The Medical, Sociological, Psychological, Religious, and Spiritual Aspects of Masturbation and a Potential Approach to Therapy Based on Catholic Teaching and Virtues Psychology

Abstract

Masturbation is common and generally accepted in Western society as a normal, healthy activity. In contrast, the Catholic Church holds that masturbation is immoral. Noting that the human person is a profound unity of body and spirit, if the Church is correct, masturbation should have negative effects on the human person. If the secular view is correct, masturbation should have conversely positive effects. This paper is divided into three parts. An in-depth literature survey was performed to evaluate the physical, medical, psychological, sociological and spiritual correlates of masturbation. The second part is a theological summary of the Catholic understanding of masturbation. The third part is an approach to therapy. Physically, masturbation was found to be less sexually satisfying than intercourse. Medical complications include penile injury and self-asphyxial behavior. Psychologically, masturbation was found to be associated with depression, anxiety, immature defenses, hypersexuality, guilt, poor body self-image and stress in the workplace. Sociologically most studies indicate a negative correlation between masturbation and relationship satisfaction, quality, intimacy, relational happiness, emotional satisfaction with the partner, trust, passion, and love. Spiritually, masturbation is highly positively correlated with pornography consumption and negatively with religion and religiosity. There is a higher rate of masturbation in homosexuals and bisexuals than in heterosexuals. Theologically, masturbation and pornography directly violate the religious virtue of chastity, undermining one's prayer life and the motivation to develop a spiritual life. Therapeutically, positive psychology, which emphasizes cultivating what it identifies as virtues, including justice, courage, temperance, wisdom (similar to prudence), transcendence (similar to hope) and humanity (similar to charity), can be used to counsel individuals struggling with masturbation. Once the harms are understood, a person can be counseled that this temptation represents a challenge, an opportunity to build self-control, and with self-control the capacity to develop character strengths and major virtues.

Introduction

Masturbation has been defined as the self-stimulation of one's own body (particularly the genitals) for sexual purposes, usually leading to orgasm (Haus and Thompson 2020). Masturbation is common and generally accepted in Western society as a normal, healthy activity. For example, in a paper on masturbation and the sexual double standard, it is claimed, “participation in masturbation has been demonstrated to enhance a person's understanding of their sexual response and anatomy” (Coleman 2002, p. 6). Coleman cites Kinsey (Kinsey, Pomeroy and Martin 1948, 1953) noting that “their research that indicated that masturbation was a common sexual activity and was apparently non-pathological” (Coleman 2002). They further state that, “it is now well recognized within science that the perceived ill-health effects of masturbation are mostly based upon ancient religious orthodoxy and mythology.” Haus claims that masturbation is “an incredible common and beneficial behavior” (Haus and Thompson 2020, p. 810). Cervilla notes that, “Nowadays, masturbation is considered a healthy lifelong conduct, even at older ages” (Cervilla et al. 2021, p. 152). Fischer notes that, “In many Western societies, masturbation is increasingly acknowledged for its multiple benefits, among others being a simple and safe sexual behavior, facilitating more pleasurable sexual practice and leading to greater body knowledge, sexual agency, and sexual self-esteem and fewer sexual difficulties” (Fischer and Træen 2022, p. 3151). In 1968, masturbation was removed from the Diagnostic and Statistical Manual of Mental Disorders II (DSM-II). “It was found to be an extremely common behavior that lacked any identified adverse effects” (American Psychiatric Association 1968; Mushy et al. 2021). Klukas noted that, “The positive power of masturbation is demonstrated by its ability to enhance an individual's sexuality (Coleman 2002), its association with sexual and marital satisfaction (Hurlbert and Whittaker 1991), and its use in the treatment of female orgasmic disorder (Laan, Rellini and Barnes 2013; Marchand 2021)” (Klukas et al. 2021).

Yet, the Catholic Church teaches that masturbation is disordered. Specifically, “By masturbation is to be understood the deliberate stimulation of the genital organs in order to derive sexual pleasure. Both the Magisterium of the Church, in the course of a constant tradition, and the moral sense of the faithful have been in no doubt and have firmly maintained that masturbation is an intrinsically and gravely disordered action.” “The deliberate use of the sexual faculty, for whatever reason, outside of marriage is essentially contrary to its purpose” (CCC paragraph 2352). The Catechism also states, “Among the sins gravely contrary to chastity are masturbation, fornication, pornography, and homosexual practices” (CCC 2396). While the Catechism also states that “To form an equitable judgment about the subjects’ moral responsibility and to guide pastoral action, one must take into account the affective immaturity, force of acquired habit, conditions of anxiety or other psychological or social factors that lessen, if not even reduce to a minimum, moral culpability,” there is still the constant opinion of the Church that masturbation is an intrinsically and gravely disordered action.

