New study finds backfire effect: The more shame experienced for sex the more the drive to engage in sex acts that are distressing; therapies that support "shame" models are likely increasing the problem behaviors, keeping patients locked paying therapists

Associations between Fluctuating Shame, Self-Esteem, and Sexual Desire: Comparing Frequent Porn Users and a General Population Sample. Piet van Tuijl, Peter Verboon, Jacques J. D. M. van Lankveld. Sexes 2022, 3(1), 1-19; Dec 22 2021. https://doi.org/10.3390/sexes3010001

Abstract: In the present study, we explore the proposed cyclic models for problematic hypersexuality (PH) that involve shame, self-esteem, and sexual desire. These cyclic models are characterized by temporal associations but have not been investigated previously with intensive longitudinal designs. In this study, we collected up to 70 measurements per participant within a period of seven consecutive days, which allowed us to investigate associations between fluctuations of shame, self-esteem, and sexual desire. Participants were divided in four subgroups: (1) women (n = 87); (2) men (n = 46) from a general population convenience sample; (3) men watching porn >2 times per week, showing non-problematic hypersexuality (NH; n = 10); and (4) men watching porn >2 times per week, experiencing PH (n = 11). Multilevel analyses, including cross-level interactions, were used to investigate between-group differences in intraindividual processes. Results showed that prior increases in shame forecasted higher current sexual desire for men with PH, but not for the other groups, suggesting that men with PH use sexual desire to downregulate dysphoric feelings of shame. Differences between groups in associations between self-esteem and sexual desire were also found. Based on our results, we propose the Split Pleasure/Shame model, which represents emotion dysregulation in PH, and juxtapose this with the pleasurable experience of sex by non-PH groups. Further intensive longitudinal research is necessary to test this model and, more generally, to investigate the fluctuating nature of sexual desire. 

Keywords: sexual desire; shame; self-esteem; split pleasure/shame model; problematic hypersexuality