Patrick J. Carnes - Sexual Anorexia: Overcoming Sexual Self-Hatred: Overcoming Sexual Self-Hatred

In many ways, this book began in 1983 when I completed Out of the Shadows: Understanding Sexual Addiction. That book described the nature of sexual addiction and the path of recovery from the illness. Yet I knew even then that Out of the Shadows told only part of the story. From that point on, I tried to define sexual addiction as part of a continuum. On one end were people who had lost the ability to regulate their own sexual behavior. On the other extreme were those who could not force themselves to be sexual without dire internal consequences. The two conditions were related. Both obsessional states drew their power from a deep sexual self-hatred.

In 1989, I completed Contrary to Love, which described sexual addiction for professionals. The book began with the continuum of compulsive sex and compulsive nonsex. It also described in detail how sex addicts go through periods of deescalation in which sex becomes the enemy. The whole process of therapy and recovery is directed toward sexual health, which at that point I only partly dened.

Since then, we have witnessed a decade of extraordinary progress. Twelve Step groups for sexual addiction, such as Sex and Love Addicts Anonymous, Sexaholics Anonymous, Sex Addicts Anonymous, and Sexual Compulsives Anonymous, have ourished across the country and throughout the world. The National Council on Sexual Addiction and Compulsivity is in its fourth year of publishing a medical journal dedicated to the problem. Inpatient and outpatient programs for sexual addiction have sprung up across the nation. In 1997, three basic medical texts included chapters on sexual addiction.

In the midst of rapidly expanding awareness about sexual addiction, a growing consciousness about what I call sexual anorexia has also emergedalbeit more slowly. Twelve Step groups held conferences, published literature, and offered groups to sexual anorexics. The concern was more tentative for sexual anorexia, however, in part because the losses are more hidden. But professionals began to note the connections between sexual acting out and acting in. Those who researched abuse, especially sexual abuse, wrote about traumatic abstinence. Sexologists separated sexual aversion as a more extreme problem than sexual dysfunction. And like the addiction specialists, they now acknowledged a continuum of extremes. Yet no one book dened the problem for those seeking recovery using a Twelve Step format. There was no Out of the Shadows for the sexual anorexic.

Another problem also started to reveal itself. As I traveled and spoke about recovery, I heard many people ask, What is healthy sexuality? In 1991, I wrote more about that in DontCall It Love, wherein I described eight dimensions of healthy sexuality. These specic dimensions grew out of the research for that book, which involved interviewing over one thousand recovering sex addicts and their partners. I used the model of the eight dimensions in my speeches and workshops. In one such workshop, it dawned on me that the workshop participants already possessed the tools for understanding what it was they sought. Those tools were the very Twelve Step principles with which they were already familiar in other contexts. Recovering people simply needed to know that they could apply their Twelve Step skills to their sexuality. When I spoke around the country, I could see how helpful making that bridge was. People started to use the materials, and soon Sexual Anorexia: Overcoming Sexual Self-Hatred started to take form. Once I realized how the principles of the Twelve Steps paralleled the dimensions of healthy sexuality, I expanded the latter from eight to twelve. A matrix matching the (now) twelve dimensions with twelve supportive strategies for achieving them and the applicable principles of the Twelve Steps can be found in . This matrix provides a quick overview of what this book hopes to accomplish and how to get there.