A deeper understanding of the Church's teaching on this issue can be gained from the insights of Pope Saint John Paul II. In his Theology of the Body, he wrote the following:

“In the spiritual life of the spouses, also the gifts of the Holy Spirit are at work and, in particular, the “donum pietatis,” that is, the gift of reverence for that which is God's work (emphasis added).…… The virtue of conjugal chastity, and even more so the gift of reverence for that which comes from God, shapes the spirituality of the spouses for the sake of protecting the particular dignity of this act, of this “manifestation of affection,” in which the truth of the “language of the body” can be expressed only by safeguarding the procreative potential.” (emphasis added) ¹

This short section confirms what Pope Saint Paul VI stated in Humanae Vitae, that the marital act has two ends or purposes: unitive and procreative. According to Catholic moral theology, for an act to be good, the intention for doing the act, the end intended and the means for achieving that end all must be good. Interestingly, while Humanae Vitae and the Theology of the Body passage noted above discuss the morality of contraception, these same principles can be applied to a moral analysis of masturbation. Masturbation is neither unitive (as it is done alone) nor is it procreative (it is a sterile act). When analyzing the act of masturbation, the intent (self-gratification) is not good, the end (sterile orgasm which violates the proper end of orgasm as unitive and procreative) is not good, and the means (self-stimulation outside the conjugal union of husband and wife) is not good.

The modernist might state that this is an individual activity which does not have negative impacts on the masturbator or on others.” Experts (as noted above) claim that masturbation is beneficial or at worst a neutral activity. This is a claim which must be evaluated. According to Catholic teaching, humans are a profound unity of body and soul, of the physical and the spiritual. This union is so profound that it follows that whatever affects the body can have spiritual consequences, and conversely whatever affects the spirit can in turn affect the body. Thus sins (which injure the spirit of a person) should have discernable physical, psychological, and sociological effects on a person. The same can be said of virtues, such as chastity, which should have corresponding positive effects on the person.

The purpose of this paper includes investigation of the medical, psychological, sociological, and spiritual/religious correlates of masturbation as a way of determining if this practice, deemed sinful by the Catholic Church, has negative impacts on the human person (as predicted if sinful) or positive impacts (as predicted if virtuous) or is neutral. This is addressed in the first part of the paper, which is a review of the medical, psychological and sociological studies on the effects of masturbation, especially excessive masturbation, the majority of which show negative effects plus a description of and evidence for the psychological harms caused by masturbation, again usually of excessive masturbation. The second part is a theological summary of the Catholic understanding of masturbation, as spiritually harmful and sinful. This can be useful in a pastoral setting or in Christian counseling. The final part is a brief presentation of a positive response to the challenge of masturbation, treating masturbation as an opportunity to develop the virtues, especially self-control. This section provides a practical approach to therapy, through growth in virtue, which can reduce and even halt this harmful practice.

Overall, the paper should provide physicians, psychologists, and other counselors with the information needed to convey to their patients, who masturbate the negative consequences of this practice, including physical, psychological, sociological and theological, and an approach to therapy.

Literature Survey

A literature search was performed in PubMed and PsychInfo for the term “Masturbation” in the title as described in the Appendix. Briefly, PubMed and PsychInfo were searched for the term “Masturbation” in the title in 2020 and again in 2022 with over 700 titles scanned and other papers derived from references in the papers selected. Papers were selected which discussed the medical, psychological, and/or sociological correlates of masturbation with over 120 articles read in depth and the data summarized in the supplementary tables. The main findings are noted here.

The vast majority of people in most studies have masturbated at some time in their lives (Driemeyer et al. 2017; Cervilla et al. 2021) albeit more frequently in men (Gerressu et al. 2008; Richters et al. 2014) and the prevalence increasing in recent years especially in women (Dekker and Schmidt 2002). There is a close correlation between masturbation and pornography use (Richters et al. 2014; Astle, Leonhardt and Willoughby 2020; McNabney, Hevesi and Rowland 2020; Wright et al. 2021) and frequent and problematic pornography use correlates with frequent masturbation (Carvalheira, Træen and Stulhofer 2015).

Physiologic studies have shown increases in sex steroids, cortisol, and endogenous cannabinoids with masturbation (Purvis et al. 1976; Fuss et al. 2017; Isenmann et al. 2021), while abstinence from masturbation increases testosterone in men (Exton et al. 2001). Post-orgasmic prolactin, which may be a neurohormonal index of sexual satiety, increases approximately five times more following intercourse compared with masturbation (Brody and Krüger 2006). This may account for the observation that intercourse generally correlates positively with sexual satisfaction while masturbation shows a negative correlation (Davidson, Sr and Moore 1994; Das 2007; Gerressu et al. 2008; Brody and Costa 2009; Regnerus, Price and Gordon 2017; Miller et al. 2019; Rowland, Teague and Hevesi 2022).

Psychologically, studies indicate an association of masturbation with depression (Cyranowski et al. 2004; Driemeyer et al. 2018; Fischer et al. 2022), anxiety (Corona et al. 2010; Carvalheira and Leal 2013; Castellini et al. 2016; Jiao, Chen and Niu 2019), immature defenses (Brody and Costa 2008; Costa and Brody 2008, 2010; Brody and Nicholson 2013), and hypersexuality (Driemeyer et al. 2018), especially in frequent masturbators who may have an element of compulsion.

