“…Virtually all traumatized patients have some degree of internalized shame (Courtois, 1992). In addition, shame is often a key component of addictions, anxiety disorders, depression, major mental illness, sexual identity or dysfunction, and personality disorders (Brown, 1988;Kaufman, 1985;Krugman, 1995;Leeds, 1997;Manfield, 1998;Nathanson, 1992;Rothbaum, 1997;Schenk & Everingham, 1995;Wernick, 1993;Wong & Cook, 1992;Zangwill, 1994). For gay men in general, shame may become over time a component of self-identity and may further be included in self-loathing, internalized homophobia, and account for a closed self-referential loop which perpetuates a hostile self-identity (e.g., ''I'm ashamed of what happened to me.…”