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Shame and self-disgust in psychosomatic diseases

Shame and Self-Disgust in Skin Diseases

Three dermatological conditions rank among the ten most common diseases worldwide. According to Augustin et al. (2011), psoriasis and atopic dermatitis are the most prevalent inflammatory skin diseases and form the focus of this project. These conditions are often associated with significant psychological distress and, in some cases, comorbid mental disorders. In dermatological practice, however, it is often difficult to adequately address or explore the psychological burden. Prior studies have shown that dermatologists may frequently overlook the psychological challenges associated with skin disease. These include strong emotional experiences of shame and disgust, which in turn can lead to reduced treatment satisfaction. To alleviate psychological burden and promote adaptive coping, parallel psychotherapeutic interventions are therefore increasingly recommended.

A more recent approach is Compassion-Focused Therapy (CFT; Gilbert, 2010), which has been successfully applied in the treatment of shame-related and somatic disorders (Austin et al., 2021). CFT appears promising for addressing disgust and shame in individuals with skin diseases. The current state of research has been summarized in several review articles (Fink-Lamotte & Stierle, 2022; Stierle & Fink-Lamotte, 2024; Fink-Lamotte, Wehle et al., 2025).

The aim of our research project is to examine the potential of compassion-based intervention techniques to reduce skin-related disgust and shame in individuals with dermatological conditions. Skin-related shame refers to the negative evaluation of one’s skin, particularly expressed through feelings of inferiority. The self as a whole is devalued and perceived as inadequate, worthless, incompetent, and socially unattractive. Self-disgust, in this context, refers to feelings of repulsion directed toward one’s own physical appearance.

 

Cooperations with:

Publications:

Fink-Lamotte, J., Wehle, S., Brinkmann, F., Pelzer, M., Exner, C. & Stierle, C. (2025). Shame and disgust in patients with inflammatory skin diseases: A systematic review of psychological correlates and psychotherapeutic approaches. Frontiers in Medicine, 12.  https://doi.org/10.3389/fmed.2025.1620940

Stierle, C. & Fink-Lamotte, J. (2024). Selbstmitgefühl bei dermatologischen Erkrankungen – Ein Überblick. Dermatologie. https://doi.org/10.1007/s00105-024-05453-1

Fink-Lamotte, J., & Stierle, C. (2022). Stigmatisierung und Schamreduktion bei Hauterkrankungen. Hautnah Dermatologie, 38(2). https://doi.org/10.1007/s15012-021-6824-4

 

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

Contributions:

Brinkmann, F., Oezdemir, U., & Fink-Lamotte, J. (2024). Nasty, icky, filthy, and sticky? The role of disgust and cognitive appraisals in sexual dysfunctions. Poster wurde auf der IASR in Berlin vorgestellt werden.

Brinkmann, F., Oezdemir, U., & Fink-Lamotte, J. (2025). Trust your gut? Die Rolle von Ekel und kognitiven Bewertungen bei sexuellen Funktionsstörunge. Talk waspresented at the 4th Deutschen Psychotherapie Kongress, Berlin, Germany; April, 07 –11.