Self stimulation behavior in infants & toddlers & preteen children. Differentiating it from masturbation

An interesting case - Dr Newton Luiz.

This 2  yr old girl was brought by her concerned parents because of her strange behaviour, which consisted of swinging her body rhythmically on the sofa or bed. It started about a year back, and became a daily habit, and now happens many times a day. It goes on for a long time, and the child starts sweating and grunting and breathing irregularly. She gets upset if she is forcibly stopped. When told not to do it again, she promises sincerely, but forgets and does it again. She is a good child, cooperative, playful, with normal intelligence.

Self-Stimulation

All infants explore their own bodies, and note that the genitalia are more sensitive and pleasurable to touch, so they touch these areas repeatedly. If the infant is permitted to move around naked, or if there is a mild bacterial or fungal itch at the genitalia, the infant scratches the area frequently, and the pleasurable sensation that results can lead to habitual self-stimulation. This is easy to manage: keep the child clothed, and treat any local infection if present.

Occasionally older children aged 2-10 years, especially girls, discover by accident that rubbing their genitalia against a pillow or the bed is pleasurable. They do it repeatedly and for prolonged periods, and there may be a blank expression on their face, sweating and grunting. One 7 year old girl was brought to me fearing that it was a type of epileptic seizure, due to the vacant stare. If they are forcibly prevented from continuing they may get very angry, as they do not feel that they are doing anything wrong or shameful; in fact, they even do it in public. The pleasure is physical but not sexual.

Masturbation

Note that self-stimulation is NOT the same as masturbation. In the latter, which occurs from adolescence onwards, the act is usually associated with a sexual fantasy, and the person is well aware that such behaviour is not approved of and should not be done in public.

Masturbation is very common in males, both adolescents and adults. Remember 95/75/55...95% have done it at some time or the other. 75% do it occasionally as adults, e.g. when separated from their spouses. 55% do it frequently.

Masturbation is often associated with severe guilt, especially in adolescents. This manifests as fears that it will damage the health physically, resulting in future infertility or impotence, intellectual disability, general ill-health etc. It is not harmful, for the same reason that coitus is not harmful to the health.

Compulsive masturbation is a different story. Just as physical strain and overwork can cause exhaustion, frequent masturbation can cause physical and mental exhaustion, with lethargy, general malaise and temporary impotence. It is harmful – not because of the masturbation, but because of the compulsive nature. Adolescent boys frequently ask how one can get rid of compulsive masturbation. Here’s what I tell them:

(As Dr MKC Nair used to say) “If you have an itch anywhere, you have a right to scratch there, but do not keep scratching and create an ulcer. An excessive interest in masturbation is more common when one is bored and does not have enough variety in one’s life. This is obviously not desirable. The right solution is to deliberately involve oneself in creative activities. Life is meant to be enjoyed: study hard, play well, take part in sports and cultural activities, move around with friends, watch a little TV – let there be variety in your life. Don’t spoil the best years of your life by getting hooked onto one activity”.       

Do not say that masturbation is ‘abnormal’ or ‘unhealthy’; it isn’t. But do not say that masturbation is ‘normal’ or ‘healthy’, as this will put pressure on the minority who are not interested in masturbating.

Source - As discussed on the Adolescent India forum via email