Intended for healthcare professionals

Views & Reviews Review of the Week

Showing the unspeakable

BMJ 2012; 344 doi: (Published 25 January 2012) Cite this as: BMJ 2012;344:e619
  1. Sandy Goldbeck-Wood, associate specialist in psychosexual medicine, Camden and Islington Mental Health NHS Trust, London
  1. goldbeckwood{at}

Despite the hype, Shame isn’t really a film about sex at all, writes Sandy Goldbeck-Wood. Instead, in inviting its audience to look under the surface of behaviours, it is a powerful reminder of the consulting room

Shame was trailed as a film about sex addiction. That made me curious: in around seven years as a practitioner of psychosexual medicine, latterly in a demographically diverse central London clinic, I couldn’t recall a single patient I thought of by this diagnosis. I remembered people distressed by their own, or their partner’s, use of pornography, or prostitutes (or work or alcohol) as an alternative to intimacy. I remember people struggling to connect with their partner sexually because of the specificity or unusualness of their preferences (so-called paraphilias). I remember fractious differences in libido between partners, often masking anger or pain; people unable to have sex in a loving relationship; people who viewed their genitals as dangerous or dirty; and people driven to harm themselves in grotesque ways. But none lives in my memory as a “sex …

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