Yleinen

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Sexuality is our deepest essence. This includes gender identity and roles, sexual orientation, eroticism, pleasure and fantasies, sexual relationships, and reproduction – in other words, it is a very central part of our human experience. The way we approach something so important and intimate cannot help but affect our overall wellbeing. Unfortunately, however, many people feel ashamed of one or more aspects of their sexuality.

Shame is often divided into two different types: good shame and bad shame. Good shame is short-lived and guides us towards acting fairly and justly towards other people – its evolutionary purpose is to ensure that an individual is not rejected by their community and thus in danger of death. Bad shame, on the other hand, goes on for a long time and makes us feel miserable and worthless, just plain unworthy. Shame differs from its neighbour, guilt, in its intensity and scope: guilt focuses on a specific, limited act, while shame is directed towards ourselves, our being and our humanity. Living with permanent shame is very difficult, so it is important to try to deal with shame and alleviate it.

Different degrees of shame – different kinds of help

Mild and severe shame often need to be treated differently. What all shame has in common, however, is that it is dispelled by talking: by sharing your thoughts and experiences in a safe environment, by feeling seen and appreciated in all your aspects, just as you are. An open conversation with a trusted friend, family member, or even your partner can reduce mild shame. An accepting look and warm welcome from another person can in itself work wonders.

If talking to your loved ones does not alleviate your shame, or if talking to a loved one feels impossible, you should consider seeking professional help. Depending on the situation, suitable helpers may include a sex counsellor or therapist, a psychotherapist, a psychologist, a nurse, or a doctor. Of these, ‘sexual counsellor’ and ‘sexual therapist’ are not protected professional titles in Finland; they involve further professional education courses which can be taken with a wide range of educational backgrounds. Many professionals may have several different qualifications. For example, some psychotherapists are also trained as sexual therapists. People trained in sexology have an understanding and knowledge of the diversity of sexuality and gender and are used to discussing these topics in a natural and sensitive way. Such skills can be particularly valuable for clients from sexual or gender-related minority groups.

Sexual counsellors and therapists as relief for mild and moderate shame

In mild to moderate situations where sexual shame interferes with life but is not constantly crippling, a few sessions with a sex counsellor or therapist may be enough. The so-called PLISSIT model (permission, limited information, specific suggestions, intensive therapy) is widely used in sexology, and in this model, the sexual counsellor works mainly at the level of giving permissions and providing limited information, while specific suggestions and intensive therapy are the domain of a sexual therapist.

Sexual counselling may be the most unfamiliar concept to the reader, so I will first explain in more detail what kinds of issues sexual counselling can help with. Sexual counselling is short-term (1 to 5 sessions), process-oriented counselling which, depending on the client’s needs, can address issues such as loss of libido, relationship interaction problems, self-esteem and identity, body image, or sexuality challenges related to different life situations. Sexual counselling involves a lot of discussion about what is normal and acceptable. The sexual counsellor’s tolerant, positive attitude towards the client and their sexuality, as well as the counsellor’s multidisciplinary knowledge on the subject, can help to alleviate shame related to things such as the body and its functions, sexual orientation, gender identity, or different preferences and fantasies.

In sexual therapy, the same themes can be explored in a broader, longer-term way (the typical duration of sexual therapy is around 5 to 20 sessions). Sexual therapy is a form of therapy that combines many different psychotherapeutic approaches and disciplines, and its content can be emphasised in different ways depending on the client’s needs and the therapist’s training and frame of reference. Depending on the situation, sexual therapy can address things such as the impact of the client’s childhood and adolescent experiences on sexuality and relationships, different thought patterns and assumptions related to sexuality, or attempting to outline concrete solutions to current sexuality problems.

However, the means of sexual counselling or therapy are not always enough to overcome a deep experience of shame. In such a case, the sexual counsellor or therapist will refer the client to a psychotherapist who is trained in issues such as shame and able to help deal with strong, long-lasting feelings of shame. Long-term psychotherapy is particularly justified if the client has a history of sexual trauma.

Conclusion

Although sexuality can be associated with very painful experiences of shame, once difficult feelings have been dealt with, attitudes towards sexuality can become much healthier. A freely exercised sexuality can be a great resource and source of joy in a person’s life. A self-aware, accepting person can harness the power of sexuality and live a life that is enjoyable and fulfilling.

Literature

Bildjuschkin, Katriina (ed.): Seksuaalikasvatuksen tueksi. Finnish Institute for Health and Welfare, 2015.

Gilbert, Paul (1997). The evolution of social attractiveness and its role in shame, humiliation, guilt and therapy. British Journal of Medical Psychology, 70(2), 113–147.

Malinen, Ben: Elämää kahlitseva häpeä. Bookbinder 2010.

Ritamo, Maija; Ryttyläinen-Korhonen, Karti; Saarinen, Saana (ed.): Seksuaalineuvonnan tueksi. Finnish Institute for Health and Welfare, 2011.

Santalahti, Tarja; Lehtonen, Mika: Seksuaaliterapia. PS-kustannus 2016.

About the author

The author is a university teacher with a PhD in engineering who will graduate in December 2021 as a sexual counsellor. The author also studies Finnish language and psychology at the University of Helsinki.

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