Shame and self-criticism in compulsive sexual behaviour

Apart from general anxiety, stress and worry, one of the most common threat experiences I see is shame. Shame can be a consequence of compulsive sexual behaviour, but it can also come first. Many of the men I work with experienced shame around sex and sexuality long before the behaviour they would now call compulsive. Sometimes that shame sits within their sexuality. Other times it comes from shaming messages about sex from many sources: culture, religion, family dynamics, and the different intersections we hold. A message has been planted that sex in general is shameful, or that something about us engaging in sex warrants shame.

That shame is itself a threat. Alongside it, the sexual drive is usually still there, pulling us towards something we are simultaneously told is shameful. So we often seek out sex in very particular ways that let us escape the shame, avoid difficult feelings or cut off from certain emotional states.

When shame comes after

For other men, shame arrives as a consequence. Many of the men I work with hadn't particularly felt shame about sex until escalating cycles began, and sex became a way of coping with other threats that had nothing to do with sex. Then, as they push boundaries, engage in behaviours they never expected to, or violate their own values, that brings shame of its own.

Shame, secrecy and loneliness

Shame also invites secrecy. Many men are already socialised to be secret about sex because they have been told it is shameful or wrong, so secrecy is built in: we are used to hiding, perhaps lying, not being open about our sexuality. For others, secrecy grows as shame grows from the behaviour, and the more secret we are, the more we deceive and the less transparent we are with the people we love, the more that drives shame. So there is a constant loop: shame, secrecy, loneliness, and then more shame.

The story men arrive with

By the time men come for help, most arrive with an ever louder internal shame and self-critical narrative: there is something wrong with me, I'm not good enough, I've failed, I'm sexually problematic. That is deeply shaming, and it can leave men hopeless about whether help is possible, or whether they should even ask, if these things are true about them. Many of the narratives available to them come from addiction, which can help people make sense of their problems but can also imply that something in them is innately broken. Most men fear that they will keep escalating and become dangerous, that their sexuality is dangerous. That links back to moral judgements about sexual deviancy. I don't dismiss that entirely, as there are forensic presentations where it has to be considered. For almost every man I see, that isn't the case. The behaviours may have caused harm, but not because the man is inherently broken or dangerous.

The shame often extends to the body. For men with difficulties in sexual function, whether those came before the behaviour or as a result of it, there is often a belief that the body is broken, shame about how our bodies compare with what we imagine other men are doing, and sometimes shaming reactions from partners when our bodies haven't worked. By the time someone seeks help, this can be an enmeshed and complex narrative in which body, mind and behaviour all seem like evidence that something is broken.

Escalation, ageing and shame

Shame can also attach to escalation itself. For a lot of straight men, having lots of partners was permissible and celebrated earlier in life. Then peers start to settle down, and a long-term relationship feels difficult or uncomfortable, and they keep reverting to sex as the fix. Often the behaviour itself hasn't changed. The context has. What was normal and fine becomes labelled as escalation once it sits inside a long-term monogamous relationship. Escalation isn't always a treadmill that only goes up. Sometimes our circumstances change and the way we have been sexual no longer fits them, and it is important to take the shame out of that.

For older gay, bi and other men who have sex with men (MSM) in particular, there is shame around ageing: feeling less wanted, less valuable sexually as our bodies age, as if we have lost social currency. I see a lot of older men introduced to drugs much later in life, through apps, into chemsex spaces, in their fifties, when twenty years earlier drugs wouldn't have been a thing for them at all. Underneath it is that shaming around ageing, and the technology offers a solution: you could be wanted here, seen here, valued here.

Why self-criticism keeps the cycle going

When we talk about self-criticism in this context, we are often talking about the internal voice that tells a man there is something wrong with him: that he isn't good enough, that he has failed, that he is sexually problematic, that he is in the wrong, to blame, broken. It is one of the emotions of the threat system, alongside anger, fear, shame and blame. Like them, it is there to alert us to danger and push us into action, which is why it so often feeds the urge to fix, escape or avoid rather than ending it.

Self-criticism matters so much because it keeps the cycle going. Some men come to me at the point of total breakdown, and almost all of them arrive with intense internal self-criticism. The overwhelming narrative for most men I meet is that they are in the wrong. They are to blame, they are broken, they are responsible. Sometimes there are things we will need to make amends for. But we can't do that without understanding why we were predisposed to certain behaviours in the first place. Understanding reduces the internal threat narrative that keeps shame high, and that matters because shame and self-criticism are often a big precursor to relapse. They keep us in the loop where we are vulnerable and need to fix, escape or avoid again.

Looking back with compassion

So the work begins by looking back with compassion: at what we were given and what we were left without, what was modelled to us and what wasn't, the opportunities we had and didn't have, and the messages that encouraged our exploration of sexuality or moved us away from it. That takes kindness, because we have to accept that, given the journey we have been on, we may or may not have had the capacity to do certain things. Compassion here isn't about letting ourselves off. It is about taking responsibility, and building the resilience to sit with discomfort rather than escape it.

Silence is part of what keeps shame alive. It feels alien to be compassionate towards ourselves when we have been told our whole lives that this is wrong, or that we are wrong, or when there has simply been silence and we just don't talk about it. That silence creates shame, which creates an inability to tolerate difficult feelings, and the message that we need to run away from them. One of the things the group does is let men model responding compassionately to each other. It is often easier to do for someone else than for yourself, and doing it for someone else helps you do it for yourself. And there is something about being witnessed and heard. Shame struggles to continue to exist when it's witnessed, not judged, and made sense of in a shared and safe space. It immediately reduces threat, and that lets thinking come back.