Prescribed masturbation in sex therapy: A critique

Abstract

The goal of this paper is to show from an interactional or systemic perspective how intimacy may be damaged through traditional sex therapy approaches. This is in opposition to stated claims by sex therapists, who have, since the pioneering work of Masters and Johnson, sought to improve intimacy by removing the impediment of poor sexual response. Prescribed masturbation in sex therapy is identified as particularly problematic in its potential for iatrogenic effects. These potentials are demonstrated from a relational perspective and from a functional perspective. Prescribed masturbation, intended to narrow the focus of attention from the "distraction" of a partner's response, may actually serve to further damage the openness and trust necessary for truly rewarding sexual expression. Difficulties in a relationship that preclude the trust necessary for open sexual interaction ought to be addressed before any sexual activity is prescribed. If clinicians' work circumvents the interactional component of the dysfunction, they may be guilty of colluding with clients in protecting them from intimacy. Recommended alternatives for clinicians are offered.

The Role of Masturbation in Healthy Sexual Development: Perceptions of Young Adults

“…Masturbation has been recommended by sexologists as a way for women to learn about their bodies and preferences, improve their body image, and improve their familiarity with their genitalia (McCormick, 1994). While large-scale promotion of masturbation has certainly not entered the mainstream of sexuality education, the use of prescribed masturbation in sexual therapy is not uncommon (Christensen, 1995). Sexual therapists have used masturbation to increase a person's understanding of their own sexual response.…”

Towards a Feminist Sex Therapy

“…Interestingly, a recent critique of the use of masturbation in sex therapy argued that the self-focus of masturbation is detrimental to intimacy, ''bypasses'' issues of emotional connection, prevents important collaborative sexual learning, and may even lead to sexual ''addiction'' (Christensen, 1995)! To no one's surprise, this article made no reference whatsoever to gender, as if the use of masturbation education in sex therapy were irrelevant to gender realities and politics.…”

“Standard Operating Procedures for Female Orgasmic Disorder” is not Based on Best Evidence

“…Other studies also showed that women's intercourse orgasm is inversely related to masturbation frequency [3,20], and that vaginal orgasm is associated with having one's first ever orgasm from intercourse rather than from masturbation (and vaginal orgasm is not correlated with orgasm from cunnilingus or partner masturbation) [3]. In promoting masturbation as the treatment for FOD, Laan et al [1] make no mention of possible adverse effects of prescribing masturbation [44], including the association of masturbation (in multivariate analyses controlling for other sexual activities) with greater risk of female sexual arousal disorder [11], and with lesser sexual, relationship, and life satisfaction [25], among other adversities [27,45]. Of note, the aforementioned prolactin study provides experimental evidence of central physiological processes that might underlie some differences between masturbation and intercourse orgasm [33].…”