The influence of shame and guilt on sexuality in men and women

This review explores contemporary perspectives on the role of shame and guilt in the development of sexual dysfunctions and disharmonies in men and women. Particular attention is given to the relationship between excessive sexual shame and guilt and disturbances of psychosexual development, highlighting the factors contributing to their emergence. The review provides a detailed discussion of the differences between sexual shame and guilt, their associated behavioral patterns, and their impact on sexual function. Based on these distinctions, differentiated therapeutic approaches to sexual shame and guilt are presented, as well as specific psychotherapeutic techniques. The review is grounded in the analysis of original Russian and English-language articles as well as extensive clinical experience of the authors. References are primarily made to statistically reliable, randomized, and placebo-controlled studies conducted over the past 20 years, with some consideration of smaller-scale and unblinded studies. The analysis demonstrated a significant lack of knowledge on this topic. It is concluded that further development of specific psychotherapeutic programs is necessary to address sexual shame and guilt in patients with sexual dysfunction, marital and sexual disharmonies, and other relational issues. Additionally, there is a need for preventive programs to address excessive sexual shame and guilt during childhood and adolescence, emphasizing parental education on their role in sexual upbringing.