carnes
49 books72 followersPatrick J. Carnes, Ph.D., is an internationally known authority and speaker on addiction and recovery issues. He has authored over twenty books including the bestselling titles Out of the Shadows: Understanding Sexual Addiction, Facing the Shadow, Betrayal Bond, Don’t Call It Love, A Gentle Path Through the Twelve Steps and The Gentle Path through the Twelve Principles.
Dr. Carnes’ research provides the architecture for the “task model” of treating addictions that is used by thousands of therapists worldwide and many well-known treatment centers, residential facilities, and hospitals. He founded IITAP (International Institute for Trauma and Addiction Professionals), which provides CSAT (Certified Sex Addiction Therapist) training and certification as well as cutting-edge information for addiction professionals. Dr. Carnes currently serves as a Senior Fellow and Executive Director for the Gentle Path Program at The Meadows in Wickenburg, Arizona.
Dr. Carnes’ research provides the architecture for the “task model” of treating addictions that is used by thousands of therapists worldwide and many well-known treatment centers, residential facilities, and hospitals. He founded IITAP (International Institute for Trauma and Addiction Professionals), which provides CSAT (Certified Sex Addiction Therapist) training and certification as well as cutting-edge information for addiction professionals. Dr. Carnes currently serves as a Senior Fellow and Executive Director for the Gentle Path Program at The Meadows in Wickenburg, Arizona.
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Displaying 1 - 25 of 25 reviews
March 2, 2025
I'm sure this book has been helpful for many people. I have no experience with 12 steps so I don't feel qualified to talk about that aspect of the book.
This book is, however, often quite sexist, even when discussing a problem that affects women more commonly than it does men. For instance, it frequently attributes social problems including *high rates of homicide in the US* to women working outside the home and children attending school.
The way it treats some of its examples is very patriarchal. At one point, it describes a married couple where the husband repeatedly brutally rapes the wife. The book then says, "[A pastor at a woman's shelter] got her into therapy and the husband into treatment for sex addiction. Sadly, the marriage did not survive, which was painful for the children." Why would any sane person think this is a *sad* outcome?
This book is, however, often quite sexist, even when discussing a problem that affects women more commonly than it does men. For instance, it frequently attributes social problems including *high rates of homicide in the US* to women working outside the home and children attending school.
The way it treats some of its examples is very patriarchal. At one point, it describes a married couple where the husband repeatedly brutally rapes the wife. The book then says, "[A pastor at a woman's shelter] got her into therapy and the husband into treatment for sex addiction. Sadly, the marriage did not survive, which was painful for the children." Why would any sane person think this is a *sad* outcome?
September 30, 2012
This is an amazing book. It sheds light on a common issue that has been seriously neglected: self inflicted sexual avoidance by individuals who actually crave sexual experience.
December 3, 2009
intended for those with *issues* this book is a fantastic sex ed and development book for all adults.
October 20, 2011
The first half gets 4 stars, the second gets 3 stars. Useful and well written, but very entwined with the 12-Step approach and process, so how well it fits you will depend on your attitude toward that approach, which isn't one I relate to. When dealing with the individual the author did very well, less so with relationships, and the chapters on sexuality toward the end of the book would only be helpful to people who had no problems with their sexuality except from choosing to refrain from it.
February 29, 2012
Don't let the title of this book scare you. I read it for a client of mine a while back. It is a good book for therapists out there! Highly recommended!
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October 19, 2024Found this one really interesting. I’m not usually super into nonfiction but I did the audiobook and would recommend that since it’s a bit of an intense one
September 22, 2015
This is one of the best books on sexual recovery that I have read. I have respected Patrick Carnes for a long time through a few of his other books on sex addiction, as well as some of the resources he has provided on his website and in other books regarding covert incest. This is so much more than simply the deconstruction of the dynamics of sexual anorexia, it is a holistic map towards recovery in sexual life.
Carnes begins by describing the anorexic system, both as a singular issue as well as a cyclical dynamic between anorexia and acting out within sex addiction. He then moves towards varying descriptions of the role of sexuality in everyday life, including categories like deprivation, extreme or healing. Part II of the book presents as the most profound aspect of the text, a categorical guide towards healthy sexuality. Although there are many useful tasks and exercises for individual and couples, it is a spiritual and narrative journey that has individuals look deeply into the process of recovery, as opposed to simply the outcome. Carnes ties sexuality to spirituality in a beautiful way, and brings a new breath of life to those who may have found themselves cynical of the role of spirituality.
Another great aspect of this book is his inclusion of gay and lesbian issues. It would have been easy to skip past this and focus only on heterosexual recovery, but instead he decides not only to reference gay and lesbian couples but to include additional information regarding the social impact on gay and lesbian relationships. He looks at how gay couples and lesbian couples can differ as well, pointing out differing ethics regarding monogamy and relational dynamics.
This is a book that I would recommend for anyone struggling with sexual issues, and especially for therapists working with couples and individuals in recovery for sex addiction and anorexia. But being a holistic exploration of healthy sexuality, it could benefit anyone wishing to grow their sexual lives.
