Case Illustration · Clinical Formulation
Religion and Sexual Shame
A client arrives with his own explanation for his difficulty. The exercise works from the presentation toward a formulation, and the two do not match.
The presentation
A man in his early thirties presents describing long-standing sexual dysfunction, including inhibited desire and difficulty maintaining erections, which he attributes to pornography use.
He is a devout member of a conservative Christian community and has internalized the teaching that any sexual thought or act outside of marriage constitutes sin.
He married at 26 and describes his marital sex life as a source of ongoing shame, because he experiences sexual thoughts that he considers inappropriate even within marriage.
Estimated time to complete this exercise: 12 minutes
Part 1 of 5
He has told you that pornography caused this. What do you do with that?
References
- American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787
- Bancroft, J. (2009). Human sexuality and its problems (3rd ed.). Churchill Livingstone.
- Mosher, D. L. (1979). Sex guilt and sex myths in college men and women. Journal of Sex Research, 15(3), 224–234. https://doi.org/10.1080/00224497909551052