My clients want to have relationships, but they also want to be 100% certain that they won’t get hurt. For emotional self-protection, they tend to seek situations that offer controllable intimacy, which is an oxymoron. Emotional intensity, over which you can feel some control, is not the same as genuine closeness. Being vulnerable enough to allow yourself to be fully known creates the potential for true intimacy. But this also comes with some risk. People who use sex and romantic intensity as substitutes for intimacy often find themselves feeling more empty and unfulfilled with each new relationship or sexual partner. The people I treat are highly vulnerable to rejection and perceived abandonment and are therefore afraid of not having emotional control over an intimate partner. Sadly, they fear the very emotional risks required to deeply and intimately bond, and will settle for short term, intensity-based experiences, which often leave them feeling more alone then when they started.

Meet Robert Weiss, one of the leading experts in sexual disorders and addiction, Founder of The Sexual Recovery Institute in Los Angeles and Director of Sexual Disorders Services at The Ranch Treatment Center in Tennessee. Robert has devoted his life to understanding intimacy disorders and treats men and women who suffer from a range intimacy issues, including sex addiction and abuse, as well as love addiction, which is most common in women, and even dysfunction related to men’s viewership of porn. Intimacy disorders have been on the rise, particularly as a result of technology and dating in the digital age. We recently spoke with Robert as part of a three-part series to learn more about intimacy disorders, understand the symptoms in women versus men and to help women form and maintain healthy relationships throughout their lives.

What is an intimacy disorder and what causes them?

Robert Weiss (RW): An intimacy disorder is the inability to find, tolerate, or stay in relationships that involve the risks that come with being fully known. Having such problems denies our most basic human need to deeply bond with others. Humans are meant to be social. From the very first moment we’re paired with mom, and throughout our life span we seek various pairings or social groups to fit in or belong—it’s an essential part of being alive. Even from the beginning, to achieve health, children need connection, not only for nourishment and protection, but so they know what it’s like to have intense engagement with an interested person. It’s part of the human condition to enter into deep social and intimate relationships; we are not meant to be isolated creatures, and those of us who spend a lot of time alone tend to be the most troubled people in our culture. The challenge for most of the people I work with is that while these men and women are quite intellectually intact or even very gifted, and some of them even able to build a strong career and are interesting, engaging people, they are unable to choose, grow, and maintain healthy relationships, especially intimate ones. This is a major problem because we all need healthy relationships for our survival—it is that important. We do not do well alone.

Why do these people have these problems? Typically, I work with men and women who have experienced some form of early life trauma (such as sexual, physical, emotional, or other types of abuse), so what they learned early-on about intimacy is that it can be scary, inconsistent, and is not to be trusted. These people never learned that that intimacy can be a reliable source of emotional nurturance, and instead they’ve become protective about letting others know them too well. Rather than allowing themselves to be vulnerable and loved, they seek situations that offer more of a sense of control, as emotional fear feeds the need to be or feel empowered. Other clients come to us with emotional deficits, such as chronic shyness or social phobias, which also leaves them unable to form and/ or maintain deep emotional bonds. Other clients are more narcissistic; with these individuals the need to be seen and known is expressed through their desire to be consistently admired rather than truly intimate.

Individuals who are unable to accept healthy intimacy will seek emotional compensation through more superficial and controllable situations. Just as we always need food and shelter, from womb to tomb, so too do we need to feel loved and connected. This is true throughout our lifespan. Those I treat have, in some ways very creatively, found maladaptive ways of coping with their sense of separation and aloneness in order to survive emotionally.

How do intimacy disorders manifest themselves differently in men versus women?

RW: For the men I treat, they typically have ego wounds or wounds to sense of self, with roughly 20% showing a history of sexual abuse. They often will marry someone or get into an intimate relationship and still not be truly intimate or fully known with that person; they don’t let their spouses in or are deeply insensitive to their partners’ sometimes limited availability. As an example, I see a lot of couples where maybe the man had sexual troubles that preceded the relationship but the relationship nevertheless had all the romance and intimacy one typically feels early on, and then something comes up that pulls the woman away from her partner, such as a job or children, and he starts to feel abandoned. Instead of being intimate and communicating his frustration to her (by saying, for example, “I miss you” or “I’m not happy with this”), he simply decides he’ll find something else. He stays in the relationship, but uses intense experiences with images (porn) or other people in order to feel as if he has a sense of control. After all, prostitutes, affairs, and porn are far less likely to let him down. Essentially, the man engages in these “compensating behaviors” because he is not willing or able to allow himself to truly be known or connected in his relationship. Either he is too afraid or he doesn’t know how.