Carnes begins by describing the anorexic system, both as a singular issue as well as a cyclical dynamic between anorexia and acting out within sex addiction. He then moves towards varying descriptions of the role of sexuality in everyday life, including categories like deprivation, extreme or healing. Part II of the book presents as the most profound aspect of the text, a categorical guide towards healthy sexuality. Although there are many useful tasks and exercises for individual and couples, it is a spiritual and narrative journey that has individuals look deeply into the process of recovery, as opposed to simply the outcome. Carnes ties sexuality to spirituality in a beautiful way, and brings a new breath of life to those who may have found themselves cynical of the role of spirituality.
Another great aspect of this book is his inclusion of gay and lesbian issues. It would have been easy to skip past this and focus only on heterosexual recovery, but instead he decides not only to reference gay and lesbian couples but to include additional information regarding the social impact on gay and lesbian relationships. He looks at how gay couples and lesbian couples can differ as well, pointing out differing ethics regarding monogamy and relational dynamics.
This is a book that I would recommend for anyone struggling with sexual issues, and especially for therapists working with couples and individuals in recovery for sex addiction and anorexia. But being a holistic exploration of healthy sexuality, it could benefit anyone wishing to grow their sexual lives.
June 2, 2015
"Our sexual behaviour is a core expression of who we are"
This book looks into addiction and anorexia. Both of these conditions are the opposite sides of the spectrum, they are just a different personal reactions to the same inner issue.
In the fist part of it, it is theoretical. It covers the symptoms of the sexual anorexia and why this problem is so difficult to be noticed by the people that experience it and the professionals.
I'm sure this first part could have been more extended but for those of us that are simply interested in psychology or read for their own benefit, it is enough. I will also need to re-read that part as it contains a lot of information.
"Sexual anorexia usually starts with abandonment or betrayal. Sexual abuse would do it. But so would a profound rejection by a loved one or exploitation by a loved one."
The second part of the book [the bigger one in fact] is a self-help section that I did not finish reading. If you decide to read this book for the self-help part as well as the theoretical, have in mind that you will either need a friend to help you out or a/your partner.
"Anorexics do not need to try harder. That is part of their problem. They need to let go and trust."
"If we can't ask someone (in the shop) where the paprika is (due to anxiety), how are we going to tell our partner what we need to meet our sexual needs"
A couple of the many book mentioned in this one:
https://www.goodreads.com/book/show/1...
https://www.goodreads.com/book/show/7...
History of Private Life
https://www.goodreads.com/book/show/2...
December 10, 2012
Carnes hits it again about healthy sexuality and the Steps you need to take to uncover the appropriate actions. The US culture maintains a "no talk" status around sexual issues and I agree with him that it needs to be discussed in an appropriate way with family, each other and friends. Risky. Yes. I hope to work through some of the action points after each chapter.
February 20, 2013
Wonderful series about the diagnosis, treatment and effects of sexual addiction. Once again, it is from a clinical perspective by the countries leading expert in the field, but intriguing and enlightening!
March 22, 2012
I'm too sexy for this shirt, and too insecure for this book. Thanks, Patrick!
December 23, 2024
new thing i think i have just dropped
December 1, 2023
The author first began by noting that a person do can indeed get addicted to sex: either wanting too much of sex or wanting too little of sex.
Modern sex researcher and modern addiction researcher both agree that "addiction" like how someone could be addicted to alcohol or drugs can't be applicable to sex addiction. The way drugs works in the brain is by completely disturb the balance of homeostasis, forcing body needing exceedingly amount of drug to (impossibly) attempt to maintain homeostasis. Such addiction can't apply to sex.
The author largely agrees with the above researchers. But the author is pointing to something else: that one is addicted to sex is merely the symptom of something deeper, and this "something deeper" is the addiction. Similarly, imagine a drug addict: many drug addict inject drugs into their vain. Thus, an observer could say the drug addict is "addicted to injection" - which is not completely false, nor completely true: wanting to constantly inject oneself is the symptom of a drug addition, and same logic applies to sex addition.
The author noted that sex addition largely stem from an incomplete childhood. For instance, a girl growing up having sexually abused or harassed would have the tendency to want less sex, because subconsciously the girl believe sex is something dangerous. On the other hand, a boy growing up without much parental love would want excess amount of sex to fill a void in oneself. But just like the drug addiction analogy, injecting ever increasingly amount of drug won't "cure" drug addition (it would only make it worse). Similarly, having too much sex won't bring someone love one craves, having too little sex wouldn't bring safty either - one must resolve the fundamental issue first (or in many cases, if the problem stem from early childhood, such person is very unlikely to ever get cured).
That's why I want to stress the importance of fatherhood. Just the fact that you could make a baby, doesn't mean you should make a baby. A good male model is extremely difficult to come by. Just as boys need good male role model to know how to care for female, how to deal with society. A good male model is also extremely important for girls too. The author has noted that even if the father doesn't physically harasses his daughter, the merely suggestion of finding her daughter "sex in a bikini" could trigger an intense adverse reaction by the young daughter, subconsciously linking sexiness with undesirable outcome (especially from her care takers, someone she grew up ingrained to trust).
