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Shame and self-disgust in psychosomatic diseases

Shame and Self-Disgust in Skin Diseases

Skin diseases such as psoriasis and atopic eczema are among the ten most common diseases worldwide and are often accompanied by considerable psychological stress such as shame, disgust, and self-devaluation. These emotions can lead to social withdrawal, reduced quality of life, and limited adherence to therapy, but are often overlooked in dermatological practice. The aim of our research is to investigate how Compassion-Focused Therapy (CFT; Gilbert, 2010) can reduce such negative emotions and improve the well-being of those affected. In an early concept paper, we described the role of shame and stigma in skin diseases and emphasized the need for psychological assessment and integrated care (Fink-Lamotte & Stierle, 2022). Building on this, we were able to show in an experimental study that a short, compassion-focused intervention reduces shame and skin-related self-criticism (Stierle & Fink-Lamotte, 2024). Our most comprehensive contribution to date is our systematic review  Fink-Lamotte, Wehle et al., 2025), which summarizes 50 studies that examined the prevalence and effects of shame and disgust in acne, eczema, and psoriasis. It shows that visible skin changes are strongly linked to shame, self-disgust, and social avoidance, and that compassionate and mindfulness-based approaches offer promising ways to reduce these emotions.

 

Cooperations with:

Interventions used (use freely available)

For the experimental induction of shame and disgust in skin diseases

For interventions with shame and self-disgust in skin diseases

Shame and Self-Disgust in Sexual Dysfunction

This project investigates the relationship between disgust and sexual dysfunction, with disgust conceptualized as a key emotional factor in the development and maintenance of various psychological disorders. Previous research, particularly in individuals with genito-pelvic pain/penetration disorder (GPPPD), suggests that disgust may inhibit sexual arousal and trigger a negative cycle leading to the avoidance of sexual stimuli. However, this association has not yet been tested experimentally, and research is lacking on other common disorders such as erectile dysfunction (ED). Cognitive appraisals of sexual situations play a crucial role in shaping emotional responses such as arousal and anxiety, but have not yet been studied in relation to disgust.

Specifically, we aim to experimentally examine how cognitive appraisals of sexual scenarios may intensify disgust and contribute to the avoidance of sexual stimuli, particularly among individuals with GPPPD. The study will include at least 190 participants divided into three groups: GPPPD, erectile dysfunction (ED), and a control group. Cognitive appraisals will be assessed through self-report and scenario-based tasks, while responses to sexual stimuli will be measured. A better understanding of these processes is expected to improve treatment approaches for patients with GPPPD and ED.

In an initial study, 66 participants with vulvas completed a scenario-based task involving imagined intimate encounters. Participants with sexual dysfunction reported significantly more disgust-related cognitions than those with high sexual functioning. Analyses revealed three distinct forms of disgust: object-related, self-disgust, and moral disgust, that were strongly associated with negative sexual beliefs, reduced arousal, and increased avoidance. Building on these findings, we developed and validated a sexual disgust questionnaire in a subsequent study.

 

Cooperations with:

  • Umut Özdemir, Psychologischer Psychotherapeut in eigner Praxis
  • Julia Velten, Ruhr-Universität Bochum