attributed to the habit. She resolved not to do it again,
and she kept her resolution. But while still in hospital she fell
wildly in love with a man. To escape from the constant thought of
this man, she sought relations with her husband, and at times
masturbated, but now it no longer gave her pleasure. She wished
to give up sexual things altogether. But that was easier said
than done. She became subject to nervous crises, often brought on
by the sight of a man, and accompanied by sexual excitement. They
disappeared under treatment, and she thereupon became entirely
frigid sexually. But, far from being happy, she has lost all
energy and interest in life, and it is her sole desire to attain
the sexual feelings she has lost. Adler considers that even when
masturbation in women becomes an overmastering passion, so far as
organic effects are concerned it is usually harmless, its effects
being primarily psychic, and he attaches especial significance to
it as a cause of sexual anaesthesia in normal coitus, being,
perhaps, the most frequent cause of such anaesthesia. 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 consci