[goldengoddess809]

The other day I had a video session with my T and I confessed that I had masturbated once a couple weeks ago while on the phone with her. I have a condition called PGAD or persistent genital arousal disorder. I have spontaneous orgasms with ejaculation , and it worsens with stress. I have trouble talking about it with my T because I'm so embarrassed and the orgasms just get worse when we discuss it

She was asking me if masturbation helped my symptoms, and as we were talking about that I got uncomfortably aroused and started masturbating, although I didn't bring myself to orgasm and I stopped when we moved on to a different topic.

When I told her she was very understanding, she said she knew my PGAD had been worse lately and that we knew masturbation helped. She said me doing this was a way of taking care of myself and self soothing. She encouraged me to do it anytime I needed to get a release, even if we were on the phone. She said there was no way of her knowing what I was doing and that I was in the privacy of my own home. She was glad I told her but really wanted me to not feel ashamed and feel comfortable masturbating whenever I chose.

I was supposed to have a phone check in earlier today, but I fell asleep. I edged for hours before she was scheduled to call, I just felt this intense sexual arousal and I hate that we didn't get to talk. I've been fantasizing about this constantly since our session, wondering what it would feel like to be masturbating while listening to the sound of her voice, whether I would orgasm, how intense it would be, etc

I feel ashamed that this is so arousing to me. Is that normal? Or is it strange to want your T to know you're masturbating and allow you to do it in a session? Should I masturbate the next time I talk to her? It's all I can think about. She basically gave me permission to do it whenever I want.

Any advice/feedback? Does anyone else struggle with arousal or compulsive sexual behavior in therapy?

[Yaowen]

Dear goldengoddess809,

I wish I had some insight and wisdom into what you describe, but sadly I don't. Hopefully others here with PGAD will see your post and respond to you with their experiences as well as with understanding and compassion for you.

The human brain is very mysterious. It is often difficult and sometimes impossible to know why it causes us to think and do the things we do. I have found that the brain often seems to have a mind of its own.

A person can only be responsible for what they do with full voluntariness. Full voluntariness requires full knowledge and full consent of the will. Many things can be impediments to these. There are many psychological conditions which reduce or totally impede voluntariness. I would bet that PGAD is one of them.

I seriously doubt that you have the requisite voluntariness to be responsible for what you do under the influence of PGAD. So please do not be harsh with yourself.

What you describe may seem bad to you, but please try to keep perspective if you are able. There have been a couple of men in the last 100 years who caused the destruction of tens of millions of people through genocide and forced starvation campaigns.
Your genital arousal disorder has not caused the destruction of tens of millions of people or millions or people or hundreds of thousands of people or thousands or people or hundreds of people and so on. So while you may feel badly about what your illness causes in you, you are not a bad person. You are a good person and a million times more than any mental illness you may be suffering.

"Normal" is not a point on a line. It is a range of points. I would be willing to guess that there are perhaps hundreds of thousands of people from all over the world who suffer from PGAD. That number may be in the millions.

It is good that your therapist treats you with the great respect and compassion and understanding that you deserve. No one is immune from being surprised by what their brain is doing. Even therapists are often surprised by what their own brains do.

I wish I had some good advice for you, but I lack wisdom. Hopefully others here will have better words for you than my poor and fallible words.

All the best to you!

Sincerely yours, Yao Wen

[PugPrincess]

Have you considered that maybe you are not so aroused by your therapist knowing you are masturbating, but are fixating on their approval and validation (something I am sure you have struggled to find and thus drawn to this new open dynamic). I do caution you to be careful as sometimes a new fixation can negatively develop into a fetish or compulsion. Maybe discuss with them how you are now developing this fixation and that it has guided your actions into a stronger behavioral pattern than previously discussed.

[goldengoddess809]

I definitely think it's more about her approval, I do have kind of a fixation in that. I really care and worry about what she thinks of me. It's almost like her telling me I can masturbate during our sessions, or whenever I need to do it to get that release, is giving me some sort of "permission" that I think I was seeking from someone else because I would not give myself that permission. I was too ashamed to condone my own behavior and I think that's why it became so compulsive.

This is an unorthodox way of handling my PGAD, maybe, but it actually feels very healing to me. There is something very comforting and soothing about having that experience while listening to the sound of her voice, it's very grounding. I have a severe form of DID and dissociate frequently, having full blackouts multiple times a day, and it is more likely to happen when I masturbate - even though I have to masturbate to get some relief from my PGAD symptoms. The orgasms I have spontaneously are not as intense or satisfying as the ones I get through masturbating. So it feels more like a comfort/safety thing

I do want to talk to her about the fantasies and my preoccupation with it, because I can see how it might possibly turn into a fetish. I have done this type of thing for years though, I just never told any of my other therapists about it. I'm hoping that having it out in the open and taking out some of the secrecy / taboo around it will help me get it out of my system. It feels that way so far. It's actually a huge relief after all this time doing this, like a huge burden was lifted from me. I always felt so ashamed of the things I did and wondered why I would want to masturbate so much or do it around people or on the phone, etc. It was nice to finally be honest about all of it and have my therapist be so supportive and understanding, and not judge me at all.