Dear Carol,

I hate to bother you and what I am about to say may offend you. I have an addiction towards m-a-s-t-u-r-b-a-t-i-o-n. I can't control the urge that I have. I am not married nor am I dating and do not have a girlfriend, in other words, I'm single and have never been with a woman.

I came upon your website and found that you were a sexologist and author and thought I would ask your advice. Please forgive me, I'm nervous about this. How can I control these sexual urges? I was told by medical doctors that seeing a madam would help my problem. I'm scared. If I have offended you, I am sorry. Nothing personal, just that you're a specialist in that field.

One more thing. I'm going to see a sex therapist but he's not what I expected, and he's not helping.

Please write back as soon as you can.

--Out of Control

Dear OOC,

From the sound of your letter you *do* need help, but I'm not sure it's the kind of help you think you need. It's clear that you're very distressed about masturbating and acting on your sexual urges, and I'm not sure that anyone you've seen so far has given you this information clearly: *Masturbation is normal.* It's especially normal for a young man (which I think you are) who has no partners. The sexual urge is part of nearly everyone's life to some extent, and from a sexologists' point of view, there are only two things about masturbating that are problematic. The first is when masturbation gets in the way of your other life responsibilities or harms you. Some examples of this: You do it instead of going to work and lose your job. Or you subject yourself to extreme kinds of stimulation that actually cause injury. You haven't said how much you masturbate, and if I were seeing you clinically, I'd certainly want to know that -- are we talking every day? There's nothing w rong with that. Twelve times a day? Are you getting your job or your school work done? Do you ever get outside to hang out with friends? Or do you spend literally all your time masturbating? That *would* be a problem, potentially, because you are cutting yourself off from a productive life and social relationships. But if you live a basically ordinary young man's life aside from this, you are not masturbating too much.

Let me put it this way: If you are a male whose age is somewhere between mid-teens and late 20s and you *didn't* masturbate and feel regular sexual desire, it might be a sign that something is wrong. There is a great range in what we would consider healthy (or normal) libido, but very low libido (that is, sexual urges) can sometimes constitute the first sign of a serious health problem. This could signal physical disease or depression. Humans are meant to be sexual creatures, and not having those feelings is sometimes a great danger sign.

Now, here's the other thing that can make masturbation a problem -- your feelings about it. You seem truly concerned about your masturbation pattern, and that in itself is a red flag -- but not necessarily a flag that you masturbate too much, but rather that you can't feel comfortable with masturbation. You have given me many hints in your letter that this is the case: saying things like "what I am about to say may offend you," referring to your self-pleasuring behavior as an "addiction." (More about that in a minute.) You are clearly very judgmental about this behavior, which is one of the reasons you feel out of control. If you accepted it, it would not seem like such a problem.

There are many reasons why you might feel worried or uncomfortable about your sexual desires and behavior. We don't live in a society that gives much respect to masturbation, for starters. That's why Good Vibrations founded National Masturbation Month several years ago -- to point out that this activity is a basic pleasure that almost everyone enjoys (or at least engages in) at some time in their lives, and that shouldn't be the target of jeers or the cause of shame. You *do* seem ashamed of it, so perhaps this social message has gotten under your skin. People are also sometimes ashamed of masturbation and erotic urges when they have grown up in a very sex- negative environment, with parents who punish them if they catch them playing with themselves, or a church that makes any sexual desire outside of marriage seem wrong. Also, some people with histories of abuse become very uncomfortable about sexual feelings. I'm not saying any of these circumstances apply to you (exce pt the first one), but these are some of the ways masturbation takes on the role of a problem, instead of a pleasure, in peoples' lives.

The good news is -- many such people have been able to see that their own feelings were influenced from the outside, leaving them burdened with negative feelings. I would encourage you to consider this possibility yourself. Even if you have never gotten positive support for being a sexual person, now is not too late to start seeking it. In fact, I think your medical doctors have given you a back-handed version of this in telling you to call a madam. They are implying that your sexual desires are natural, and that if you don't have a girlfriend, you should hire someone to have sex with. Of course, lots of people do this. It isn't necessarily the choice you are going to make, and personally I would rather see you have a few sessions with a professional surrogate partner -- this is someone who has been trained to work with a sex therapist, and unlike most sex workers, she can help you get comfortable with intimacy at a more natural rate and with the help of your therapist i n working out any distressing feelings that come up. Because I want to stress that if you feel bad about masturbating, you might also find yourself having mixed feelings about sex with a partner -- and more than that, it is important to understand that masturbation isn't just a substitute for sex with a person. That may be what your doctors are thinking: "Oh, poor lad, he needs to get laid! Let some pressure off!" It may well be that when you have a partner, you will feel much more at ease with your sexuality, but most people who have partners *still masturbate.* It is a separate pleasure, good for dealing with tension and stress, and good for smoothing over any differences in sexual desire when you do have a partner. It is not second best or something you do until a girl wants to have sex with you -- it is a way of satisfying sexual urges no matter what your relationship status.

Now let me say a little something about your choice of words to describe your masturbation pattern. You said that you are "addicted" to it. Most sexologists are uncomfortable with this term. You may very well be pretty obsessed about masturbation, and that may not be the most comfortable or healthy thing -- but "addiction" doesn't just mean you do something all the time, it means you have a chemical need for a substance, like alcohol or drugs. Sexual arousal does cause some temporary chemical changes in the body, but as I said earlier, those are natural -- almost everyone has them to some degree. It's not a need you develop only when exposed to a substance, like liquor or heroin. The term "addiction" has a very negative tone and embracing it will tend to reinforce that there *is* something wrong, and that you are pretty helpless to do anything about it. It takes away your own power and control. I realize you have been feeling out of control about this, and it is also pos sible that you have been using masturbation as stress relief from other problems in your life (some possibilities -- extreme shyness, a difficult family life, feeling picked on at school... there are many, many possibilities). And it may be that instead of masturbating as much as you do, you would be well served to get some help in confronting these other problems head on. But masturbation itself is not causing these problems -- if anything, it is a behavior that you are using to try to keep yourself less stressed. The problem is, because you feel bad about doing it, it also causes more stress in your life.

Please look at your life as a whole, not just the role masturbation plays in it. And if you want to masturbate less, go out more and engage with things that interest you. Meet people -- not just potential girlfriends, all kinds of people. Volunteer to help others. (Wow, I'm sounding like Dear Abby now!) Take up a hobby. Try to find a job that interests you. Take a human sexuality class if you are in college -- it may help put things into perspective for you. And please bring this column to your therapist and ask him to read it and then discuss it with you. It may be that the ensuing discussion helps you decide whether he really *can* do anything to help you. Good luck!

Note to my regular readers: You may have noticed that I used a word in this column that's very unusual for me: "normal." Ordinarily I avoid it like the plague. Why? Because I am firmly convinced that the real issue in any one person's sex life is not "Am I normal?" (a very common question indeed) -- it is, rather, "Is my life working? Am I happy? Am I staying safe and healthy?" But -- and here's the rub -- many people are convinced that they can't be happy unless they're "normal." "Normal" is a statistical concept, though -- it doesn't really matter whether you do something everyone else does, it only matters if *you* like doing it. Everyone else isn't in bed with you (although a few busy people seem to come close!) However, I think Out Of Control may be actually reassured by the notion that his experience is common and natural -- which is what I mean when I use "normal" in a context like this and, I believe, is the sort of reassurance that may make a real difference to him.