Anxiety, shame, and sex

Many of us have been taught, implicitly or explicitly, to hide our most vulnerable parts. We live in a world of dualities, where love and apathy dance, and where pride and shame co-exist in tension. Sexuality, as one of our most intimate human experiences, often becomes a focal point for these emotions. In this blog post, I’m joined by guest reviewer, counsellor and psychosexual and relationship therapist Coralie Tauty, to explore the role of shame in sexual anxiety.
Sexual anxiety, while a relatively widespread experience, is a sub-type of anxiety that is particularly personal, making it difficult to talk about. Despite the perception of increased openness about sex in our modern culture, anxiety about sexual performance, sexual identity and intimacy continues to cause distress, despite help being more widely available. This anxiety can manifest as physical tension, emotional withdrawal, or difficulties in connecting with a partner. Over time, if left unaddressed, it impacts not only sexual relationships but also mental health and self-worth.
In psychotherapy, clients often share their experiences of disconnection, sexual dissatisfaction, or frustration, inviting a dialogue to unpeel the deeper layers of what drives these struggles. Sexual anxiety rarely exists on its own; it touches broader themes like self-esteem, identities, and belonging. There is increased acceptance of the connection between sexual anxiety and shame. Left unspoken, buried beneath layers of cultural conditioning and personal history, shame can trap people in a cycle of loneliness and fears.

Shame in a sexually liberated world?

Even in a world that claims to be sexually liberated, sexual shame is still prevalent and drives anxieties and insecurities. Shame around sex can be inherited from generations of moral, cultural, and religious conditioning that has often view sexuality as sinful or dirty. From a young age, we are taught to suppress our natural desires, to control our bodies, and to align with societal expectations around gender roles, sexual orientation norms and others, as a way of maintaining the normative social order. These societal messages are strong and tell us who we should be and whom or what we should like, including in the bedroom. Shame operates quietly but powerfully within our subconscious. If unacknowledged, shame can intrude on sexual encounters, creating an internal dialogue of self-judgement and anxiety, with the persistent question, “Am I enough?”
Shame makes us want to retreat within ourselves, to hide, to be invisible, to stay away from others. Unlike guilt, which concerns actions, shame is about identity - it convinces us that there is something fundamentally wrong with who we are. Internalised shame around our sexuality is particularly difficult to contend with as it can be such an important part of our identity.

Lisa Etherson’s Shame Containment Theory

Lisa Etherson’s Shame Containment Theory helps us understand how shame contributes to sexual anxiety. Etherson, a psychotherapist and scholar, attempts to normalise shame as a natural emotion which we all feel. When “uncontained”, shame can feel overwhelming or even traumatic; we want to hide and run away. We then intuitively attempt to “contain” it by adopting, unconsciously or consciously, behaviours that Etherson calls containment strategies. Some of these strategies are avoidance, criticism or self-criticism, rumination, and numbness. We might become so good at containing shame that we don’t even know it’s there, or shy away from admitting it even when we know it is. However, unacknowledged shame can lead to low self-esteem, imposter syndrome, and anxiety.
In psychosexual therapy, we create an environment where shame can be brought into the open without fear of rejection or further shaming. Etherson’s work emphasises that healthy containment is distinct from suppressing or ignoring shame. Instead, it involves developing awareness around shame, giving it permission to be felt, and fostering a compassionate attitude toward oneself. This involves recognising the origins of shame (often stemming from societal messages or early childhood experiences) and actively challenging the narrative that shame creates about one’s worth or desirability. As Brene Brown would say, shame needs three components to survive: secrecy, silence and judgement. When spoken in the presence of a safe other and met with warmth and compassion, shame shifts and lessens. If we are able to trust that vulnerability will be met with acceptance, it can extend beyond therapy into personal relationships and into the bedroom.

