Too Much and Not Enough: Building Self Compassion with Shame's Final Boss (Sex Therapists)

By Caitlin Bovard, LPC, Certified Couples Therapist, Dual-Certified Sex Therapist (AASECT CST) offering online sex therapy for individuals, couples and partners in Colorado

If you constantly feel like you're not good enough, always apologizing, or questioning your worth in relationships, you're not just being dramatic or overly sensitive. You may be stuck in a shame-guilt cycle that’s impacting your confidence, your communication, and your ability to feel safe in your own skin.

This pattern is incredibly common and often invisible from the outside. It can affect how you show up in your friendships, romantic relationships, sex life, and even your work. Whether or not you’ve been diagnosed with ADHD or experienced trauma, shame and guilt can quietly shape the story you tell yourself about who you are and what you deserve.

In this post, we’ll explore what shame and guilt really are, how they influence your self-esteem, and how these experiences can show up for adults with ADHD or those seeking sex therapy support. You’ll also find practical insights for building self-compassion and feeling more confident and whole again.

Guilt vs. Shame: What’s the Difference and Why It Matters

It’s common to confuse guilt and shame, but understanding the difference is crucial to emotional healing. According to the NICABM (National Institute for the Clinical Application of Behavioral Medicine) framework, guilt and shame are two distinct emotional experiences with very different impacts on your mental health and self-worth.

Here’s a breakdown:

• Guilt is about something you did. It’s usually tied to a specific behavior or choice. For example: “I forgot my friend’s birthday and I feel bad about it.” Guilt can be helpful when it motivates repair or change.

• Shame is about who you are. It’s not just “I made a mistake,” but “I am a mistake.” Shame tends to lead to isolation, avoidance, and long-term damage to self-esteem.

But there’s also a third category that often goes unnoticed: unhelpful guilt.

What Is Unhelpful Guilt?

Unhelpful guilt is guilt that lingers even when you haven’t done something wrong, or when you’ve already made amends. It often comes from unrealistic expectations, internalized criticism, or anxiety around disappointing others.

Unhelpful guilt might sound like:

• “I didn’t respond fast enough. They must be mad at me.”

• “I took a day off. I feel lazy and selfish.”

• “I said no to something, and now I feel guilty for having boundaries.”

For adults with ADHD, unhelpful guilt can become a constant background noise. You may feel guilty for being “too much,” for needing reminders, for having emotional ups and downs, or for simply existing differently. A way this shows up in my practice frequently is when those with some vectors of privilege using that privilege to shame themselves. It's one thing to be aware and process how privilege has benefited you (which is crucial work to be done by all), it's another thing to punish yourself emotionally for having advantages others don't have. That’s not helpful guilt. That’s internalized shame in disguise.

Guilt, Shame, and Self-Support: A Practical Table

Use this table as a quick reference when you're feeling overwhelmed by guilt or shame. It helps you identify what you're experiencing and how to respond with more clarity and care.

Emotion	What It Sounds Like	What It Feels Like	How to Support Yourself
Helpful Guilt	"I made a mistake and want to make it right."	Motivated, regretful, open to change	Reflect on values, apologize or repair if needed, learn from it
Unhelpful Guilt	"I didn’t do enough, even though I tried my best."	Anxious, stuck, overly self-critical	Check if your guilt is realistic. Use self-talk and boundaries.
Shame	"I’m the problem. I always mess things up."	Heavy, isolating, hopeless	Name the shame. Use self-compassion. Reach out for support.

This kind of self-awareness is a key part of therapy. Whether you're managing ADHD, navigating intimacy, or simply feeling overwhelmed by high expectations, learning to recognize these patterns can help you move from self-blame to self-understanding.

Shame, Guilt, and Self-Esteem: How It All Connects

Self-esteem refers to the way we see and value ourselves. When we carry unresolved shame, our self-esteem often becomes conditional. You might believe you are only worthy when you are productive, liked, sexually desirable, or emotionally easy to deal with.

Shame can cause:

• Difficulty trusting others or receiving compliments

• Fear of rejection or abandonment

• Emotional avoidance or people-pleasing behaviors

• Chronic self-criticism or perfectionism

• A sense that you are "too much" or "not enough"

These patterns can be especially powerful in intimate or sexual relationships, where vulnerability is high and self-perception is often magnified.