Modern sex researcher and modern addiction researcher both agree that "addiction" like how someone could be addicted to alcohol or drugs can't be applicable to sex addiction. The way drugs works in the brain is by completely disturb the balance of homeostasis, forcing body needing exceedingly amount of drug to (impossibly) attempt to maintain homeostasis. Such addiction can't apply to sex.
The author largely agrees with the above researchers. But the author is pointing to something else: that one is addicted to sex is merely the symptom of something deeper, and this "something deeper" is the addiction. Similarly, imagine a drug addict: many drug addict inject drugs into their vain. Thus, an observer could say the drug addict is "addicted to injection" - which is not completely false, nor completely true: wanting to constantly inject oneself is the symptom of a drug addition, and same logic applies to sex addition.
The author noted that sex addition largely stem from an incomplete childhood. For instance, a girl growing up having sexually abused or harassed would have the tendency to want less sex, because subconsciously the girl believe sex is something dangerous. On the other hand, a boy growing up without much parental love would want excess amount of sex to fill a void in oneself. But just like the drug addiction analogy, injecting ever increasingly amount of drug won't "cure" drug addition (it would only make it worse). Similarly, having too much sex won't bring someone love one craves, having too little sex wouldn't bring safty either - one must resolve the fundamental issue first (or in many cases, if the problem stem from early childhood, such person is very unlikely to ever get cured).
That's why I want to stress the importance of fatherhood. Just the fact that you could make a baby, doesn't mean you should make a baby. A good male model is extremely difficult to come by. Just as boys need good male role model to know how to care for female, how to deal with society. A good male model is also extremely important for girls too. The author has noted that even if the father doesn't physically harasses his daughter, the merely suggestion of finding her daughter "sex in a bikini" could trigger an intense adverse reaction by the young daughter, subconsciously linking sexiness with undesirable outcome (especially from her care takers, someone she grew up ingrained to trust).
August 26, 2025
Lettura illuminante soprattutto perché ci insegna in che modo sono interconnesse l'espressione della propria sessualità e sensualità in relazione alla nostra infanzia, alla nostra emotività e psicologia. Una lettura necessaria per chiunque voglia riconnettere la propria sessualità ad una esperienza più ampia, ad una spiritualità. Ho trovato soprattutto interessante la parte diagnostica dove ci dimostra come ci sia un range di manifestazioni sessuali che vanno dalla dipendenza sessuale all'anoressia sessuale, e che ci mostra come i nostri traumi ed emozioni si possano riflettere in qualsiasi aspetto della nostra sessualità. Le nostre esperienze sessuali sono direttamente correlazionate ai nostri pattern e stati d'animo.
July 27, 2023
This book was interesting. My therapist told me to read this to explore sensuality. This book mainly focuses on how to communicate about sexuality and explore aspects other then just the act of intercourse. There is a lot of stigma around sexuality and the church generally doesn’t talk about this at all. I’m sure I will revisit this book early on into marriage, but this book definitely showed me different aspects such as passion, nurturing, sensuality, and how to incorporate it in to daily life. Examples include uses your senses more or savoring a bowl of ice cream and stopping to smell the flowers and expressing what you like.
December 21, 2019
This was an incredible book. It is one I now want to work through with my spouse and feel like after working through it on my own I have gained so much in my journey to heal some of my brokenness. It is not a hard read but at times the content was hard for me to process and taking breaks was needed. I liked how he had questions and exercises to do at the end of chapters 6-17. Worth the time to read and do the tasks.
April 1, 2025
i love to learn about obscure psychological phenomena, and i think the first half of this was v good. He manages to combine research, testimony, and personal anecdotes in a very clever way. and a lot of his advice is v clear and i imagine very helpful, but once he starts suggesting these divas join AA …. it’s a trap !!! Go to therapy instead im begging you !!
September 12, 2019
I noticed lately that more people have been giving up on dating and have become more anti-sex, so I decided to read this book. It was very interesting to find that sexual addiction and sexual anorexia were basically two faces of the same coin. It makes me want to read the Humanae vitae later on.
January 17, 2024
Very helpful book for a surprisingly common problem. I wish I had read it long ago. Reading it now, I hardly learned anything. Nonetheless, I hold Patrick Carnes in the highest admiration. His books are priceless.
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October 14, 2024Very interesting lots of journaling prompts
March 27, 2025
wasn't a fan
July 27, 2025
Lærte meget, både om sund og usund seksualitet men også on afhængighedsmønstre og hvor meget der egentlig hænger sammeb ifht. Sundhed, både fysisk og psykisk
September 9, 2025
Thought provoking. Great insights and perspectives.
November 14, 2025
Stopped at 25% as I was more interested in a definition of what sexual anorexia was and it’s causes rather then learning how to recover from it
June 24, 2023
one of the most influential books i have ever read. an incredible book that has helped me on my sexual journey.
Displaying 1 - 25 of 25 reviews