Are you afraid of sex and intimacy?

I was all ears when Joyce, a 70-year-old lady, walked into my consultation room and declared that she had brought her baby, Jane, a 35-year-old for treatment.

This was strange because in the African setting, it is always the other way round – young and middle-aged adults walk their aging parents to the clinic for treatment of chronic conditions.

Of course it was also unusual for a mother to describe a 35-year- old as her baby.

Falling short

“Yes, my baby because until she takes her womanly responsibilities of becoming a wife and a mother she remains a baby,” Joyce explained.

“I have tried everything under the sun and each day I get this conviction that I am a failed mother,” Joyce continued, “you are my last resort, if you are defeated I am done.”  Jane sat motionless as her mother did the talking.

It turned out that at the age of 35, Jane had neither had a baby nor a boyfriend. She was sexually inactive. Jane’s mum depicted her as a social failure who was good for nothing.

Jane’s calm demeanor soon turned into restlessness. She frowned and behaved as if she would walk out of the room at any moment. And then, suddenly, she poured out her heart:

“I know I worry you mama but I prefer to be pure, to be clean, to have peace of mind; haven’t you heard that men mistreat their wives? Aren’t you worried about HIV? Would you rather I died of the disease? Sorry but I can’t mama!”

“There you go again!” the mother exclaimed. “She gets emotional whenever we discuss relationships and sex.

In fact if I were not her mother she would have walked out of this room by now; treat her, doctor, please treat my baby.”

Jane was suffering from sexual anorexia. Anorexia is a term commonly used to refer to compulsive avoidance of food due to an abnormal lack of appetite.

Anorexia, when used in eating disorders, refers to cases where people deny themselves food to the extent that it becomes dangerous for their health. The reason for self-denial could be put down to body dysmorphia.

Pathological fear

Similarly, sexual anorexia is an abnormal and compulsive avoidance of sex and intimacy. Sexual anorexics have a pathological fear of sex.

They only see danger and destruction in sex, nothing good. They do not believe that sex can be pleasurable. They fear and abhor being intimate and romantic, and avoid relationships that could become intimate.

Sexual anorexics are also strongly and negatively judgmental of other people’s sexual behaviours. Sometimes they use religious beliefs as an excuse for their attitude.

Should they get sexually aroused, sexual anorexics feel guilty and dirty, and may punish themselves for positive sexual desire or arousal. In rare instances, they may respond by overindulgence in what they do not believe - casual sex, and become even more self-hating.

Incidentally, some sexual anorexics find themselves in marriage. They find every reason to deny their spouses sex. Some may become hostile after a sexual act.

Some pretend that they enjoy sex but they do it just to keep the marriage going while hurting internally. Their real wish is that they could avoid sex.

“So tell me doctor, exactly what causes sexual anorexia?” Jane’s mum asked.

Sometimes it is a result of an unpleasant experience in early childhood that totally distorts the way one looks at sex, such as rape or incest.

Occasionally, it is disappointment in a relationship. In other cases, it may be a distorted strong belief system pegged on religion or culture. Whatever the cause or a combination of causes, the results are much the same.

Confronting the problem

Treatment involves confronting the cause of the problem. The sexual anorexic may not even tie his or her belief and behaviour to the cause.

The sexologist has to dig deep into the victim’s life and help them realise the source of their troubles.

“I don’t believe this,” Jane exclaimed. Tears were flowing down her face. She then cried uncontrollably as her mother moved to hold her tightly to her chest.

“I am sorry Jane, did I touch a nerve?” I asked gently. Amid sobs, Jane revealed how she had once been raped on her way to school by a gang of boys. She was 12 years old at that time.

She had never discussed the experience with anybody but from that point of her life she did what she could to keep away from men; she took them to be beasts. She hated sex because she did not want to be intimate with beasts.

Sad, very sad indeed, I thought to myself as I referred Jane for psychotherapy, the ultimate care for this kind of problem.