The Truth About Sex A Sex Primer for the 21st Century Volume I: Sex and the Self. Gloria G. Brame

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 little further. Working at his pace, I helped him to see that disfigurement was not the solution to emotional conflicts about sex. There were no miracles for Alfred but after three years, he was finally able to find some good things in his life and in himself. Most importantly, he had stopped blaming all his miseries in life on his masturbation and genitals and was now trying to improve himself on several fronts: going to the gym, tentatively dating, and going back to school so he could get a better job.

      Anxiety about sex can radically influence a person’s life. Exactly how it will play out varies according to individual psychology and circumstances. I’ve seen a thousand permutations in my practice. I’ve worked with troubled people who became compulsively promiscuous or led secret double lives — one in which they act and appear completely ordinary, and another where they engage in risky sexual adventures with strangers. I’ve seen the other extreme, where someone vows to be abstinent because sex feels too complicated and not satisfying enough to make it worth the anguish.

      As I occasionally tell clients, “Anxiety is the opposite of sexy.” Emotional conflicts thwart a range of sexual responses, from blocking our ability to get aroused to impacting our performance with partners. I believe this concept reaches right into our biology. I think of negative emotions — guilt, fear, shame, disgust, internal conflict — as a massive organic filter through which sexual responses must pass. The more intense those feelings, the more difficult it is for the body and brain to function in harmony. The “happy” brain chemistry of sex is fighting the chemicals released by stress. Muscles which should be relaxing are tensing. Whereas people who are relaxed are assisting their brain in doing its sexual business, people who can’t relax are ultimately most likely to be left feeling unsatisfied. It may even cause some of them to crave more and more intensity or experiences just to achieve a simulacrum of the pleasure that balanced people derive from sex. It has been the rule, not the exception, in my clinical practice that the people who make the most disturbingly risky, unhealthy behavioral choices are invariably the ones who are at psychological war in their minds over their sexual identity. They are also the ones who seem to have the most issues and complexes about masturbation, and similarly seem to get the least pleasure out of the act.

      In emotionally balanced, socially-adjusted and reasonably physically healthy people, there really is no upper limit on the number of times a day one may safely masturbate. The time to stop is when it stops feeling good; if your genitals start to feel raw, if it’s exhausting you, it’s common sense to give yourself some time to recover before doing it again. Most typically, high frequency of masturbation simply means a strong sex drive and a robust appetite. On the other hand, if masturbation interferes with or diminishes the quality of your daily life — your ability to socialize, your ability to have intimacy, your ability to focus on work — then it stops being a harmless pleasure and becomes a potentially self-destructive behavior pattern. But the biggest health risk factor related to masturbation seems to be when you do NOT masturbate. Given all the proven benefits of orgasm, failure to masturbate during times when you don’t have a partner may reduce your lifespan, speed up your aging process, and contribute to a range of health problems, including