Reading Assignment

Self-Directed Disgust: Reciprocal Relationships with Sex and Sexual Dysfunction

Peter J. de Jong & Charmaine Borg , 2015

by
Eni Maria Sisca
Supervisor
Tjahjo Djojo Tanojo, dr, MS, Sp.And (K)

PPDS-1 ANDROLOGI
FK UNAIR/RSUD dr. SOETOMO
2021
 Introduction
• Contemporary models of sexual behaviour propose sexual response
‒ sexual excitatory and
‒ sexual inhibitory processes
• Strong inhibitory tendencies interfere with having pleasurable sex  rise
sexual problems:
‒ depression,
‒ anxiety and
‒ negative self-evaluative processes.
 Introduction
• Disgust and disgust-related preoccupations inhibitory tendencies in
sexual contexts.
• Disgust has received only scant attention in the ‘sex’ literature
• (self-)disgust and sexual behaviours are still awaiting empirical scrutiny
 Disgust, Self-Disgust, and Sexual Behaviour
Variation stimuli that lead people to become disgust
Disgusting stimuli seems to cluster in three coherent domains of disgust: pathogen disgust,
sexual disgust, and moral disgust
 Disgust subtype and its corresponding adaptive problem.

Pathogen: disease avoidance

-subjective experience of disgust

-function to prevent contamination by pathogens
-a distinct facial expression

Example:
- Stimuli such as body products and spoiled foods that
are implicated in an increased risk of infectious diseases.
- Wiping off the semen from their body, or take a shower
immediately following sexual intercoursethese types of
“neutralizing”behaviours may also affect their partner
(interpret such cleaning behaviour as a rejection)
 Disgust subtype and its corresponding
adaptive problem.
Pathogen: disease avoidance
Example:
-disgust may elicit retching during kissing or oral sex
- flinching of the pelvic floor muscles during attempts at sexual
intercourse.
-These types of defensive reflexes may not only interfere with
pleasurable sex but may also be experienced as a sign of
rejection, thereby triggering negative self-evaluative appraisals
(including self-disgust) in the sex-partner
 Disgust subtype and its corresponding adaptive problem.

Sexual disgust subtype:

This type of disgust does not refer to any disgust that may arise during sex, but
specifically refers to disgust elicited by potential sexual mates

Example:
1. High genetic similarity prevent having sex
2. intrinsic quality as reflected in their physical appearance
(Body assimetris)
3. Accident, illness, or surgical intervention such as stoma
surgery (physical features)
Disgust subtype and its corresponding adaptive problem.

Sexual disgust subtype:

facilitate avoidance of sexual partners

challenge long-term reproductive success

Disgust subtype and its corresponding adaptive problem.

Moral Disgust subtype:

Safeguard the integrity of important social norms and social

structures.

Individual’s adherence to strict moral rules concerning sexual

behavioursindividuals’subsequent emotional responding
toward particular sexual behaviours
 Disgust subtype and its corresponding
adaptive problem.
Moral Disgust subtype

- The experience of moral disgust may bolster already internalized

socio-moral rules prevent the occurrence of future infringements
-The experience of disgust may, as with shame and embarrassment, help
people stay on the allotted path
-This more ideational type of disgust may also be elicited by sexual
behaviours that violate important and strongly ingrained socio-moral
rules
Self-disgust.

11
 Pollution of the self
 Two different pathways may give rise to self-disgust following sexual assaults;
- 1st, being sexually molested might elicit a discrepancy between the ideal-self and the
actual self
- 2nd, a discrepancy between the ideal self and the actual self may arise when the victim
starts thinking that she or he should and could have done more to prevent the molest,
- Example:
- Self disgust may arise if a body part that is very central to the sexual self (e.g.,
vagina, breasts, penis, scrotum, etc.) is damaged following disease or surgical
interventions.
- self-directed disgust may also arise when critical body-parts are otherwise not in line
with the ideal/core-self. For example, when having male genitals (a penis), yet
actually experiencing the core-self as being a woman

12
 Low mating quality attributed to self
A person’s physical appearance (e.g., extreme obesity, physical deformation due to
accident or surgery) may not only elicit disgust in potential sex partners but may
also give rise to self-disgust, fuelled by the implied low mating quality attributed to
the self.

Example:
If a person finds out that his/her partner has systematically cheated on him/her with
another person, this may be taken as a signal that the person is no longer considered
as someone with sufficient mating quality.
To the extent that one’s mating quality is an important feature of the core-self, this
may give rise to self-disgust in a way to distance oneself from this
damaged/shattered part of the ideal-self.
 Unacceptable thoughts or behaviours
 Transgressions of one’s own norms  disgust directed at the self
 If the transgression concerns a core-value, it can cause the person to feel self-repugnant and may elicit
the urge to wash (Rachman et al., 2012).
 Betraying partner might be one of the behaviours that may thus generate feelings of self-disgust.
 The moral type of self-disgust  the result of repeated/persistent thoughts or fantasies that are in
strong conflict with one’s own core-values

