He devotes
an important chapter to this matter, and brings forward numerous
cases in illustration (Adler, _Die Mangelhafte
Geschlechtsempfindung des Weibes_, pp. 93-119, also 21-23). Adler
considers that the frequency of masturbation in women is largely
due to the fact that women experience greater difficulties than
men in obtaining sexual satisfaction, and so are impelled by
unsatisfying coitus to continue masturbation after marriage. He
adds that partly from natural shyness, partly from shame of
acknowledging what is commonly accounted a sin, and partly from
the fear of seeming disgusting or unworthy of sympathy in the
doctor's eyes, women are usually silent on this matter, and very
great tact and patience may be necessary before a confession is
obtained.
On the psychic side, no doubt, the most frequent and the most
characteristic result of persistent and excessive masturbation is a morbid
heightening of self-consciousness without any co-ordinated heightening of
self-esteem.[340] The man or woman who is kissed by a desirable and
desired person of the opposite sex feels a satisfying sense of pride and
elation, which must always be absent from the manifestations of
auto-erotic activity.[341] This must be so, even apart from the
masturbator's consciousness of the general social attitude toward his
practices and his dread of detection, for that may also exist as regards
normal coitus without any corresponding psychic effects.
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