Shame and Anxiety

https://www.mindfulexposurebook.com/shame-anxiety/

Shame based individuals will tend to experience significant discomfort and anxiety, especially in social contexts and situations. It only stands to reason, that if one feels inherently flawed and lacking, social settings will maximally provoke feelings of personal inadequacy, contributing to a generalized perception of threat when entering social settings.

Like anxiety, shame is a drive state, and thus can compel one to engage in many maladaptive behaviors in the hope of reducing (avoiding) the experience of shame. Thus, for example, shame based individuals often tend to be highly socially avoidant, and resist engaging in social interactions or even personal relationships. They will find it difficult to trust others sufficiently to be truly open and intimate at the deepest levels, since their fears of abandonment and rejection will contaminate this capability.

This can even impact sexual performance. So for example, a particular fellow I am treating, whom is very shame based due to his early history, is attempting to “prove” his masculinity to women, and of course by doing so, his focus is on his own performance which undermines erectile capability. This then only reinforces his perception that he is flawed, perpetuating a very vicious cycle.