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  1. Specific Strategies to Enhance Sexual Empowerment

Specific Strategies to Enhance Sexual Empowerment

While permission-giving and psychoeducation are essential elements to addressing sexual shame, clients may also benefit from therapeutic interventions that further encourage the development of sexual empowerment. Given that sexual shame is primarily developed through the internalization of sex-negative messages, it can be especially helpful for clients to analyze their sexual shame narratives critically as they work toward envisioning a narrative of sexual empowerment. Interventions geared toward externalizing shame, exploring pleasure and desire, increasing body acceptance, and inspiring sexual creativity are essential in the journey to heal from sexual shame.

Narrative Interventions. Due to its focus on the externalization of problems and re-storying distressing narratives, narrative therapy may be a particularly useful approach for deconstructing sexual shame. Sellers’s (2017) framework of healing from religious sexual shame captures key narrative therapy concepts by working with the client to: 1) confront sexual misconceptions and stereotypes with accurate sexual health knowledge (i.e., “framing” the session); 2) embrace positive elements of sex and intimacy through claiming and celebrating meaningful sexual pleasure; 3) address feelings of secrecy and shame by sharing personal sexual narratives with the counselor and other compassionate support members; and 4) envision future goals related to sexual empowerment by considering the question, “What story do you want to write that will honor the beautiful, unique gift that is the sensual, powerful you?” (italics in orginal; Sellers, 2017, p. 111). Inviting clients to externalize their personal stories related to sexual shame empowers them to explore and deconstruct the hidden ideologies that have contributed to their sexual wellbeing and self-determine which beliefs and values are congruent with their current sexual worldview. Many clients are unaware how much of the baggage they carry with respect to sexuality are based on ideas in which they no longer agree. Identifying and illuminating these conflicts allows clients to propose sexual worldviews that are reflective of their enhanced understanding of sexuality, cultural and religious values, and future sexual wellness ambitions.

Somatic Interventions. Clients who have formed negative associations related to sex may report feeling disconnected or out-of-touch with their bodies, genitals, or other erogenous areas—body- and/or genital-shame, and sexual self-consciousness (Sanchez & Kiefer, 2007). As defined by Hartley (2004), somatic therapy is a “holistic approach to therapy and healing that embraces body, mind, and spirit within a changing social, cultural, and spiritual context” and provides a useful supplement to traditional talk therapy by inviting clients to explore the embodiment of their cognitive meanings about sex (p. 1). Examples of somatic therapy include breathing, meditation, dance/movement-based interventions, and other body-based exercises that may assist clients to integrate newfound sexual knowledge within the body, allowing for deeper exploration of the barriers that clients may experience around accessing pleasure, desire, and empowerment. An example of this is the “Mirror Acceptance” exercise, wherein clients are invited to explore and affirm the uniqueness of their bodies in the privacy of their own home. Once in a safe and private location, the client is encouraged to position a mirror that allows for them to gaze upon their unclothed body while offering positive affirmations such as “I accept myself, in this moment, just as I am” with mindful intent. This somatic intervention may also include observance of one’s genitals, with more specific affirmations about the smell, taste, and appearance of the client’s breasts, vulva, anus, penis, or testes. Clients are encouraged to develop their own personal affirming mantras in counseling to use as an anchor when negative thoughts are encountered during the exercise. It is important that counselors prepare their clients to address any feelings of discomfort, guilt, shame, and disgust that may arise during the exercise beforehand, including permission to discontinue the exercise when it no longer feels therapeutic. Somatic homework assignments including sensual self-touch, masturbation, and partnered intimacy (e.g., sensate focus) may also be used to generate self-acceptance with pleasure, desire, and eroticism.

Expressive Arts. An essential component to deconstructing sexual shame involves the client’s “practice of possibilities,” or the process of generating unique, novel, and emergent sexual meanings that serve to empower the client’s sexual wellbeing (Author, 2018, p. 169). Because negative messaging about sex can be deeply engrained in the client’s sexual self-schema, interventions involving creativity and self-expression may be particularly useful in enabling clients to re-imagine personal sexual meanings. Expressive interventions provide the client a non-verbal pathway to explore topics related to sex, allowing a process of “working through, clarifying, organizing, and expressing what is often felt and unnamed or named in ways that reduce the fullness of the experience” (Metzl, 2016, p. 6). Sexual shame and empowerment may be explored through paint, sculpture, collage, photography, music, and numerous other mediums. One example is the “Nourishing Pleasure” exercise, which is intended for established counseling relationships where the client has already been working on sexual shame-related issues. The exercise involves the client sketching or painting a portrait of their body, while imagining their body in the midst of joyful pleasure. During the sketch, the client reflects on the following questions: 1) How does pleasure nourish you? 2) Where do you feel it most profoundly? 3) What messages empower your joy? Your pleasure? Your sensuality? Through this exercise, the client can express and affirm their right to feel joyful pleasure, as well as document the empowering messages that enable their experience of joyful pleasure. The exercise may also be used to cultivate body acceptance, self-compassion, and increased awareness of sexual and erotic desires.

Group Interventions. Shame, by nature, is an emotion of isolation. Several researchers have suggested that “speak ing shame,” or sharing one’s shame experiences with others, is a pivotal aspect of shame recovery (Brown, 2006; Kyle, 2013; Sellers, 2017). Group counseling and peersupport group models have shown to be effective in reducing shame and increasing shame resiliency in diverse populations (Gilbert & Proctor, 2006; Milliken, 2008) and may be particularly suited to address the needs of clients experiencing sexual shame. Core processes involved in the group treatment of sexual shame include: 1) normalization of the existence of sexual shame, 2) mutual empathy development, 3) consciousness-raising about sociocultural norms related to sex, 4) peer support and guidance, and 5) cultivating empowerment through relational closeness (Kyle, 2013).

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