Julie is a typical “sexual anorexic”. The unmarried teacher, 38, plays hockey for a local team and has a full social life. But, for her, mixing with the opposite sex is fraught with difficulties. She occasionally enters relationships with men but these are always very short-lived because Julie is obsessed with avoiding sex.

Sexual anorexia is a worrying new trend in sexual dysfunction that I increasingly encounter in my practice as a psychotherapist. The term was coined by Dr Patrick Carnes in his 1997 book, Sexual Anorexia: Overcoming Sexual Self-Hatred, to refer to a form of disturbed behaviour played out in the sexual arena when people become obsessive about avoiding sex, even when they are in a relationship.

On the first date or two, Julie’s obsession can be easy to hide; often it’s under the guise of being concerned about appearing “too forward”. But soon she has to use a variety of techniques to avoid sex: pretending to have her period; claiming to suffer headaches; to being physically sick; and orchestrating a row to make her partner leave her alone.

Julie says: “My friends are amazed that I can’t keep a boyfriend. They can see I’ve got a good figure and I’m friendly and outgoing. But I could never admit the truth to my friends.”

Dr Mark Collins, a London-based consultant psychiatrist who treats addictions, believes that sexual anorexia may be on the increase because “we live in an age where people are increasingly interacting with each other at one remove, either by text or on the internet”.

The condition is, in effect, a compulsive, self-destructive way of avoiding the reality of your life. If it is left untreated, it can cause problems with a sufferer’s work, family, finances and personal safety. Like other forms of emotionally dysfunctional behaviour, it is difficult to stop. As with the eating disorder anorexia nervosa, secrecy is a big component to sexual anorexia, which is what makes detection, diagnosis and treatment so hard.

Self-punishment is another factor. This is where people deny themselves something that deep down they want badly but cannot admit to. Sometimes sexual anorexics are afraid of their own sexual appetite and are scared to give in to it.

Occasionally, the sex drive will overcome the fears and this can lead sexual anorexics to binge on sex, usually with strangers. Michael, 31, a City lawyer, is a sexual anorexic but he binges on sex about once a month and only when he is drunk. Despite being tall, accomplished, with a winning smile, he struggles on a daily basis to live up to being a “stud”, which is what he sees as the male ideal in today’s society.

The idea of a long-term, intimate relationship with a woman terrifies him in case he is judged inadequate. “I routinely win major court battles on behalf of my clients; in fact I thrive on the adrenalin. Yet the thought of spending a night alone with a lovely woman is enough to make me hit the bottle. This breaks my heart as I’d love nothing better than to get married,” he says. Bingeing on sex follows a typical addictive pattern of behaviour, in the sense that having drunken sex with strangers makes Michael feel ashamed. This, in turn, leads to deeper emotional withdrawal, and his sexual anorexia snaps back into place as a means of controlling his sexual desires. In this way, he can reject others before they get a chance to reject him.

Sexual dysfunctions have a variety of origins, ranging from fear of intimacy, or of losing control to another, to poor self-esteem. Some people have a phobia of sexual intercourse. Others torture themselves with impossibly heightened expectations. Sexual anorexics are often perfectionists who like to have their lives under control as a way of dealing with things such as their feelings that are not within their control.

Carrie became a sexual anorexic when the sexual behaviour of her husband James, a 46-year-old management consultant, began to get out of control. He was secretly watching porn at work and spending a lot of time planning trips to prostitutes. Carrie subconsciously compensated for this by working late, or being “too tired” for sex. Dr Collins says that sexual anorexia is often found in couples where the other partner is addicted to sex.

Sexual anorexia appears to stem from difficulties in early attachment. If a child experiences violations of trust and intimacy (such as, but not only, sexual abuse), it can have profound repercussions for his or her sexual identity as an adult, causing them to starve themselves of sex, or to act out confused emotions in subsequent relationships.

It is vital for anyone with a sexual problem to get help. In the UK, this is available in one-to-one therapy or in groups dedicated to sexual problems. Relate, and the British Association of Sex and Relationship Therapists have useful websites, as does Sex Addicts Anonymous (see box below). Psychotherapy can help by exploring a patient’s relationships. Michael has been helped by examining his confused feelings about his relationship with his parents, which suffered when his younger brother became ill and died.

Carrie is looking at the ways in which her behaviour was connected to her unconscious anger towards her porn-addicted husband. And Julie is finally coming to terms with a period of childhood sexual abuse she suffered at the hands of a close relative. “By learning to reconnect with myself sexually,” she says, “I can consider letting someone else love me sexually, too.”

Lucy Beresford is a practising psychotherapist. The names and some details of case histories have been changed.

Where to get help

Sexual Anorexia: Overcoming Sexual Self-Hatred, by Patrick Carnes (1997), is available from www.amazon.co.uk