Masturbation during phone session with therapist

Hey guys,
Yesterday I had a really good session with my therapist. I have DID as well as PGAD, or persistent genital arousal disorder, which means I have spontaneous orgasms constantly. I am under a lot of stress so the dissociation is severe right now. I have a lot of sexually compulsive behavior, including compulsive masturbation.

A couple weeks ago I was on the phone with my therapist, we have been having phone sessions for about a month instead of meeting in person due to the quarantine. I brought up the PGAD and how bad it was. I felt very aroused and uncomfortable. My therapist asked me about masturbation and we talked about how it helps. I was so turned on that I masturbated while we were talking about it. I didn't bring myself to orgasm and I stopped when we switched to a different topic.

I confessed this to my T yesterday and to my surprise she was really supportive. She said it made sense that I might need to masturbate right now, rhar we knew it was one of the things that helps and I should do whatever is helpful. She said me masturbating was a way of self soothing and taking care of myself

She encouraged me to masturbate as much as I needed to , even if we were talking on the phone. We had our first video session the day I told her and I didn't touch myself at all then, but I have been fantasizing constantly about what it will be like when I do, how it will feel, whether I will orgasm, just the thought of hearing her voice when it happens is comforting somehow

Should I take her advice and just masturbate whenever, even during therapy sessions? I am desperate for some relief at this point, and she essentially gave me permission. I've had fantasies about things like this for years, and I feel this out of control sexual arousal whenever I think about it. That feels really embarrassing and shameful.

Any advice/feedback, or anyone with a similar experience?

Would that be ethical?

How about do it just before your session?

I don't like the sound of that. Serious alarm bells are ringing in my mind that your T is encouraging you to perform sexual activities while on the phone to each other, regardless of the condition which I know from others is extremely difficult to live with. My concern is that your T is using your behaviour for her own gratification, under the guise of concern for you. Either way, it isn't ethical practice to be doing this. Her encouraging you to find ways to managing your condition and impulsions in your own time is another matter, but with her is a no no, sorry.

Are you able to concentrate on talking to your T while masturbating? It seems like it would distract you from therapy and then you wouldn't be getting the help you need from her.

Also, how would this affect you when you start meeting in session again? I'd think it might cause problems if you get used to it.

I am very glad that your T handled it so well when you told her you were masturbating during the session. If you can’t control it you shouldn’t be punished or made to feel bad about it after all I assume that is part of why you are seeing T. I find it a little troublesome that your T is encouraging it though. I am very dissociative. T understand that I get very dissociative during sessions and don’t always realize it yet alone have the ability to do something different. T is supportive when it happens and in dealing with the aftermath of my dissociation. T does not, even in these times, encourage me to use dissociation as a coping technique. He reminds me to try and keep my anxiety and strong emotions below a 5 on a scale we have worked out. He reminds me to do self care. He gives me space to talk about the things that are causing stress.
I can understand under the current significantly higher stress and phone or video sessions it is a lot harder to control the need to masturbate. It doesn’t sound like it is a sexual thing towards your T. It sounds like you are self soothing and having the unusual opportunity to have both sources of calming. Perhaps in these times your T is choosing not to focus on the PGAD. That bothers me a little because the more we allow any behavior that becomes troublesome the more we reinforce those nuropathways making it harder to stop later. I didn’t get the impression that your T was in any way participating, or even aware of it beyond your telling them. I also didn’t get the impression they were turned on by it or getting something out of it. So I would lean towards perhaps it not being best practice but not going so far as to say it was unethical.
Personally I would try to refrain from doing it in session on the phone/video just as you would face to face. I wouldn’t be hard on myself if it happened though.

Not gonna lie its crossed my mind but i couldn't do that

I'm not sure it's actually in your best interests to give in to the compulsion during therapy. Seems like it could just intensify your arousal in general when talking to her to sexualize the encounter. It sounds like you have some sort of fantasy around this and I don't think it is appropriate to act on that given your therapist is not a sex worker. Just because something is somebody's way of self soothing does not mean it is automatically good for them. I don't really understand why your therapist conceptualizes compulsions that way.

Edit: Maybe try sitting on an ice pack or something.

I really feel this is unwise. How can you possibly focus on what you are talking about with your t if you are doing that? He/she isnt a sex worker. Also, you are supposed to see your t as a guide and even an authority figure. How can that possibly work with you making them a sex object? I would suggest getting a same sex t (unless you're gay).

I think Ts have to toe a fine line between accepting and encouraging some things. But this:

'She encouraged me to masturbate...even if we were talking on the phone'

seems a very obvious breach of professional ethics to me. Saying that I know very little about PGAD. But given all the other issues you mention I cannot think of anyway in which it could be beneficial to therapy.

Hi. I know about PGAD, I get that it is hard when you feel it constantly. Itwas good you talked to your T about it, but I do not think she should encourage that. Especially when at some point you will meet in person again. I get that maybe you need to before and after. I have read about some people putting an ice pack in the area, since sitting down can be uncomfortable. I hope you find some relief.

I think the thing that would benefit you the most would be to ask your t why she is encouraging it, exactly. And also to tell her that you’ve had fantasies of doing such a thing.

I don’t think it’s clear-cut at all that anything unethical is happening, but what really matters here is the t’s level of expertise with your particular kind of issues, and her motivation for encouraging the behavior. Sexuality and masturbation aren’t, after all, just adult things but something that lasts through the entire lifespan. Many children touch their genitals openly in front of adults, and many parents react strongly and angrily, instilling the child with a strong sense of shame.

I don’t know enough about these disorders or how they’re treated to say yes or no, but I can suggest finding out more about what’s behind her thought and paying close attention to whether she struggles to answer it. If she’s doing it purely for your benefit and not in any way for her own gratification, she should have an easy enough answer.

Masturbation isn't an exclusively adult thing, of course, but it is a sexual thing - even in children. And children are taught that it should be private even by sex-positive parents. Sexual behavior has no place in session.