Managing Sexual Anxiety

In sexual relationships, the interactions between partners can be like a container for either the experience of, or healing shame. When the container is filled with judgement, criticism, or unmet expectations, shame deepens, and gives rise to sexual anxiety, which can then affect future interactions. On the other hand, when there is acceptance and empathy in the connection, it allows for the safe containment of shame and a deeper level of compassion. When individuals experience sexual anxiety, developing an internal container for their own shame is an important starting point. Recognising the specific thoughts, physical sensations and other accompanying impulses that arise when shame is triggered can provide the needed self-awareness to act with more intent, rather than undetected shame impacting sexual experiences negatively.

With more awareness arises the need to practice self-compassion. This involves gently reminding oneself that shame is a universal human experience, and not evidence of inferiority. For many, it can be helpful to work with a therapist to process the deeper roots of sexual shame, as psychosexual therapy can help you to understand any effects of past trauma or cultural conditioning. In psychotherapy, shame containment takes the form of a non-judgemental therapeutic relationship where the client’s vulnerabilities are held with care and empathy. This can help a people contend more effectively with any feelings of shame when they arise over time.

Within trusting intimate relationships, partners can support each other by creating a safe, open, and non-judgemental space for dialogue about their anxieties and fears. Expressing vulnerability - “I don't feel confident about my body” or “I worry you might think I am weird if I..” requires courage, but also opens the door to deeper intimacy. When shame is met with empathy rather than judgement, it loses its grip, and anxiety diminishes. While needing a change in mindset, part of the solution could be that sexual anxiety can be approached differently than as a psychological issue to be 'fixed'. It is an invitation to look deeper, to confront the shame we carry and to engage with it consciously. In trusting intimate relationships, allowing, understanding, and holding shame with compassion can help to cultivate a sex life that is grounded in safety and connection. Through this process, we open the possibility of discovering that true intimacy arises not when we are perfect, but when we are willing to share our experience of being human fully with one another.

 


About our Guest Editor / Reviewer Coralie Tauty

Coralie is a qualified counsellor and psychosexual and relationship therapist.
www.counselling-directory.org.uk/counsellors/coralie-tauty

 


A Few Questions for Our Reviewer

How did you decide to train as a Psychotherapist?
I started my journey as a support worker in charities working with survivors of domestic abuse and sexual violence. This led me to wanting to deepen my knowledge and I studied counselling alongside lots of short courses to build my knowledge on trauma work. After working in private practice for a few years, I wanted to have the tools to work with partners and couples as well as on sexual healing, pleasure, and consent. It led me to the pluralistic and intersectional clinical sexology and relationship therapy course at CICS!

What do you do for leisure?
I move my body and spend time in nature! I enjoy bouldering and sport climbing, hiking, but also reading and drinking a cup of herbal tea in a beautiful park. I resource myself through a mix of time spent with loved ones and time spent alone. Also, Netflix!

What is the most important book you read until now? What made it important?
Oh, there are so many books I love and that felt important to me for different reasons!
One of the first ones was “The Little Prince” by St Exupery with invaluable messages shared simply and beautifully. Then, there were collections of poems by Victor Hugo that helped me connect to feelings of love and grief.
I have also enjoyed all books written by Brene Brown on the themes of vulnerability, courage, connection, and shame.
The books “4000 weeks” by Oliver Burkeman and “The denial of death” by Ernest Becker felt important to make mindful choices in my life and to align them with my values.
I have loved and recommended the book “All about love” by bell hooks as a profound reflection of how we define love and relationships. On this topic, but with prompts for reflection, there is the anti self-help guide by Meg-John Barker titled “Rewriting the rules” which I’d recommend.
The most recent book I read was “In the dream house” by Carmen Maria Machado; she writes with a powerful and unique style about her experience of domestic abuse within a queer relationship.
I also read lots of books by adventurers, climbers, and mountaineers, for fun and inspiration!
I’ll stop here.

Quotes that you find meaningful
“If we can share our story with someone who responds with empathy and understanding, shame can't survive.” Brene Brown
“I've learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.” Maya Angelou

 


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