he began seeing told him that she loved giving hand-jobs, and encouraged him to explore creative sex with her. I can’t say that all of his emotional baggage from life with his mom vanished, but Ed’s contentment and optimism rose spectacularly, thanks to a good sex life with an understanding and caring girlfriend, and he stopped demonizing masturbation.
Considering that they are so often punished for it, sometimes by their mothers, wives or girlfriends, sometimes by clergy, sometimes by culture itself, it’s not surprising that many men struggle with emotional pain over masturbating. The culture accepts that men are highly sexed and jokes about masturbation are now as prevalent as condemnations and shaming about it. But if male masturbation gets the lion’s share of public attention, it’s because there is still an underlying belief in our culture that women aren’t fully sexual and therefore don’t need to masturbate. But we are and we do. Women just don’t seem to belabor their masturbation with the same negativity as men (and especially heterosexual men).
An interesting clinical tidbit to add some perspective: When women seek me out for help with masturbation issues, it’s usually because they want to have more or better orgasms. When men seek me out for advice about masturbation issues, they usually fear they are having too many orgasms.
I don’t believe in “too much” but I definitely believe in “using masturbation as an escape mechanism.” There is a significant difference between the two: a socially functional, healthy person may masturbate repeatedly through the day without problems. On the other hand, you could masturbate only once a day and it could still represent a problem. Sex can never be judged as an isolated event; its healthfulness is contingent on whether it fits into your life in a balanced and sane way.
Karl S., a single professional in his mid-30s, was worried that his interest in masturbation was unhealthy. After taking a full sexual history, I concurred. Karl was using masturbation as an escape from problems that were steadily looming larger, threatening his future both socially and professionally. In high school and college, Karl was a friendly, social guy who played sports with friends and went out regularly. Now he was living in an unfamiliar city and working at a high-stress job that required lots of overtime just to remain competitive. By the time he got home at night, he was worn out. He had developed a routine of logging onto the Internet while heating something for dinner, then eating while he browsed the Web for sexual entertainment. By the time he finished his meal, he was hot and bothered and completely obsessed with his on-line sexplay. When he got to a point where he needed relief, he masturbated and went to bed, only to wake up and repeat the cycle the next day. Because he was new in town and didn’t know anyone but his work colleagues, who were mostly married, on weekends he stayed in, sometimes spending all his free hours on porn and chat sites. He was spending hundreds of dollars a week on his habit, and beginning to accumulate debt paying for all the on-line sex-workers he chatted with. He was disgusted with himself — the more ashamed he felt, the more he withdrew from people. On a few occasions he got so down on himself, he called in sick to work rather than face the world — and, of course, ended up spending his days off glued to the screen, chatting with sex-workers.
The solution for Karl was to break what was becoming a very troubling and ultimately self-destructive cycle. The more he masturbated, the less he wanted to cope with the world; the poorer his skills at coping with the world, the more he wanted to masturbate to relieve the tension and numb his mind. I suggested that he revise his approach, not by going cold-turkey (which is only seldom effective) but by taking control over his behavioral patterns. As a first step, I recommended that he schedule his masturbation so that he felt he was doing it when he honestly wanted to, and not because he was avoiding his real-world responsibilities. To start, he had to budget his time and expenses for on-line adventure. To help him break the habit, he had to stop hitting the computer first thing when he got home. Going on-line would be a reward after he ate, did laundry, paid bills, or any other chores he typically avoided. Step by step, one small behavioral change at a time, Karl began to focus on the long-neglected parts of his life and imposed a schedule on his play-time, with a strict curfew every night. He began going to the gym regularly, accepted invitations from co-workers he would have blown off before, started going out on weekends, and slowly became the man he used to be. It took him almost a year, during which he backslid and broke his resolutions more than once, but gradually, he emerged from his obsessive sexual fugue and regained his self-respect.
If Karl had come to me saying he masturbated five times a day but was happy, adjusted, functioning, my approach would have been completely different. I would have told him he didn’t need therapy. It’s a myth that frequent masturbation is a gateway to sexual addiction or psychological problems. There is no evidence whatsoever that people who masturbate regularly become obsessed with it, or need more and crazier masturbation to feel satisfied. Those who have positive sexual self-esteem generally experience masturbation as a warm, fun experience and feel satisfied and complete afterwards. They can repeat the experience as often as they wish, with positive results.
On the other hand, people who are sexually conflicted are the ones at greatest risk of becoming obsessive or compulsive about masturbation. Sometimes they are simply so nervous and overwrought about their sexuality (or sexual identity) that their sexual impulses are neurotic and malformed. They may lead secret lives in which they indulge in every guilty pleasure they can imagine. They may go on binges — during which they lose all self-control — followed by purges during which they deny and punish themselves. They may have underlying stresses or compulsive tendencies that express themselves sexually (for example, my clinical experience has shown that people with Obsessive Compulsive Disorder or Attention Deficit Disorder often are OCD or ADD in their sexual behaviors as well).
In all cases, when someone spirals out of control it isn’t the fault of the masturbation itself. My clinical experience has repeatedly shown that people who feel comfortable and relaxed about touching themselves are more likely to exert sexual moderation than people who think genitals are dirty or that sexual pleasure is a sin. The more deeply sexually inhibited the client, the more likely he or she is to be compulsive and self-destructive in their sexual behaviors and fantasies.
Alfred M., a man in his mid-40s, told me he occasionally wept after masturbation because he was so disappointed in himself for giving in to his urges. Masturbation had ruined his life. To him, sex was one of life’s dirty necessities, like evacuating the bowels. He hated himself for needing to do it but grudgingly accepted that, without it, his internal tension was unbearable. Although heterosexual, he stopped dating seriously years earlier and, on the whole, avoided any form of intimacy with women. Because Alfred never got the satisfaction he needed, he lived in a near-constant state of frustration and mental anguish. By the time he finally saw a sex therapist, Alfred had grown to hate his genitals for causing him so much grief. He was contemplating castration to bring a final end to all his problems. He had found a disreputable doctor on the Internet who was willing to perform the procedure in secret. He just wanted a one-time session with me to hear my opinion.
My opinion was that he had to deal with his low self-esteem before he made the final decision to irreversibly change his life. The larger the picture I was able to develop of Alfred’s life, the more I understood the scope of his problems. His mother had been a deeply religious, stern matron, also cold, narcissistic, and verbally abusive. She punished him severely for small infractions, including whipping him with a belt and locking him in a closet. His father was a hollow shell of a man, too intimidated by his wife to help his son. When he was in high school Alfred lost control of the car he was driving, killing his high school sweetheart, a guilt he always still carried with him. Alfred grew up to be a classic underachiever, an overly polite man who was much smarter and better educated than his position in life suggested. Deep down, he was an angry, frightened, deeply wounded man, and perhaps the most difficult and challenging client I’ve worked with. I acknowledged that he was in pain, and for good reasons, but I didn’t think self-mutilation would make him feel any better about himself.
Alfred worked with me, on and off, for almost four years. At times he would vanish and I’d fear the worst but he would return again, ready to push a