*Movie ‘A Late Quartet’ Robert has a one-night-stand with a beautiful womanhe

goes instantly to have an intense shower, to wash off his feelings of self-disgust. Robert’s
behaviour could be perceived as if he was washing off his ‘dirt’, the (self) disgust he felt
towards his own behaviour
*Self-disgust may arise when having repeated fantasies about having sex with children.
Persistent fantasies about homosexual contacts might give rise to self-disgust in people for
whom homosexuality is fully unacceptable.
 Unacceptable thoughts or behaviours
 Various types of disgust often present themselves in a blended form combination
of pathogen and moral based feelings of dirtiness.
 Example: feelings of disgust became especially prominent when she realised that
this undesired marriage violated the core value that one should marry for love not
money.
 Self-Disgust as a Pathway to Sexual Problems

Interrelationships between disgust and sexual arousal.

 If people encounter a sex-relevant stimulus both sexual arousal and (self)
disgust, the experience of disgust will motivate avoidance of the sexual
stimulus and inhibit sexual arousal.
 Elicited sexual arousal facilitates approach behaviour and may inhibit the
tendency to experience disgust.
 Disgust
Sexual respons

Sexual
arousal

Negative loop
 Sexual
arousal
Sexual respons

Disgust

Positive loop
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Self-Disgust as a Pathway to Sexual Problems
Self-Disgust as a Pathway to Sexual Problems
(Self-directed) disgust e.g., “how could I have
Sexual arousal <</-
●

done that, I am a dirty person/disgusting person

Post Arousal The goal keeping away from contamination

●

of the self might have been compromised

• minimize the intrinsic feeling of dirtiness e.g., brushing

teeth after oral sex, showering, etc.
Neutralizing compensatory
behaviour
 Self-Disgust as a Pathway to Sexual Problems

Gener
sexual arousal counteract all kinds of mechanisms that

moral contamin
otherwise promote avoidance of particular sexual behaviours
or stimuli:

borders ation risk al

having sex
●
condo
● ●
General
with a 12
year old m use repulsion
Conse ●
continues to feel dirty
(and perhaps also

quent shameful/guilty);

Consequ if the person has either a strong moral

●

ent more code or a highly religious devotion that

frame specific sexual behaviours as
less appropriate or even sinful

intense
 Sexual
Dysfuncti
Bodily on
feartures Ex:
(one’s vaginismu
Direct core-self: s
disgust vagina dispareun
-penis) i
Patient describe: vagina as being a tangle of folds, slime and secretions, it is ugly and cannot be kept
clean; it stinks although I am too far off to actually smell it myself; when I had the infection it also
smelled very badly
In this level that this person started avoiding sexual initiation or sexual contact
altogether.

A series of prolonged exposure exercises with response prevention (to counteract these strong
avoidance tendencies), appeared highly successful in breaking disgust and to alleviate the symptoms
of sexual pain
 Self-Disgust and Sexual Functioning: preliminary data

General self SELF DISGUST

Appearance Behavior SCALE
concept (12 statement)
Self-Disgust and Sexual Functioning: preliminary data

Over the past 4 weeks, how

FSFI satisfied were you with your ability
Female sexual
Functioning to reach orgasm (climax) during
index
sexual activity or intercourse?
Self-Disgust and Sexual Functioning: preliminary data

Are there 3 weeks in

which you did not
GRISS have sex at all?
 In men…
• Disgust directed towards the self the insecurities surrounding the man’s erection, and be in
itself a risk factor for premature ejaculation,
• Increases the gap between the desired self (of being a good sex-mate) and the actual self (with
premature ejaculation, inadequate etc.).
 In woman…
» Feel inclined to avoid any sexual contact altogether (e.g., in women with
genito-pelvic pain/penetration disorders) result of compensatory
behaviour:
– low desire (e.g. low mental sexual arousal, no strong wish to have sex)
» feels shameful or guilty that she cannot fulfil the role of a married woman
(especially in extreme religious cultures)
» Self disgust might become even more emphasized (as an extension of moral
and or sexual disgust)
 Recapitulation

Self-disgust may either arise from:

(i) Being polluted by other people’s violations of the self (e.g.,
being sexually misused),
(ii) Internalization of (assumed) social evaluative appraisals of
key aspects of the self (“I can never be a proper sex mate”),
(iii) down behaviours/thoughts that violate important values of
the self (“it cannot be me who had sex with this child”)
 Clinical Implication

For all pathway, self

disgust..

to preserve the
integrity of the
desecrated,
unworthy, core-self.
deplorable
aspects of
discrepancy the self
between ideal self
and actual self
 Clinical Implication:

Helpful for starting

point to
interv ention

type of self-
discrepancy

Knowledge about the

different types of
self-disgust
 Clinical Implications,

• Persistent dyspareunia is not so much driven by a phobic fear

of pain, but is essentially due to sex-triggered self-disgust
• The understanding of how/why a common intervention that
focuses on fear of pain is not effective in some cases.
 Remaining issue

• validity of the categories of self disgust,

• To test types of experiences can indeed be seen as category
specific triggers.
Terima kasih
PE,DE and Psychological disorders
PE, DE and Psychological disorders