Now, I'm not a therapist *I hate therapists actually* but I think I can help. Living with a pathological liar with supernatural abilities of manipulation and denial, I have some insight on how people tick. -_-
This may seem unrelated, but from what I've read you've had a lot of issues/crisis throughout your life. I may not be qualified, but I want to help, so answer me this:
When ever you fail at something, or don't do your best, what do you tell yourself?
When something like being rejected happens, what do you tell yourself?
How do you feel when you satiate your fetishes? For example, what kinds of thoughts go through your mind?
You don't have to answer anything if you feel uncomfortable about it, you can answer through PM or not at all.
A serious problem I have is procrastination (way unrelated, but I have a point). I don't procrastinate because I'm too lazy or anything similar to do the work. The problem, is I'm a perfectionist. When I have to do something, I expect from myself perfect results. Looking even deeper into the problem, I live by this equation - (Self worth = performance). I'm afraid that I won't be able to do perfectly or even decent on whatever I work on. If something I do is judged as average I feel even worse than the guy that just failed. So what I do, is I procrastinate, which creates what my mind perceives as a life or death situation which forces me to do the work and I don't worry about the outcome because with those circumstances there's no way I could have done my best, which breaks the equation of (Self worth = performance). Kinda like this - there's two buildings and a thin board connecting the two. I have to cross, and I want to cross the board perfectly without falling, but I'm afraid I can't so I just stand there. Now light the building on fire. I've GOT to cross and I don't really care how I cross, no matter how awkward, as long as I get to the other side.
Now, what I said may seem like I went off on a tangent, but my point is that sometimes things we say to ourselves can subconsciously cause us to do things we don't want to do.