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How CBT Helped Anna Overcome Sexual Anorexia

A Story of How CBT Can Be Used to Treat Compulsive Sex Avoidance


Updated January 18, 2011

This story is an example of how Cognitive Behavioral Therapy (CBT) helped Anna to overcome frigidity and compulsive avoidance of sex, or sexual anorexia. While the characters and the story are fictitious, the characteristics and circumstances described are often seen in people who come for treatment for sexual anorexia. Cheryl’s story is presented for illustrative purposes, to help readers understand how CBT can help people overcome compulsive sex avoidance. Click here to share your own CBT story.

Anna had never had a sexual relationship as an adult, and at age 30, had approached her doctor for help getting pregnant through IVF. She told her doctor she believed she was frigid and incapable of a sexual relationship, and was referred for CBT treatment for sexual anorexia, or compulsive avoidance of sex.

Phillipa, Anna’s cognitive behavioral therapist, guided Anna in recording the thoughts and feelings she experienced before, during and after potentially romantic interactions with men. By analyzing the thoughts and feelings Anna had around her interactions with men, they came to understand that Anna had become avoidant of sex because she blamed herself for sexual abuse by her father in childhood. She reasoned that if she hadn’t lead him on, the abuse never would have happened, which is what her father had told her at the time. She tried so hard to avoid leading on any other men that she avoided any kind of warm interaction with them, although rationally, she longed for a relationship and children.

Phillipa helped Anna to understand that her feelings of guilt and responsibility for the abuse were inappropriate. As the adult, her father was responsible for the interactions between them and for setting appropriate boundaries, and Anna’s father had blamed her to avoid taking that responsibility. As Anna replaced her thoughts of personalization and blame she began to lose the feelings of guilt she had been experiencing when she interacted with men. In time, she was able to develop a romantic and later sexual relationship with a long-term acquaintance whom she had wanted to get close to, but had felt unable to before her CBT.

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