Numerous studies show a negative correlation between masturbation and relationship satisfaction (Santtila et al. 2007; Wright et al. 2021), quality (Dekker and Schmidt 2002; Corona et al. 2010), happiness (Perry 2020a), intimacy (Carvalheira, Træen and Stulhofer 2015), emotional satisfaction with the partner (Randolph et al. 2015), trust (Costa and Brody 2007), passion (Costa and Brody 2007), and other relationship parameters. The one exception encountered is a study that showed a small-to-moderate positive but significant correlation between the frequency of masturbation and satisfaction with primary relationship in women (Csako et al. 2022). But otherwise, there seems to be a consensus in the literature that masturbation negatively correlates with many aspects of relationship health.

Masturbation appears to be associated with prepubertal sexual contact and frequency of sexual ideation (Das 2007), alcohol consumption (Gerressu et al. 2008) and with dissatisfaction and stress at work (Corona et al. 2010). Negative correlations were seen with religion (Richters et al. 2014), religiosity index (Perry 2022b), and motivation for abstaining from masturbation correlates with stronger religiosity and Christian affiliation (Zimmer and Imhoff 2020). Masturbation appears to be associated with frequency of erotic fantasies (Carvalheira and Leal 2013) and hypersexuality (Walton and Bhullar 2018), and sexual excitation but negatively associated with levels of religious attendance (Zamboni and Crawford 2002).

The frequency of masturbation in both men and women who identify as bisexuals/homosexuals appears higher versus heterosexuals (Dekker and Schmidt 2002; Gerressu et al. 2008; Richters et al. 2014; Perry 2022b). LGBTQ+ orientation appears to correlate positively with porn consumption, porn arousal, and porn masturbation, but negatively with sexual satisfaction (Wright et al. 2021).

Masturbation in children appears to be associated with phobias, obsessive work, stress disorder, motor tics, separation anxiety, generalized anxiety disorder, conduct disorder, oppositional defiant disorder, and thumb sucking (Tashakori, Safavi and Neamatpour 2017), as well as somatization, obsessive-compulsive, personality sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid thoughts, and psychoticism (Murat, Uçar and Eray 2021). Higher-quality family of origin and more time with biological parents appear to ameliorate some of these effects (Astle, Leonhardt and Willoughby 2020).

Numerous papers refer to the positive effects of masturbation, primarily in women, including having more sexual pleasure, enhanced sexual desire and satisfaction, greater self-esteem, becoming more easily aroused, and greater marital satisfaction. However, very few of these studies had primary data. In a small study in women, effects noted included more orgasms, greater sexual desire, higher self-esteem, greater marital and sexual satisfaction, and requiring less time to sexual arousal (Hurlbert and Whittaker 1991). Studies in men and women indicated that masturbation was lowest in those who were married and highest in those who were single and was associated with watching sex videos, the number of sex partners, frequency of intoxication, and negatively associated with intercourse during the past month (Kontula and Haavio-Mannila 2002). The use of directed masturbation as therapy for female orgasmic disorder is recommended by some authors (Laan, Rellini and Barnes 2013; Marchand 2021), but alternatives are available (Brody, Costa, and Hess 2013).

It may be argued by some that the effects noted of masturbation apply only to those who masturbate excessively and that less frequent masturbation may be harmless or even beneficial. However, in studies that have included infrequent masturbation (once a year or more), there is a strong correlation with pornography use, having used a sex toy, digital anal stimulation, and identifying as homosexual or bisexual (Richters et al. 2014), and a negative correlation with happiness and emotional and physical satisfaction (Das 2007). Studies of any masturbation are correlated with not being in a stable relationship, a conflictual relationship within couples, and reported extramarital affairs (Corona et al. 2010) and in women with less emotional satisfaction with their partner (Randolph et al. 2015). This suggests that even infrequent masturbation may have negative associations.

There are gaps in this survey of the literature, among them studies that focus on infrequent masturbation, masturbation that does not use pornography, and longitudinal studies of individuals who were masturbators but stopped. The latter is of particular interest as many of the negative associations of masturbation are only associations and not necessarily effects of masturbation. Some could even be causes of this behavior. Longitudinal studies would be very beneficial to see if these negative associations decrease when masturbation ceases. With organizations such as NoFap (see below), such longitudinal studies may be feasible and would certainly be of interest.

Psychological Interpretations

Part 1: Psychological Characteristics of Masturbation

We now turn to describe five obvious psychological characteristics that are associated with masturbation, primarily when masturbation is habitual or excessive. All of these can be considered harmful and can be understood in the context of the above findings, plus a dash of common sense.