The women I treat tend to have more overt abuse in their histories, including much higher incidents of sexual abuse. In fact, roughly 60% of the women we see have suffered sexual abuse. The women also tend to be less functional in life than the men we see. Men by nature, in terms of the way they’re built biologically, are better able to tolerate objectified sexual experiences. In other words, they are much less likely to say, “I wonder if that person cares about me?” (Hence, the existence of strip clubs.) Women, however, tend to need some relational connection to feel good about their sexuality. Women certainly can enjoy casual, objectified sexual experiences, but they oftentimes want to attach relationship meaning to sexual behavior, whereas men on the whole do not. Furthermore, the woman who goes out and has lots of casual sex, the woman who is dating multiple people at one time, or the woman who is aggressively sexual arguably suffers more than a man engaging in the exact same behaviors because of the cultural constraints placed on women in our society. (For example, men who have a lot of sex are “studs” and women who have a lot of sex are “sluts.”) So, for a woman to bring herself to the point where she will cross those cultural boundaries, especially considering she has a more relational sense of self and sexuality, she is often more deeply emotionally wounded than a man.

On the whole, my clients want controllable intimacy, which, as mentioned earlier, is an oxymoron. If you see a prostitute or have a hot affair it may feel incredibly powerful and intimate, but really it’s just emotional intensity, which is not the same as true intimacy. Intimacy is being known and accepted. My clients have learned to substitute intensity for intimacy. Being fully known and revealing themselves to an intimate partner presents a risk they are not willing to take.

Some of my male clients will drive to downtown Los Angeles at three in the morning in a brand new car and pick up a prostitute and feel perfectly safe. But ask that same man to be honest and open with his partner about what he needs emotionally and he would rather eat dirt. The prospect of that scares him silly, and he’d much rather enjoy the excitement of an intense experience where he’s not really thinking about emotions or potential consequences (robbery, arrest, STDs, etc.).

The women I see are nearly always working out some kind of control issue. Letting go and letting someone know and care about them feels scary or uncomfortable. Sadly, these women find unhealthy ways of meeting their intimate and emotional needs, such as dating guys who really aren’t available. The men might have a drug problem, be abusive, or have issues of their own; the women find these unavailable men who don’t threaten them because they sense the men are distracted or distanced enough to make the encounter “safe.” These women might spend years chasing unavailable men—wondering what’s wrong with them that causes these men to not love them—when the reality is the problem is with the men they’re choosing. Or the women will engage in a relationship with an available man, but will then act out sexually by having affairs or casual sex. In either case, the women are not being intimate with a primary partner.

I’m not saying you have to be in a long-term monogamous relationship to be happy. What I am saying is, as humans, we need deeply intimate, social or family relationships in order to be healthy. As long as friends and family really know you and are meeting your emotional needs, as long as you are really intimate with them, they may be a perfectly good substitute for a long-term romantic partner.

Unfortunately, my clients don’t know how to be intimate with friends or family, either. As an example, when I asked one woman I treat if she has many friends, she said, “Of course.” But then I asked how many of her friends know she’s seeing her massage therapist and letting him masturbate her, or that she’s having an affair with her co-worker. She responded by telling me that she would never share that information with her friends. If that’s the case, then these people do not really know her; these friendships aren’t intimate because she’s not totally honest in them, and therefore she’s not bonding. There are parts of her life that she’s keeping a secret from her “friends.” She’s only showing these people the parts of herself that she thinks they’ll like. She’s not really letting them care for her the way truly intimate friends do.

