Understanding Compulsive Masturbation

By Robert Weiss, LCSW, CSAT

Of all the types of sexual acting out, compulsive masturbation is one of the most secret and isolative. The man or women who compulsively masturbates with or without the use of porn is often the last to seek help, often not seeing or understanding their behavior as problematic. Their hidden behavior is often related to past trauma, familial societal, or religious shame associated with the sex act and intimacy. Many clients report that their internal beliefs about masturbation are that the act itself is “dirty,” “shameful,” or “sinful.”While most sex addicts actively seek treatment when they pushed by some obvious external consequence of the legal, occupational, health, or relational type, the solitary nature of the compulsive masturbator’s behavior leaves his or her actions less subject to the direct consequences of other forms of sexual acting out. The sex addict engaging in compulsive masturbation more often seeks help for anxiety, obsession, isolation, and the inability to seek or maintain healthy intimate relationships. Some compulsive masturbators do experience consequences through the viewing of inappropriate materials (e.g., child pornography), through masturbating in inappropriate places (e.g., the workplace or an automobile), or due to self-injury. However, the most frequent consequence of compulsive masturbation is a life devoid of intimacy, removed from feeling, and filled with hidden shame.

Compulsive masturbation itself this can take place in differing forms. For example, there are women who masturbate daily as a part of their “morning or evening routine.” Jennifer, in treatment for her problems with both sex addiction and early trauma, has the following to say about her experiences:

Looking back now I can see that before I started working on this I had huge denial about how compulsive and driven an experience masturbation was in my life. Because the behavior itself was so built into my routines and I saw it like washing my hands or brushing my teeth I never thought of it as something that could interfere with my attempts at sexual relationships or self-esteem as a woman. My association with masturbation was simple. Every morning when I showered I masturbated to fantasy and every night before I went to sleep I masturbated to porn to help me relax. I never questioned it and at 37 years old I had a 22-year history of this behavior before I got into treatment and was asked the question by my therapist, “How often do you masturbate and why do you choose to masturbate when you do?” Choose? I never chose. Masturbation is just what I did.

Interestingly, Jennifer did not come into treatment seeking help for a problem with masturbation. She actually entered treatment to eliminate having multiple sexual affairs and resolve ongoing challenges with romantic commitment. She had long wanted to get married and have a family and was concluding from her experiences that she was unable to create that. It was only during the course of her initial treatment assessment that the questions regarding masturbation were posed and she was forced to consider changing this life-long behavior pattern.

While some like Jennifer compulsively masturbate in a brief, routine fashion, others can act more as binge masturbators. They may find themselves spending hours at a time “lost” in fantasy, porn use, and masturbation. Likely responding to some strong internal, intolerable stressor or emotion combined with an external identifiable trigger or stimulus (like a disagreement or hurt), this type of compulsive masturbator can lose hours or even days to online and offline porn with or without drug use and masturbation. They can literally lock themselves up at home, or in motel rooms, and disappear into their masturbatory escape.

This type of behavior may result in genital injury due to the amount of time and energy devoted to the masturbation. While usually the injury and pain is not sought for pleasure, the binge compulsive masturbator will not use physical damage as a guide toward stopping or self-care. Instead they will likely continue their sexual activity, even hurting themselves further and bringing about more shame.

Treatment for Compulsive Masturbation

Treatment and recovery for compulsive masturbation can be a complex process. It is essential for anyone who compulsively masturbates to get a thorough psychiatric assessment because some people’s masturbation concerns are driven by underlying issues (e.g., Obsessive Compulsive Disorder and/or Anxiety Disorders) that would require a different format for treatment. The most commonly prescribed first step in treatment involves an abstinence agreement, which is a prescribed period of no sexual activity with self or others, no viewing of pornography, no chat room visits, affairs, or related activities.

The primary goal of the sexual abstinence is to give the fear, anxiety, pain, and shame that the client has been avoiding the opportunity to surface. It is in this place of awareness that someone can often for the first time begin to glimpse the feelings, emotions, and thoughts they have sought escape by engaging in ritualized fantasy.

During this period it is important to be in therapy and 12-step or faith-based groups to get as much support as possible for any unexpected feelings that may arise. The compulsive masturbator has to be on the lookout for any other potentially additive behavior to surface, such as drug abuse, eating disorders, spending, or related, problematic distractions. Most importantly, the addict needs to have hope for a future that will include healthy intimacy and healthy sexuality. They need to see that over time they can live with dignity and self-respect.