The judgment and withdrawal of masturbation addiction (or compulsive sexual behavior disorder, CSBD) need to be handled with caution, because it involves physiological, psychological and social factors.
There is no global unified diagnostic standard, but the following characteristics may indicate that attention is needed:
1. Too high frequency of behavior
• Beyond personal comfort range: frequent masturbation (such as multiple times a day) leads to physical fatigue, genital pain or urinary pain.
• Interference with daily life: masturbation delays work, study, social or important responsibilities.
2. Psychological dependence and sense of loss of control
• Impulse is difficult to suppress: Even with negative consequences (such as guilt, anxiety), the desire to masturbate cannot be controlled.
• Escapism: Escape from stress, emotional problems or interpersonal conflicts through masturbation.
3. Functional impairment
• Decreased sexual function: Erectile dysfunction, dulled pleasure or inability to satisfy during sexual intercourse due to excessive stimulation
• Damage to interpersonal relationships: Concealment behavior triggers suspicion from partners, or frequent solitude reduces social interaction.
4. Withdrawal reaction
• Anxiety, irritability or depression occur when trying to reduce the frequency, and even other high-risk behaviors (such as drug abuse) are substituted.
1. DSM•5 diagnostic reference
• Compulsive sexual behavior disorder (CSBD) must meet the following conditions (needs to be evaluated by a psychiatrist):
• Recurrent sexual behaviors (masturbation, sexual intercourse, etc.), the frequency and intensity of which significantly exceed the norm in the social and cultural context.
• The behavior causes significant pain or functional impairment.
• The behavior is not directly caused by drugs or diseases (such as mania).
2. Physiological mechanism
• Dopamine reward system disorder: high-frequency stimulation may strengthen the desire for sexual impulses, similar to the neuroadaptive changes of substance addiction.
1. Self-regulation stage
• Set clear goals:
• Gradually reduce the frequency (such as from 5 times a day to 2 times a week) rather than abruptly quit to prevent rebound.
• Alternative activities:
• Replace the urge to masturbate with exercise, reading, artistic creation, etc.
• Record a behavior log: record masturbation time, triggers and emotional state, identify triggers and develop a response plan.
2. Psychological treatment
• Cognitive behavioral therapy (CBT):
• Correct the wrong belief that "stress must be relieved through masturbation".
• Use "thought blocking method" to interrupt the urge to masturbate (such as pinching wrists, counting loudly).
• Mindfulness therapy: Improve awareness of current feelings through meditation and reduce impulsive behavior.
3. Social support and family intervention
• Frank communication: Share troubles with trusted partners or friends to get emotional support.
• Family therapy: If it involves relationship problems, both parties need to participate in the therapy together to rebuild trust.
4. Medical intervention
• Drug therapy:
• Tricyclic antidepressants (such as clomipramine) or selective 5•HT reuptake inhibitors (SSRIs) can reduce the frequency of compulsive behavior (doctor's guidance is required).
• Physical therapy: Experimental treatments such as transcranial magnetic stimulation (TMS) may regulate the brain's reward circuit.
1. Avoid stigmatization
• Masturbation addiction is not a moral defect, but a health problem that needs treatment.
• Avoid increasing the psychological burden through "abstinence punishment".
2. Gradual progress
• Withdrawal reactions (such as insomnia and irritability) may occur in the early stage of withdrawal, which is normal and can be alleviated through gradual adaptation.
3. Prevent relapse
• Long-term monitoring: Regularly evaluate behavioral patterns after withdrawal to avoid returning to high frequency.
• Stress management: Learn healthy emotion regulation techniques (such as deep breathing and yoga).
