A Billion Wicked Thoughts

The world's largest experiment on human desire.

Fetishes Do Not Exist

The terms "paraphilia" and "fetish" should go the wayof terms like "retarded," "spastic," and "hysteria." Men and women have diverse sexual interests, not atypical fetishes. Read More

Fetishes & Kink vs paraphilias in therapy

There is so much coming out right now about the many problems with the DSM, the book mental health clinicians use to diagnose (and presumably then guide the process of therapy). It is no question that there are questionable entries in the chapter about sexuality. I can tell you that my studies in clinical sexology, we were taught that fetishes and kink were interests, and that paraphilias (as described in the DSM) were problematic. Showing your naked self on webcam with consenting partner(s)? Interest. Showing yourself off (compulsively) so unsuspecting strangers without their consent (and without a hope that they will show off for you)- paraphilia called exhibitionism. The way I deal with kink and fetishes in therapy is basically- if you are in the driver’s seat, we’re good. If you feel compelled to treat people as objects or objects as people and this causes you and others emotional conflict, then it might be paraphilic behavior, and might be self-defeating.
I can see the need to study and label, no problem there. But when we use these labels to define healthy/normal sexuality based on one dominant group’s definition of healthy/normal, then I have a problem. It seems like throughout the history of the mental health field, clinicians have been sometimes used as tools of the oppression. Not sure what to do with your autistic daughter? Send her to the insane asylum. Can’t deal with your gay son? Send him to the insane asylum. Shock therapy (ECT) will cure what ails ‘em! Or how about cold water enemas? Or leeches? Have uncommon (and often harmless) sexual tastes? Fetishes! Get thee to the head shrinker!
Modern therapists who have any experience at all with dealing with fetishes and kink will tell you- if it’s safe, sane and consensual, then you’re definitely more sexually liberated and healthy than a good number of so-called normophilic sexually active people.
Michael DeMarco

The box model of mental pathologies.


Thank you for your thoughtful comment. One reason for what you term questionable entries may have to do with the historical perception that behavior - and the brain function giving rise to it - can be neatly boxed into crisp categories. This paradigm served us well when treating other bodily ailments but is not as useful when it comes to the brain and its dense, complicated interconnections that marshal multiple regions while tackling problems of perception, emotion, and cognition.
This is also true when it comes to sexual desire. A finite, small, biologically endowed set of sexual cues can combine to create a whole spectrum of desires. Healthy or unhealthy cannot just be defined by the behavior itself, but by its effects on the person and the people it may affect.

Non-existing fetishes

I'm having a hard time with the logic here. Fetishes/paraphilia do not exist because they are widespread?

Their designation as fetishes/perversions makes people feel 'different,' therefore we should deny they "exist?" Help me out.

Concepts of health are normative, not statistics-based. Our ideals about optimal functioning, or health, are meant to give us guidance, not just to establish the lay-of-the-land. Gathering more facts about actual behavior doesn't change anything in that equation.

One clearly stated ideal of psychoanalysis being that relationships to part-objects are not 'optimal' and not spiritually-morally equal to sex with loved individuals. It's not a question of efficacity or function, and the end-point is the same, viz. "getting off." It's a question of sexual morality, and sexual morality is not isolatable from questions of spiritual ideals.

The interplay of culturally transmitted attitudes toward sexuality [Judaeo-Christian ones in particular] and the normative presuppositions of mental health practitioners and theoreticians would be an interesting subject to investigate. Any suggestions?

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Ogi Ogas, Ph.D., studies computational neuroscience. He is co-author of A Billion Wicked Thoughts.


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