1. Masturbation is Regressive: It is an immature defense against anxiety, usually social or interpersonal anxiety, in that sex is naturally meant to bring us into relationship with another person. These contentions are supported by the relationship between masturbation and immature defenses (Brody and Costa 2008; Costa and Brody 2008, 2010; Brody and Nicholson 2013; Brody, Costa, and Hess 2013) and free-floating anxiety (Corona et al. 2010; Castellini et al. 2016; Jiao, Chen and Niu 2019). For a man, sex is a challenge to relate to a woman (and a woman to a man) and to learn the sometimes difficult and complex skills that this involves. By choosing self-soothing masturbatory behavior, one avoids the challenge of responding to the other and this involves a regression to an infantile and simple behavior.

As already documented above, masturbation is often obsessive or excessive and this undermines self-control (Driemeyer et al. 2018). Growth and maturity are associated with the development of self-control and in general anything that interrupts self-control is regressive. Some of the no fap responders said that when masturbation was obsessive, they felt like a loser, obviously a regressive response. In addition, obsessive masturbation is often found with young autistic subjects (Haracops and Pedersen 1992; Angelina 2022).

Sigmund Freud, who was hardly a sexual puritan, explicitly wrote that masturbation is “by no means harmless” because such auto-erotic behavior is “conditioned on a regression of the sexual life to an infantile form.” Freud notes that such behavior undermines character because it provides an easy way to obtain important goals that normally require energetic effort. This is important since Freud considered “that the attitude to sex is the prototype of the attitude to life” (Freud 1963, p. 36). He also mentioned that the fantasies involved create unrealistic sexual objects that will not be met in reality. A curious example of this regression is found in the sex life of Jean-Jacque Rousseau- a life that combined frequent masturbation with an understanding of his mistress as “Maman”. He also reported a related regressed behavior, namely that he liked to be spanked (see Johnson 1988, p. 16–17.)

2. Masturbation is often Excessive, Obsessive or Addictive: It is a common observation that masturbation often becomes obsessive, sometimes for a few weeks but often for years (Driemeyer et al. 2018). (We prefer the word obsessive rather than addictive, since addiction has become a complex issue.) As many psychologists do, one of the authors has had a good number of clients with this problem. One was a married man in his late 50s, who was plagued by this compulsion at least once and often several times a day. All addictions or obsessions are harmful because they undermine a person's will and sense of efficacy, and they cause him or her to lose control of behavior. Being out of control can have obvious negative consequences. For example, one case reported by a colleague involved a young man who masturbates several times a day at his workplace by going into the men's room. He was fired because he spent too much time in the bathroom and not enough time at work! The possibility of obsession is clear from even a casual perusal of the published medical literature on masturbation where it has been reported in conjunction with various medical conditions such as: intensive, excessive, pathological, or compulsive. It also seems to be often associated with autism (Schottle et al. 2017; Cividini-Motta et al. 2019). It takes little imagination to think of ways such compulsive behavior may express itself destructively. In some cases, this addiction may set up a propensity for later addictions to internet pornography, or possibly to alcohol or drugs. One highly educated professional client explicitly stated that this was the case for him. He said that masturbation was his first addiction as a pre-adolescent child, and it facilitated his later addictions to alcohol, drugs, internet pornography, and prostitutes. At the end, he was sober and off drugs, but he was still addicted to porn, masturbation and prostitutes for which he wanted help. Freud has commented on masturbation in a way that supports this understanding. He stated, “…masturbation is …the “primal addiction,” and it is only as a substitute and replacement for it that the other addictions—to alcohol, morphine, tobacco and the like—come into existence.” (Quoted in Masson 1985, p. 287)

Further evidence of the obsessive character of masturbation is the spontaneous development of internet resources for individuals to cope with this obsession. The website NoFap.com is devoted to escaping compulsive masturbation and pornography, at least for some reasonable period of time, such as greater than ninety days, because of its benefits for the person. Other websites, such as stopmasturbationnow.org, come from a Christian perspective and are opposed to both masturbation and pornography. There is now even an app called Stop masturbating.

An important point to note is that these popular websites have spontaneously arisen by those suffering from what men perceive as negative effects of masturbation. The helping professionals in psychology and medicine have hardly responded, presumably because of a pro-masturbation bias. However, the NOFAP and similar responses make it clear that masturbation can often have disturbing negative effects. The negative consequences of excessive masturbation, especially the NOFAP responses, also strongly imply that the pro-masturbation position has become too extreme and that a more rational middle ground is needed.

3. Masturbation Promotes and Usually Involves Pornography: In fact, masturbation is almost invariably associated with pornography as noted above (Kafka and Hennen 1999; Richters et al. 2014; Carvalheira, Træen and Stulhofer 2015; Miller et al. 2019; Praus 2019; Astle, Leonhardt and Willoughby 2020; McNabney, Hevesi and Rowland 2020; Pozza et al. 2022; Fischer and Træen 2022). Often, the very purpose of pornography is to bring masturbation to orgasm. For most people masturbation involves highly erotic self-generated (imagined) pornographic images and scenarios. These fantasies typically express intense unconscious motives, ranging from a need for love and fear of rejection, to hatred of the women or men imagined, and even self-hatred. Often, people use actual pornographic material while masturbating, but self-generated pornography is extremely common. The accompanying pornographic scenarios often involve the mental acceptance of fantasized extramarital acts, sometimes even criminal behavior, especially sadistic violence toward women, such as physical or psychological abuse, rape, or even killing. Studies have shown that male users of pornography are more prone to sexual violence toward women. (For example, see Linz, Donnerstein and Penrod 1988; Page 1990; Adams 2000; Carr and VanDeusen 2004.)