As another example, I work with a married man with kids. His spouse says she’s going to a yoga class and asks him to watch the kids, and what he feels is frustrated or hurt or alone or unhappy that he’s not going to have that time with his wife. Instead of expressing the frustration or sadness that he’s feeling, he acts out by going to a massage parlor or seeing a prostitute. So he goes out and does what he does, comes home with enough time to take a shower and watch the kids, and then when his wife gets home and sees him in the living room playing with the kids and remarks how impressed she is with him and what a great Dad he is, he can’t accept the compliment because he feels she wouldn’t say those things if she knew where he was earlier.

Through their behavior, my clients have secrets and lies and a double life, and they aren’t able to take in the intimacy that is available to them in the relationships that have because they’re keeping secrets and that creates distance. So they’re not getting their emotional needs met in the relationships they have because of the secrets and lies, and they’re also not getting their emotional needs met in the connections they seek out (affairs, prostitutes, etc.) because those encounters don’t produce true intimacy.

The majority of the men we see in treatment are between the ages of 35 and 55, although those numbers have skewed younger recently, mainly because of pornography. I’m getting 25-year-old guys who’ve been looking at hardcore porn on the Internet since they were 15 and now say they have trouble with relationships. The reason for this is their expectation of sexuality and orgasm is based off unrealistic imagery that produces an unnatural intensity. It’s like drugs. Nobody enjoys the little things, like smelling flowers, if they’re doing a lot of cocaine because, why bother? Smelling a flower releases a small of dopamine—the brain chemical that makes us feel good—whereas cocaine releases a veritable tsunami of dopamine. So who needs flowers when you’ve got cocaine? And who needs a relationship when you’ve got hardcore porn?

A lot of my work is about giving boundaries and putting structure around these people’s lives, holding them accountable to behavior change around sex and intimacy so they can begin to appreciate and value the small moments and experiences that they have with other people, whether those experiences are social or intimate.

The men I treat are typically in a primary relationship with either a man or a woman, and the reason they’re in treatment is their spouse has finally learned about their secretive sexual behavior (or grown tired of putting up with it), and has demanded the acting out stop. So the most frequent reason a man comes to me is that he doesn’t want to lose his relationship. I do have men who come in because they’ve been arrested or have gotten into trouble with their employer (for having an interoffice affair, looking at porn on a work computer, etc.), but usually men come in because their partner has threatened to leave them.

The women I treat tend to be younger, between the ages 22 to 32. Oftentimes they’ve been unable to form or maintain a primary relationship because of an intimacy disorder. So, unlike the guys who are married and lying to spouses and living a double life, the women are unable to build intimate relationships to begin with, or the relationships they have are with dysfunctional people, or their relationships deeply involve drugs, alcohol, and other chaos. They’re almost like “failure to launch” women. They cannot get themselves together in life, so they end up getting stuck in abusive relationships or on an emotional rollercoaster because their toxic relationships don’t allow them the room they need to feel good about themselves or to be functional.

Some of the women who come in have been having sex with someone in their chemical dependency program, or maybe they got kicked out of Betty Ford or some other chemical dependency treatment center because they did something sexually inappropriate and the facility won’t keep them because they don’t know how to handle it. Women also come to us through eating disorder programs. The simple fact is women with histories of abuse and violation act out in various ways, and unfortunately in most treatment programs the piece that’s almost always missing is talking to them about their adult sex and relationship issues. Every treatment center in the country will ask you about your eating and exercise habits and will do an assessment of your education and social relationships, but hardly any will ask if you masturbate or act out sexually. Consequently, a lot of women bounce from treatment center to treatment center because no one has identified that what they really have is a sex and intimacy problem.

The buzzwords for the work I do are cheating, infidelity, betrayal, addiction, sex addiction and intimacy disorder. Sex addition and love addiction (constantly searching for and obsessing over potential partners but never finding the right one) are symptoms of an underlying intimacy disorder. These are maladaptive attempts to get what we all need and what we all want. But because the people I treat either never learned how or they never allowed themselves to truly be intimate, they do all this compensating stuff that looks really crazy to an outside observer.

Want to know more about intimacy disorders? Stay tuned for our next Q&A session with Robert Weiss on hooking up, the impact of technology on intimacy disorders and dating in the digital age and how women can maintain healthy relationships for life.

Thanks to Vixley for the post!