If you’ve read our recent blog post on adult friendships and the "liking gap," you know that many people underestimate how much others enjoy their company. That same internal narrative can carry over into how we view ourselves in every area of life, especially when it comes to intimacy and identity.

How Shame and Guilt Affect Adults with ADHD

Adults with ADHD often grow up hearing that they are too loud, too forgetful, too emotional, or too disorganized. Over time, these repeated messages may turn into internalized shame. Instead of thinking, “I forgot my appointment,” you may think, “I’m irresponsible. I’ll never get it together.”

Because ADHD is often misunderstood or overlooked, especially in women and marginalized groups, many adults carry an invisible emotional burden that others cannot see. This includes:

• Constantly apologizing or overexplaining

• Hiding symptoms or masking to seem “normal”

• Feeling intense guilt for missed deadlines, forgotten messages, or impulsive reactions

• Struggling with emotional regulation and then feeling ashamed for having a “meltdown”

ADHD also intensifies Rejection Sensitivity Dysphoria (RSD), which can make even small miscommunications feel like devastating personal attacks. When you’re constantly bracing for rejection, shame becomes a survival strategy.

If this sounds familiar, working with a therapist who understands both ADHD and shame dynamics can be life-changing. In therapy, we explore not just behavior management but identity repair. You are not broken. You are a person who deserves kindness, connection, and tools that fit your brain.

How Sexual Shame Impacts Sexuality and Intimacy

Shame thrives in silence, and nowhere is this more true than in our sex lives. If you struggle with sexual self-esteem, fear of intimacy, or difficulty communicating your needs in relationships, shame is often part of the story.

In sex therapy, we often explore:

• Vague or specific feelings of being broken, dirty, pathetic, perverted, that something is just inherently wrong with you even if you can't put your finger on what it is exactly

• Shame around sexual desire (too much, too little, or too specific)

• Anxiety about being seen or touched

• Guilt around past choices or experiences

• Difficulty trusting partners or feeling safe during intimacy

• Disconnect from your own pleasure or body

For people with ADHD, these struggles may be magnified. Sensory sensitivity, difficulty initiating or staying present during sex, or feeling overwhelmed in emotionally intense moments can all lead to a buildup of sexual shame. You may avoid intimacy altogether or feel like you're always getting it "wrong."

Sex therapy offers a safe, affirming space to explore these experiences without judgment. It is not just about sex. It is about rebuilding trust in yourself and your body.

Healing Through Self-Compassion

Whether you are navigating shame from ADHD-related struggles, sexual trauma, relationship wounds, or simply years of being too hard on yourself, the path to healing often begins with self-compassion.

Self-compassion is the practice of being kind to yourself, even when you mess up. It does not mean avoiding accountability. It means holding yourself with care and curiosity instead of punishment.

In therapy, we work to:

• Identify shame triggers and interrupt the inner critic

• Replace black-and-white thinking with more flexible narratives

• Explore body-based techniques to regulate emotions and reconnect with your needs

• Create realistic coping strategies that support your brain and nervous system

• Build relational skills that help you ask for what you need, set boundaries, and receive care ("No is a complete sentence" -- maybe not grammatically correct but still true!)

Self-compassion is not just a practice. It is a radical reorientation of how you relate to yourself and your world. It is the foundation of confidence, resilience, and intimacy.

Ready to Break the Shame Cycle and be Free from Sneaky Shame Sprials?

You do not need to be fixed. You need to be supported.

Whether you are navigating ADHD, sexual shame, relational trauma, or low self-esteem, therapy can help you move from self-doubt to self-trust. In my online Colorado-based sex therapy practice, I work with individuals and couples to unpack shame, build self-compassion, and reconnect with their most authentic selves.

Book a free phone consultation today.

You deserve to feel confident in your relationships, your body, and your mind.

Just a heads up: This blog is for informational purposes only and isn’t meant to be taken as medical or mental health advice or treatment. Always talk with a licensed provider about your specific situation and reach out to emergency services if in crisis.