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Sexual guilt refers to a feeling of grave responsibility and deep remorse associated with participation in or even thoughts and fantasies about sexual activity. Individuals who feel guilt related to sex or particular sexual activities generally believe that sex (or a specific sex act) is immoral, sinful, or unclean. The understanding of guilt associated with sexual activities began with the work of the psychoanalyst Sigmund Freud. While many people, including many psychologists and psychiatrists, reject a Freudian approach, his ideas are of interest as a starting point for understanding sexual guilt. Freud maintained that libido, or the sexual instinct, is one of the core drives in human behavior and personality formation. From birth, a child receives messages from its parents about what are and are not acceptable ways of expressing sexual desire, as well as messages about approved or disapproved attitudes toward sexual issues. These social hindrances on the free and open expression of basic desires contribute to the formation of three distinct aspects of the human personality, according to Freud. First, there is the id, a combination of the most primitive drives and the psychic energy needed to initiate actions designed to satisfy these desires, including the desire for sex. Next, there is the ego, which refers to an executive function in the human mind that takes in information from the body's sense organs about the external world and directs the day-to-day fulfillment of sexual and other desires in socially acceptable and achievable ways. Finally, there is the superego, consisting of the learned and internalized social standards of behavior received from parents and others, including an understanding of banned or punishable behaviors. The superego is our conscience; it consists of internally held values about what is right and commendable, on the one hand, and what is wrong and condemnable on the other. Transgression of superego standards leads to guilt feelings as well as to a sense of remorse, anger directed at oneself, and a loss of self-esteem. These transgressions need not be actual behaviors, such as participation in banned sexual activities. They may occur in dreams or fantasies as well. Normally, when we are awake, the mind maintains strong boundaries between the id, ego, and superego, but during sleep and in fantasy these boundaries may weaken, allowing open expression of otherwise controlled sexual or other desires. Conscious awareness of these unrestrained desires and fantasies is another source of sexual guilt.

While Freud thought of his analysis of the forces that shape personality as universal, cross-cultural studies suggest that many of his ideas are most applicable to Western societies, especially to the Judeo-Christian tradition. Western missionaries, for example, were surprised to discover that the Japanese traditionally did not evidence much guilt associated with participation in sexual activities; rather, guilt in Japanese society was generally associated with a failure to fulfill internalized values about responsibility to one's family. This realization has led to considerable discussion of the relationship between Christianity and its emphasis on moral absolutes (e.g., sins) and the emergence of sexual guilt. The early Christian church, for example, banned sexual intercourse even among married couples during many days of the year (e.g., for 40 days before both Easter and Christmas and from the time of conception until 40 days after the birth of a child). Further, enjoyment of sex and sex for nonprocreative purposes have been condemned within this tradition (although certainly not by all Christians). Some observers have suggested that the strong restrictions placed on sex and the constant emphasis on sex as a moral shortcoming in Western culture may only have succeeded in fostering an underlying obsession with sexual objects and activities.

Some psychologists differentiate two forms of sexual guilt. The first is called "morning-after guilt", which involves conscious recognition of feeling sinful after the breach of a specific internalized value, such as having sex outside of marriage. The second type is "latent guilt", stemming from a pervasive belief that sex in general is inherently wrong or dirty. Individuals with latent guilt commonly believe that sex is personally degrading and associate it with base, animal instincts. Individuals with these values tend to view sex as an expression of lack of self-control. In such instances, a person may feel guilty even without actual involvement in sexual activities. Such a person is sometimes described as having a guilt-laden personality. This personality configuration often is associated with an inability to enjoy or consciously desire sex, lack of awareness of sexual feelings, inability to admit sexual arousal, and inability to experience orgasm, which have, in turn, been found to be common sources of problems in marriages and in other relationships. Further, latent guilt has been found to be highly associated with a diagnosis of sexual dysfunction, depression, or diverse psychosomatic illnesses.

Other negative outcomes have also been found to be associated with sexual guilt. Failure to admit or accept one's sexuality can block a person from taking precautions (such as the use of condoms) to avoid unwanted pregnancy or exposure to a sexually transmitted disease including HIV/AIDS. Consequently, individuals who have a high level of sexual guilt may be at a heightened health risk because they are emotionally unable to employ safer sex behaviors that involve taking conscious responsibility for sexual acts. Additionally, guilt-laden individuals who are victims of rape may blame themselves, and as a result be unable to report the crime to the police or to seek medical attention or emotional support. Moreover, confusion about one's sexuality and the appropriateness of sexual contact may lead some guilt-laden individuals to communicate mixed signals to potential partners. These individuals unconsciously engage in a conflicting type of sexual seduction. Giving vent to underlying sexual drives, they may seek to attract others, only to act cold and unresponsive once the other person begins to express interest. If sexual contact takes place, the event may be viewed as a major moral failure and the individual may feel revulsion or hatred toward the seduced partner. The end result of such episodes, which for some individuals becomes a regularly repeated life pattern, is enhanced sexual guilt.

If a behavior is condemned by adults, there is the potential for individuals who have engaged in that behavior, or have had similar experiences, to feel guilty. For example, if sexual play with peers, a widespread activity among preadolescent children, is believed to be wrong by adults, children who participate in such play may experience guilt. Penile erection and the onset of vaginal lubrication, normal biological processes that have several causes other than sexual stimulation, may present additional occasions of sexual guilt in children if parents blame the child or define such experiences as wrong. Masturbation, an almost universal practice among males and a very common one among females, is another potential occasion of guilt among the young. Recent studies have noted considerable levels of sexual guilt associated with masturbation among the elderly as well. In both instances, masturbation produces guilt because it is defined as an inappropriate behavior by adults or by society in general.

Some anthropologists, like Ruth Benedict, have argued that guilt is not a prominent personality characteristic in all societies. While guilt may be an important means of social control in some societies, others emphasize shame. Although these two emotional states are similar, there is one notable difference: shame involves embarrassment in the eyes of others, while guilt arises from the violation of internalized values, even if no one else knows about the transgression. Benedict argued that there are "guilt cultures" and "shame cultures." It has been suggested that certain types of child-rearing practices produce a predominance of guilt, while others lead to feelings of shame in response to the violation of social expectations.

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