Sexual Shame: A Bigger Problem Than Any Dysfunction

At least half my patients struggle with shame.

At our first session, when I ask “what would you like to accomplish in our therapy?” people will often mention their fantasies (too weird?), their desire (too low or too high), or their penis or vagina (which won’t do what they want when they want it).

Very few people say. “I want to feel less shame.” Of course not; they’re too ashamed.

Some people may have been coerced, when they were young, into having sex with a family member or other adult in position of authority such as a member of the clergy. They’re afraid it means they’re gay, or that they secretly wanted it. Some are afraid they will sexualize their own or others’ children, even though they have no interest in doing so.

Some people were “caught” masturbating as kids.

Some people like to smell panties, or underarms, or think about Hillary Clinton during sex. Or they like being spanked, choked, bitten, or violated. Perhaps they’ve never told any of this to another living soul, and so they’ve never received any comforting, nor any reassurance that they’re not the only one who has had fantasies about sex with comic book characters, unicorns, or dragons; about positions no human body can accomplish; or about raping or servicing dead people.

No One Is the Only One

No matter what someone does or wants, they’re not the only one. No matter how unusual, how seemingly deranged, how un-sexy, how disgusting it seems, no matter how illegal or immoral, no one is the only one. If the human mind can imagine it, lots of people imagine it, desire it, or do it.

Shame is the sense that one is morally defective. It puts someone outside the human community. And that’s what’s so damaging about it: As a person hides or withdraws, they have fewer opportunities to receive compassion, validation, or support—and they hear fewer of others’ stories, which could be similar to theirs.

Isolation begets more isolation.

The ashamed are strangely narcissistic; as they project their self-loathing onto others, they imagine that other people think way more about them than they actually do. And they imagine that others focus on their deepest flaw, rather than wanting to engage them in talking about, say, their kids, their health, or their golf score. It’s not a narcissism of conceit; it’s a narcissism of anxiety.

Shame helps explain why so many people with “sexual dysfunctions” withdraw from sex and from their partners. They feel they don’t deserve pleasure. They don’t want to pollute their mate. They don’t believe their partner’s stated affection or desire. They’re trapped in a prison of their own making. And many don’t feel they deserve to be freed.

When you’re ashamed, satisfying sex—pleasure, connection, self-expression, adventure—is for other people. In contrast, most people who are ashamed feel they're eligible only for lousy sex or no sex.

George, so ashamed of looking at porn that he felt he didn’t deserve his wonderful wife, withdrew from her. Sora was so ashamed of gaining weight that she started calling her husband a sex maniac and stopped all oral sex. Mitch was so ashamed of using a butt plug when he masturbated that he deliberately didn’t use lube—and hurt himself each time. And Ruben was so ashamed of getting turned on by wearing stockings under his clothes that he wouldn’t play with his beloved dog on days when he indulged his fetish.

Shame as a Health Issue

For some, shame is a health issue. I have bisexual patients who won’t tell their physicians about engaging in anal sex. I have patients who have several different doctors for several different medications, such as Viagra, STD treatment, and high blood pressure, because they fear that if one doctor knew everything about them, that clinician would judge them and gossip about them. I explain that sandbagging your own doctors in this way works against their own health—and I’m often ignored when I do.

How do I help people struggling with shame?

To be honest, I don’t always succeed.

I try to help people see that they’re suffering from a big misunderstanding long ago—either from misguided adults (like parents or clergy), or from their own decisions when they discovered their sexuality in adolescence or young adulthood.

Their pain is real: disappointment, outrage, grief, whatever. Still, it’s often just a long-term misunderstanding. That’s why it’s so crucial for parents to criticize what kids do—but not to say “you’re a bad boy” or “only bad girls hate their sisters” or “God hates children who lie.”

The Narrative Process

And so I talk about the narrative process: that how we feel isn’t inevitable, but constructed from assumptions that are often arbitrary and changeable.

Sometimes that helps; Gayle came to realize she was ultimately the one condemning her masturbation, and that she could stop the unending reproaches even if her church didn’t. Sometimes that approach doesn’t help: Mitch refused to consider that he had become his own ultimate critic, convinced that any “reasonable” person would find his interest in butt plugs disgusting.

When people are ashamed about their sexuality, I don’t immediately talk much about sex. I talk about the misunderstandings of young children, and of frightened or ignorant or compromised parents. I talk about the ongoing opportunity of examining our narratives. I talk about self-acceptance.

If we succeed in those conversations, sometimes the concern goes away—because “symptoms” aren’t symptoms anymore. And eventually, yes, we sometimes talk about sex—penises, vaginas, desire. When you’re able to welcome people back into the human race, that solves a lot of problems.