The Silent and Deadly Cancer in Many Marriages

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Douglas Weiss^ Ph.D.

Intimacy anorexia is very common among married couples.

Marriages are destroyed by adultery, alcoholism, sexual addiction and other severe life events. Although devastating, the demise of such a marriage makes logical sense.

But there is one kind of marriage that dies slowly. It looks good on the outside for decades. This couple is raising their family, working together in their community and serving in their church.

This couple has tried counseling but didn’t follow through. They don’t pray together or connect emotionally. The husband or wife rarely touches their spouse. Sometimes a couple experiencing the effects of this hasn’t had sex in years. 

This couple has a cancer in their marriage. They don’t give a name—it’s just there. They don’t know what to do, so they plod along hoping it gets better, but it doesn’t. It becomes intolerably worse.

The spouse reports feeling like a roommate, married but alone. They describe their spouse in ways most can barely imagine because the public image is picture-perfect. 

The good news: There is a name for this cancer along with the ability to heal it if the couple is willing to reconnect. I’ve been treating it for more than 15 years. Its name is intimacy anorexia.

Intimacy anorexia is the active withholding of emotional, spiritual and sexual intimacy from the spouse. The intimacy anorexic can have positive relationships outside the marriage and even look normal, but is intentionally different at home with their spouse.

Here are 10 characteristics of intimacy anorexia so you can discern it when you hear a couple describe their marriage. I will walk you through the causes of this cancer and offer helpful exercises that will help the couple save their relationship from the starvation of love and intimacy that can eventually lead to its demise.

Characteristics of Intimacy Anorexia

Busyness: The anorexic stays so busy they have no time for their spouse. They may be busy outside the home with work, sports, extra jobs or helping others in some manner. Intimacy anorexics can also make themselves busy in the home by taking excessive time cleaning the house or garage, reading the paper, spending time on the computer, making telephone calls, reading emails, engaging in excessive social media or other projects that allow them to justify not spending time with their spouse. This couple rarely goes on dates, and the intimacy anorexic in the marriage does not set aside time to spend with their spouse.

Blame: The intimacy anorexic blames their spouse for many of the marital problems. Those who have intimacy anorexia live alone, in a relationship with themselves. They believe they are wholly good or wholly bad. I call this the “good box or bad box.” If their spouse brings up the slightest correction, the intimacy anorexic believes the spouse is telling them they’re a bad person. If the spouse offers anything other than praise, the intimacy anorexic puts all defenses up to avoid going to the bad box where they see themselves as a bad person. In the intimacy anorexic’s mind, this leaves only one logical solution: the spouse is the problem.

Withholding love: I’ve worked with intimacy anorexics and their partners for about 20 years. When I ask an intimacy anorexic, “If I held a gun to your head and told you to tell me how to love your spouse, what would you say?” the anorexic can immediately rattle off at least five ways their spouse wants to be loved. He or she will say the withholding of love is not intentional, but whenever the anorexic is trying to reconcile with the spouse, they will make them feel loved. After a few days or weeks, everything goes back to what it was, and the anorexic will actively withhold the loving behavior once again.

Withholding praise: This behavior only shows up in relation to the spouse. Intimacy anorexics can praise others, even their children, but withhold praise from to their spouse. Many spouses of anorexics have told me the last time they heard their spouse praise them in a heartfelt manner was years ago. Without positive reinforcement, the spouse feels neglected and unloved.

Withholding sex: I must be clear—many male intimacy anorexics will have sex regularly, but they will be disconnected during the act. During sex, anorexics have their eyes closed and won’t talk. They also want lights off so they don’t have to connect with their spouse. Some anorexics do withhold sex, refusing to have it at all. Others may punish their spouse before, during or after sex in some manner, whether through negative verbal interaction or refusing to communicate. Some female anorexics will intentionally withhold an orgasm as a way to avoid being sexual or sexually engaging with their husband.

Withholding spiritually: The intimacy anorexic can quote the Bible publicly, counsel people, work in the church, and even preach or pray beautiful public prayers. Others wouldn’t understand that at home, this person never prays with their spouse. They may not discuss their spiritual struggles or even minister to their spouse when the opportunity arises.

Withholding feelings and emotions: Since the anorexic’s agenda is to avoid intimacy in the marriage, they will rarely discuss their feelings. When you share your feelings, you are sharing yourself, not just information, which the anorexic is not willing to do. The spouse can go weeks or months without hearing their spouse’s heart or emotions. This lack of emotional connection from the anorexic drives the spouse out until they feel pain and become angry. The anorexic will then make his or her spouse feel ridiculous for their response. We call this technique of the anorexic “starving the dog.”

Maintaining control through silence or anger: Sadly, anorexics know they can control their spouse by not talking to them for hours, days or weeks. A couple came to my office recently; the husband hadn’t talked to his wife for weeks although they lived in the same house. Anger can also be used to intentionally push the spouse away, creating distance in the marriage.

Criticism: Anorexics often point out their spouse’s shortcomings. This criticism is often ongoing and ungrounded, but it is effective at creating distance. Criticism may remain unspoken, but the spouse can feel the internal judgments of their anorexic spouse. These criticisms are painful to live with no matter how often they occur.

Controlling or shaming through money: Not all anorexics practice this, but when they do, it’s severe. The anorexic can spend and do what they want with money, but the spouse has to justify expenses or get shamed for purchases.

Roommates: An unofficial characteristic of intimacy anorexia is called “roommates.” Here, the spouse reports feeling like a roommate, sibling or good friend, but not a lover. They can even like the anorexic but not feel loved in a romantic way.

This identifiable cancer slowly tortures the spouse until they hit a breaking point. 


I have found four causes of intimacy anorexia.  First, this person may have suffered sexual abuse. They can also be sexually addicted to porn, self-sexual behavior or sex with others outside the marriage (this is a large factor for most male anorexics). They may lack attachment to the opposite-gender parent. Finally, the intimacy anorexic may have experienced no attachment or role modeling of intimacy in their family of origin.

What Do I Do?

What do you do now that you find this silent killer of marriage sitting in front of you? First, have the couple pray together out loud. Then they need to share two feelings with each other every day that have nothing to do with their spouse (for a free feelings list, email [email protected]. The next step would be sharing praise. Have the husband and wife give each other two praises, thanking their spouse after receiving the praise. These three steps are called the three dailies and are included in my book, Intimacy: A 100-Day Guide to Lasting Relationships

Early assessing is much better than evaluating after the divorce bomb drops. Couples have traveled to my office in Colorado Springs as a last attempt to salvage their marriage before filing for divorce. They are met with deep truths and a plan to recover from this cancer. Their marriages receive healing, sometimes experiencing sex and intimacy for the first time in as many as 15 years or more.

There is hope. There is healing. There is a way to recover from this cancer. {eoa}

Doug Weiss, Ph.D., is the executive director of Heart to Heart Counseling Center in Colorado Springs, Colorado, where he and his team work to heal marriages struggling with sexual addiction and intimacy anorexia through his 3 and 5-Day Intensive program. He is the author of Intimacy Anorexia and Married & Alone.  You can learn more about Intimacy Anorexia at or, by phone at 719-278-3708 or through email at [email protected].

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