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The interest which analysts have shown in masturbation and masturbation fantasy goes back to the beginnings of psychoanalysis (Levin, 1963). In fact, there is no analytic case in which the topic of masturbation is not an issue involving considerable conflict for the patient. In 1908 Freud discussed masturbation in terms of two basic components: (1) the return of early autoerotic activity; (2) the merging of a later sexual fantasy with the autoerotic activity. He believed that the renunciation of masturbation involved not only the giving up of autoerotic activity but also the repression of the associated fantasies, either of which could then be revived in the form of symptoms. Arlow (1953) has stated: "From the point of view of the dynamic, defensive functioning of the psychic apparatus, masturbation and symptoms have much in common. Both demonstrate how the ego operates in attempting to achieve a satisfactory solution of the conflicting claims of the instincts, the pressure of the superego, and the demands of reality. Masturbation and symptom formation both portray the end product of a complicated and overdetermined set of mental operations in the ego, operations which proceed according to the principle of multiple functioning [Waelder, 1930]" (p. 45).
It is well known that the act of masturbation and the fantasy accompanying or preceding it may become separated from each other and that defenses may then be directed against either the fantasy or the physical activity or both. Furthermore, a variety of fear fantasies and defenses against them may also arise, reflecting the castration anxiety evoked by masturbation, as in the case described by Bornstein (1953) of a five-and-a-half-year-old boy whose fear of masturbation