In addition, pornography represents an intense attachment to images involving idealized, that is unrealistic, women's and men's bodies. This sets up later sexual disappointment with real women's and men's bodies. A client of one of the authors, a young married serious Catholic man with two children, had a masturbation problem that was discovered by his wife in the fifth year of their marriage. His wife insisted he see a psychologist. She was deeply hurt by her understanding of his masturbation as a rejection of her body and a preference for the fantasy bodies that accompanied his masturbation.

Another common consequence of masturbation, both with fantasy and actual pornographic imagery, is the objectification of women and men. Neither of these kinds of sexual activity involves actual interpersonal experience and the result is that women (for example) are no longer persons but become sexual objects for men (or men for men or men for women or women for women). It is not uncommon, in the experience of one of the authors, for a wife to complain that when she and her husband are having intercourse, her husband does not really relate to her. Instead, he seems withdrawn into himself where he is having a relationship with something in his head, some idealized fantasy female or centerfold sex goddess. Normal sex becomes bad pornography.

In short, the harmful effects of violent imagery, of idealized sexual bodies and of the objectification of women and men are all likely increased by masturbatory fantasy. Therefore, all those who promote the pro-masturbation position are indirectly pushing the pro-pornography position as well.

Masturbation and pornography go together so often that they almost represent the same sexual problem. However, the specific topic of pornography for our society is a large issue and the authors leave its treatment to others. (A relevant report is by the Witherspoon Institute of Princeton University ²⁰⁰⁹; also, Layden 2009.)

4. Masturbation Promotes Extreme Sexual Practices: Sex when it is separated from love and serious interpersonal relationship almost always becomes just sensory pleasure. Like other such pleasures, the positive effect declines with repetition, and more extreme stimulation is needed to keep the pleasure occurring (for example, the association of masturbation frequency with porn-type sex (Miller et al. 2019)). In short, there is an adaptation to normal sexual stimulation: it gets boring and the person begins to seek out more and more extreme forms of stimulation. This is a common reason for the development of sexual perversions. For example, every year in this country about a hundred males, usually teenage boys, die from autoerotic asphyxiation (Sauvageau 2012; Sauvageau and Racette 2006). This practice refers to the fact that increased pleasure at orgasm occurs when there is a reduced amount of air/oxygen at orgasm. This is commonly brought about by some kind of strangulation such as putting a towel or rope around the neck to cause partial asphyxiation. Every so often, this auto-erotic practice is done clumsily, and the result is death from strangulation. In the United States, estimates of such deaths range from 250 to 1000 (Cowell 2009), although it is often misdiagnosed as suicide. (For other reports about such deaths, see Sheehan and Garfinkel (1988), Jenkins (2000), and Scheleg and Ehrlich (2006)). Such autoerotic activity is not restricted to teenage boys as prominent celebrities have died from this practice (Louise 2020). Extreme negative effects, such as auto-erotic asphyxiation, document clearly that masturbation can promote extreme sexual practices, along with the rationale of adaptation to erotic rewards.

An interesting example of a death brought about in part by masturbation is the death of the famous sex researcher Alfred Kinsey. Kinsey was often filmed from the chest down masturbating (Jones 1997, p. 609) and he would show off his masturbation techniques to his staff. Kinsey also often participated in masochistic behavior (p. 603–605) and is described using various procedures involving his private parts in a painful and destructive manner. At his death, he was suffering from an infection of the pelvic region including his testicles, which had undermined his health (p. 738–739).

As another example of the need for increasingly extreme stimulation, let us consider another case. The client, a young Catholic man getting an advanced degree in a religious education program, had been arrested by the local police for exposing himself to teenage girls in a public park. As part of his probation, he had to see a psychologist, hence the author's (P.C.V.) involvement. He was no longer able to arouse himself enough to masturbate. However, he discovered that exposing himself to teenage girls was sexually exciting and arousing enough for him to masturbate. Some men find the risk of discovery necessary for sexual activity and complaints of and arrests for masturbation in public are relatively common.

A recent example of an extreme form of masturbation is with a vacuum cleaner, which often results in physical damage to the penis. (See Wenderoth and Jonas 1980^; Pomeroy 2021.)

The point is that sex for its own sake, without love or concern for the other, often leads to more and more extreme behaviors to get pleasure. These extreme behaviors frequently involve serious mental, legal or physical harm to the self or to others.

