CBT for compulsive masterbation

Dear Colleagues,
This is the first message I have posted to the forum. I would like some peer consultation on a therapy case. The patient is a 25 year old African male who has lived in the US for the past three years. He works and goes to college. He reports that when he sees an attractive Caucasian woman in a store or on the train, etc. he begins to think about "touching himself" and at the first opportunity goes into a bathroom or other place where he can't be easily observed and masterbates. He denies any desire to meet or have any personal contact with the woman. He denies being attracted to children or adolescent females. He denies involvement with internet pornography. He has a girlfriend and is sexually active with her. He denies symptoms of OCD in other areas of his life. He denies any history of sexual abuse victimization. He denies spending excessive time masterbating, and that he masterbates once and then "doesn't have to think about it anymore" and can get on with his studies. In fact he worries that if he doesn't masterbate, he will be proccupied during the day and this will impair his concentration and his ability to study. He has a strong desire to succeed in school, and has a history of test anxiety. He is concerned because he can't control this behavior, wonders ehy he does it, and that he could get into trouble if he is caught. I am trying to think through treatment options for him. One approach would be to treat this as OCD and design a safe plan for E&RP combined with cognitive work. The other approach would be a behavior approach of extinguishing the response, as is done with sexual offenders. Any thoughts or references to the literature would be appreciated.

Steve

Replies:

Re:CBT for compulsive masterbation, by Jim Pretzer, 10/11/03

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