You make some good points, I'll add some stuff to my game with these ideas as a way of threatening / control
Can you tell me what you mean by CBT as a mechanic? Like, if damaged your player has trouble moving? Or something different
I will put a disclaimer to not emulate the game IRL
Well, for example, in a game like femdom university zero, there's a mechanic for energy, hunger and willpower, but they could have also implemented another metric for pain. Like if the MC gets hit in the balls, that would cause a certain level of immediate pain, which would diminish over time as the MC heals. At the very least some lasting discomfort. This could negatively affect tasks or conversations, which would then end up putting him in worse positions.
You could also say, for example, have some kind of "libido" meter where every time the MC suffers some cbt, his libido is lowered. This would effectively make it so that the more hits the MC takes, the less he is able to "perform" with women, further snowballing the MC into a position of defamation or humiliation. This could allow players some control into how "dominant" or "submissive" their experience is, based on how often they take hits.
You could also simplify that with something like, for example, having it so that if your character takes a hit from a woman in one scene, then he would be locked out of certain dialogue choices or introduce new ones in the next scene. Or if he takes a hard enough hit, or enough hits, he gets sent to an infirmary and that introduces new scenes. Maybe a female character notices some swelling or bruises, and that alters a conversation.
You could also have some kind of health or status bar where, every time you take a hit, the state of your balls is negatively affected. This could lead to something like an increase in damage taken from subsequent hits, an increased chance of rupture or even loss for the MC(this could result in a game over state, a change in how the MC is treated or a whole new route for the game).
You could also have some kind of social status/respect meter, and every time the MC suffers any kind of cbt, his social status is lowered because of it, as more and more women lose respect for the guy that all the other women are brutalizing.
You could have it so that every time the MC suffers some cbt, he loses some willpower, he could be slowed down a little, he could gain a certain amount of "fear", or he could develop a new fetish for cbt over time, which could then alter the way other cbt scenes play out.
Another could be if the MC has some kind of pain tolerance perk or toughness perk, he could maintain composure to a higher level of torture, which could change the outcome of a scene.
Those are just random ideas at the top of my head. I'm sure there's more that other devs could come up with. I would love to get more involved in some development myself but a project like that seems pretty daunting.