5. Masturbation is Narcissistic or Self-focused: A fifth and obvious but overlooked negative consequence of masturbation is that it facilitates an increase in a person being self-focused. This self-focused or—self-loving or narcissistic—aspect of masturbation was noted long ago. Again, we quote Freud who, in the context of a discussion of auto-eroticism, wrote “We have discovered, especially clearly in people whose libidinal development has suffered some disturbance, such as perverts…, that in their later choice of love-objects they… take as a model not their mothers but their own selves. They are plainly seeking themselves as a love-object and are exhibiting a type of object-choice which may be termed narcissistic” (Freud 1957, Vol. XIV, On narcissism: An introduction, p. 88). Masturbation is obviously self-focused, and thus intrinsically narcissistic. For example, there are studies that found porn users to be more narcissistic than non-porn users. (Kasper, Short and Milam 2015)

It also seems appropriate here to quote C. S. Lewis (Hooper 2007) on the topic. Lewis writes “…the real evil of masturbation would be that it takes an appetite which, in lawful use, leads the individual out of himself to complete (and correct) his own personality in that of another … and turns it back; sends the man into the prison of himself, there to keep a harem of imaginary brides. This harem, once admitted, works against his ever getting out and really uniting with a real woman. For the harem is always accessible, always subservient, calls for no sacrifices or adjustments, and can be endowed with erotic and psychological attractions which no woman can rival” (Vol. III, p. 758).

It is useful to recall that both Freud and Lewis were writing long before the existence of the contemporary world saturated with easily available pornography, especially on the Internet. Masturbation takes the sexual energy and activity meant for another person and focuses it only on the person's own body and on the self. What is meant as something to give to another is now given just to the self. We live in a society often characterized as a “Culture of Narcissism”, as first identified over forty years ago by Christopher Lasch (1978). More recently, the claim has been made that the American society is suffering from a “Narcissism Epidemic” (Twenge et al. 2009). A paper by Kasper, Short, and Milam (Kasper, Short and Milam 2015) using adult participants has documented that the hours spent viewing internet pornography was positively correlated with narcissism level; in addition, those who used internet pornography had higher levels of narcissism than those who had never used internet pornography. It should be kept in mind that pornography use reliably occurs along with masturbation.

This is not to imply that the serious clinical conditions of narcissism, for example, Narcissistic Personality Disorder, are caused by masturbation. The narcissism referred to is a more general and familiar socially learned narcissism that increases a person's selfishness, sense of entitlement and social isolation to a degree harmful to the person and society.

Some may claim that masturbation can act as stress release. In this scenario, there is no pornography, just self-stimulation until climax. This has been postulated to be beneficial as a sleeping aid. While there are no studies, the authors encountered that address this form of masturbation, the psychological underpinning of this behavior would still be self-focused and would still use mental imagery in a way that objectifies persons to stimulate the orgasm. Other sleeping aids are also available, such as praying the rosary or the Jesus prayer.

The authors are also not suggesting that all the identified negative psychological effects always occur whenever there is masturbation. Nevertheless, regression, pornographic images, and narcissism are intrinsic to masturbation and to some extent are always present. Obsessive masturbation for some months, or longer, is quite common, and extreme behaviors are relatively frequent when masturbation becomes obsessive. Masturbation and pornography go together so often that they almost represent the same sexual problem.

Part 2: A Brief Response for Serious Christians, Men, and Women

The previously cited negative psychological consequences of masturbation and pornography identify why both should be avoided by men and women, in general. But there are special reasons why all serious Christians, Catholic, Orthodox, or Protestant, who understand that they are called to holiness should strongly avoid this activity.

To begin with, Christians are called to chastity, which constitutes a serious reason to avoid whatever might undermine this important commitment. Masturbation and pornography directly violate the virtue of chastity and make a man or woman much more open to sexual behavior with others. For the Christian laity with lust in their heart, it makes them open to sex outside of marriage. Such an involvement is rarely a genuine relationship but is typically a lived-out fantasy with the other as a sexual object. If the involvement remains a secret, it still undermines a Christian for one knows he or she has broken a major vow or commitment to be faithful. If the sexual involvement, facilitated by masturbation, becomes public it may cause scandal, and for priests and ministers it may cost thousands or even millions of dollars in lawsuits. In view of these serious and costly risks, all reasonable steps to reduce masturbation and access to pornography should be taken by and for those aiming to be consecrated Christians.

Second, the emotional intensity of masturbation and its associated pornography intensifies extreme attachment to this world. Such attachments, especially when obsessive, act as psychological idols and therefore as direct competitors to the worship of God. The Old Testament presents well-known examples of people who worshiped external idols, often of a sexual kind. These external idols have been replaced by today's mostly internal images of sex goddesses and gods, etc. These new internal idols require sacrifice: We give them money, time, emotional commitment, and through birth control and abortion even the sacrifice of children. Consequently, sexual idolatry undermines a person's prayer life and the motivation to focus on things above and to place attachments to this world in a proper, reduced perspective.

