Some people suffering from pornography addiction find themselves less able to engage in intimate acts with their partner. This can be confusing to spouses of pornography addicts, who may worry that their partner is no longer attracted to them, preferring pornography to actual sex. The truth is often more complicated.

While pornography addiction can be a stepping stone to higher-risk sexual activity such as seeking out affairs or hiring sex workers, it can also lead to a decrease in sexual function and emotional availability known as sexual anorexia.

Psychology Today defines sexual anorexia as a condition in which a person “may refuse all sustenance—in this case, emotional and sensual sustenance—in order to keep chaotic feelings, anxiety, and unexplored trauma at bay.”

Related: Inpatient Addiction Treatment Center Explains How Trauma Affects Addiction

Some sex addiction recovery groups consider sexual anorexia to be the “other side of the coin” to sex addiction, with both issues stemming from a desire to avoid intimacy and negative emotions such as shame.

For pornography addicts, a deep sense of shame can both drive more pornography use while also making it more difficult to connect with a partner sexually. While the partner of a person with pornography addiction might conclude that they can “win” over the pornography by being more sexually available, this is seldomly the case for those who are also experiencing sexual anorexia.

If a person suffering from pornography addiction has low self-esteem and sees themselves as unworthy of love, they may also view their sexual desires as a destructive force and avoid relationships out of fear of hurting or disappointing their partner.

Sexual anorexia doesn’t only occur in people who are in relationships. Unpartnered people suffering from sexual anorexia often go long periods without partners, avoiding meeting potential suitors for fear of emotional intimacy. They may use pornography as a substitute for emotional connection, and sometimes have difficulties even maintaining friendships because they fear opening up emotionally.

For those who seek out romantic relationships, sufferers of sexual anorexia often have difficulty being vulnerable with their partner, and may also have difficulty satisfying with their partner’s emotional needs. Their partners may feel like they “shut down” around emotional discussions, leaving their needs unmet. They may engage in pornography use instead of opening up to their partner, adding to their partner’s feelings of inadequacy.

Those suffering from pornography addiction and sexual anorexia often have unprocessed trauma that they haven’t dealt with, leading to shame and feelings of self-loathing. In order to help overcome those negative feelings and disrupt the cycle of addiction, Desert Solace offers a residential addiction recovery program with a focus on substance and behavioral addictions, such as pornography addiction.

Desert Solace officials said that “coming out of our shame, having the courage to reach out and say, ‘This is what I’ve done, this is where I am, this is where I’ve been, and I’m going forward,’” goes a long way towards reaching recovery.

“The days of isolating are over,” Desert Solace officials continued. “Reach out for help … let’s move forward and the past is the past.”