Jesus was quite clear about avoiding sexual fantasy. In Matthew Chapter 5:27–30, Jesus says:

“You have heard that it was said, ‘You shall not commit adultery.’ But I say to you that everyone who looks at a woman lustfully has already committed adultery with her in his heart. If your right eye causes you to sin, pluck it out and throw it away; it is better that you lose one of your members than that your whole body be thrown into hell. And if your right hand causes you to sin, cut it off and throw it away; it is better that you lose one of your members than that your whole body go into hell.” (Revised Standard Version: Catholic Edition)

This passage very clearly rejects scenarios based on looking at a woman and by extension to looking at images such as photographs or videos. Adultery has been committed in the heart. Plucking out an eye in response is hyperbole but Jesus is quite clear about the seriousness of the behavior.

Furthermore, the authors think that the reference to the right hand causing one to sin is a polite way of referring to masturbation. Note that the passage and the one that follows are dealing only with sexual matters, there is no implication here of any other way in which the hand might offend. There is no evidence that the passage refers to stealing or striking someone as this would suddenly change the subject of the passage. (Besides, stealing hardly needed such a critical, unusual, and powerful statement since stealing and fighting was routinely understood as wrong in the familiar moral codes of the time.)

For scholarship supporting this interpretation of Matthew 5:27–30, see Loader (2005, p. 28–29). He provides considerable evidence for the prohibition of masturbation in the Jewish law and tradition, for example citing the Babylonian Talmud and the Christian scholarship in agreement with it. The orthodox Jewish prohibition against male masturbation remains strong (Ribner 2004). A supporting tradition can be found in Gill (1810), where in his discussion of Verse 30, p. 18–19, he references rabbinical comments about committing adultery in imagination with the hand and Jewish use of the phrase “let his hand be cut off” at the level of the navel in order to keep the limb from stimulating the genital area. Of course, as with Jesus, the advice to cut off the hand is presumably hyperbole, but it shows that Jesus was expressing the same meaning and seriousness.

If this interpretation of “the hand” is valid it means Christ clearly was rejecting masturbation, presumably because it was an activity well known then, as now, as being closely related to the willed fantasy of adultery, of lustful sexual relations committed in a man's heart. In any case, using the eyes lustfully with respect to a woman was clearly condemned.

Part 3: A Positive Therapeutic Response to the Problem

Psychology, for some decades, has been emphasizing the virtues and character strengths. This movement called “positive psychology” was pioneered by a past president of the American Psychological Society, Martin Seligman (1990^{, 2011;} Seligman and Csikszentmihalyi 2000^; Peterson and Seligman 2004), a professor at the University of Pennsylvania. Positive psychology is now well-established and thriving. Its emphasis is on the virtues such as gratitude, altruism, resilience, love, wisdom and others (Emmons and McCullough 2004; Post 2007; Worthington 2007; Lopez and Snyder 2014; Snyder et al. 2020).

The insertion of explicit training in virtue into psychotherapy itself is also underway (Seligman et al. 2005). Those proposing the introduction of virtues into psychotherapy include Waring (2016), and Peteet (2013).

These are important developments, for although philosophy and theology have long understood the importance of the virtues, these disciplines have had little to say about how virtues and character strengths are actually learned. Positive psychology emphasizes traits that promote happiness and well-being. These positive characteristics are generally called “character strengths” and are considered as aspects of the major virtues. Seligman and his colleague Christopher Peterson distinguish three conceptual levels: virtues, at the highest level; character strengths as major sub-properties of the virtues; and situational themes at the lowest and most specific level. In their view, the virtues are “the core characteristics valued by moral philosophers and religious thinkers…”

Positive psychology proposes six major virtues: justice, courage, temperance (these three retained their traditional names) and a fourth that they termed wisdom, close to prudence; thus, they account for the four cardinal virtues. In addition, they propose transcendence, which turns out to be close to hope, and humanity, which is close to charity. These roughly correspond to two of the theological virtues, with only faith being omitted. Their six virtues were arrived at after extensive analysis of the world's major religious and philosophical traditions. In the process, Seligman explicitly acknowledges among others Aristotle and Aquinas (see Titus 2017).

They speculate that all these virtues must be present at above-threshold values for an individual to be deemed of good character. It now looks as though psychology is in the process of developing tests to measure the virtues—hence good character. At present, most psychological tests are still measures of possible pathology rather than measures of strengths based on virtues.

In “discovering” positive human characteristics that need to be cultivated in order to strengthen a person and to help heal past sufferings, psychology has, unknowingly, made a momentous conceptual or paradigm change. The prior model, what Seligman called “negative psychology,” was the study of how our pathologies were caused, and was based on the traditional scientific worldview of a deterministic past causing a problem. In moving to positive psychology, the discipline has moved not only from traditional science to philosophy, but also from the past and its causal effects, to the future and freely chosen goals. In short, psychology has moved from an emphasis on determinism to a serious concern with teleology, to flourishing through the growth of virtues.

As noted, Seligman and colleagues identify character strengths as subcategories of the virtues. In a relevant chapter in Peterson and Seligman (2004) on the virtue of temperance, they identify the character strengths that constitute temperance. One of these is self-regulation (p. 499), which they also call self-control. In covering the psychological literature on self-control, Peterson and Seligman mention several existing psychological tests for measuring it. Examples of items from a self-control scale reflecting low self-control are such statement as: “I have a hard time breaking bad habits,” “I am lazy,” and “I do certain things that are bad for me, if they are fun.” Saying “no” to such items and “yes” to statements like “people can count on me to keep on schedule” indicates a person with strong self-control (p. 505–506).

Consider some material from the NOFAP participants. Many of those who have taken the NOFAP program write up their experience of its effects. The positive effects are most often described in terms close to virtues or character traits. The reports commonly mention problems of a negative kind, such as being lazy, feeling like a loser, feeling incompetent, unmasculine, etc. The NOFAP program is often described as difficult, even very difficult and with relapses, but the positive results frequently noted include having more purpose, especially having more control of life, also better relationships, especially with women. Often mentioned are actual accomplishments and greater positive motivation. In short, the ninety-day abstainers typically refer to life as improved. The results may not be just due to NOFAP principles since the group support is also very important. Certainly, one recommendation to a man who wants to get rid of masturbation, or at least get it under control, is to investigate the strategies on NOFAP. There is also a Catholic help group. (NOFAP comments can be found at https://forum.nofap.com/index.php?forums/success-stories.24/)

The positive results certainly establish an increase in the virtues, especially self-control, which Seligman (2011) notes as part of flourishing. I asked a wise, holy, elderly Dominican priest why God would allow the temptation to masturbation, which has been and is faced by all men, especially young men in every place, culture and time period, and increasingly in women. His answer was that the purpose of the temptation to masturbation was for young men to learn self-control, a character strength needed to develop most of the other virtues. A person who has learned to control their sexuality is in a position to control their fear and thus develop the major virtue of courage. If a person can control their sexuality, they are also much more prepared to reject indulging their self-interest and to be able to deal fairly with others—thus demonstrating the virtue of justice. Wisdom, or prudence, presupposes the character strength of self-control because it is needed to refrain from impulsive actions and to reflect on future consequences. As conceptualized by Peterson and Seligman, self-control is an important characteristic of temperance. Indeed, self-control/self-discipline has been found to be a better predictor of academic performance than a student's IQ. (Duckworth and Seligman 2005)

In many respects, the noFap participants have rediscovered the importance of the virtues, something our popular culture (like much of past psychology) has long neglected. There is notable research by prominent psychologists that highlights self-control, self-regulation, and self-discipline as major contributors to positive life outcomes, especially in young people (Moffit et al. 2010; Mischel and Ayduk 2011; Baumeister and Tierney 2012; Mischel 2014).

To conclude, here is a proposed general strategy for those dealing with masturbation in a client or advisee. First, one should explain that if it is practiced very much it leads to a wide range physiological changes, and is associated with psychological and sociological harms. Second, emphasize that this temptation represents a positive challenge, an opportunity for a person to build self-control, and with self-control they will have the capacity to develop other related character strengths and virtues. This is like an athlete who controls his diet and rejects smoking and drinking. These sacrifices are made to develop athletic ability and to be able to perform well in the public sports arena.

With the difficult challenge of sexuality—as with all real challenges—there may well be failures and times of back-sliding, but the basic goal is to learn to control one's sexuality as part of building the character strength of self-control. The failures need to be addressed in terms of when and where they happen. These conditions often involve triggers: being in the shower, having a failure at school, or experiencing an interpersonal rejection. They need to be identified and discussed, and plans should be made to avoid or cope with them in the future. Much of the therapy technique can be cognitive and behavioral. (This is not the place for a specific discussion of those therapeutic procedures which would take an article in its own right.)

However, the client or advisee should often be reminded of the goal of self-control and its benefits. With self-control, a person will be much more able to show courage (control of their fear), justice (control of their self-interest), wisdom or prudence (control of their anger) and temperance (control of harmful extremes). This challenge with its life-long positive payoffs makes controlling one's sexual urges well worth the effort.

Biographical Notes

Paul C. Vitz, PhD, PsyD, is an American psychologist, who is Professor Emeritus of Psychology at New York University. He now teaches at the Institute for the Psychological Sciences at Divine Mercy University in Sterling, Virginia. His teaching and research focused on the integration of Christian theology, especially Catholic anthropology, with psychology. This requires breaking from the modern secularism and post-modern relativism prevalent today. His present focus includes the psychology of hatred and forgiveness; the psychology of the virtues; the psychological importance of fathers; and the complementarity of men and women. Dr. Vitz's books include Psychology as Religion: The Cult of Self-Worship; Sigmund Freud's Christian Unconscious; Modern Art and Modern Science: The Parallel Analysis of Vision; Faith of the Fatherless: The Psychology of Atheism; and The Self: Beyond the Post-modern Crisis, and most recently A Catholic Christian Meta-Model of the Person: Integration with Psychology & Mental Health Practice. Vitz, Nordling, & Titus (Eds.)

William V. Williams, MD, FACP, is the president and CEO of BriaCell Therapeutics Corporation and Adjunct Professor of Medicine of the University of Pennsylvania. He is also a permanent deacon in the Archdiocese of Philadelphia. He and his wife Lorraine have three children and four grandchildren.