Fetishism is sexual attraction to objects, situations, or body parts not traditionally viewed as sexual.
The term "fetishism" was coined in the late 1800s. It originates from the Portuguese word feitico, which means "obsessive fascination". There is a degree of fetishistic arousal in most normal individuals who find particular bodily features attractive. However, fetishistic arousal is generally considered a problem when it interferes with normal sexual or social functioning and where sexual arousal is impossible without the fetish object.
Fetishism is characterized as a disorder when there is a pathological assignment of sexual fixation, fantasies or behaviors toward an inanimate object -- frequently an item of clothing -- such as underclothing or a high-heeled shoe -- or to nongenital body parts -- such as the foot. Only through use of this object can the individual obtain sexual gratification. The fetishist usually holds, rubs or smells the fetish object for sexual gratification or asks their partner to wear the object during sexual encounters. Fetishism is a more common occurrence in males, and the causes are not clearly known. Fetishism falls under the general category of paraphilias, abnormal or unnatural sexual attractions.
Inanimate object fetishes can be categorized into two types: form fetishes and media fetishes. In a form fetish, the object and its shape are important, such as high-heeled shoes. In a media fetish, the material of the object is important, such as silk or leather. Inanimate object fetishists often collect the object of their favor. In some cases, the fetishism is severe enough to inspire the fetishist to acquire objects of his desire through theft or assault. Fetishists smell, rub or handle these objects while masturbating or ask their sex partners to wear the objects; male fetishists may be unable to get erections without the presence of the objects. Nearly all fetishists are male, though some women also exhibit fetishism.
Aside from those listed above, other common objects used by fetishists are panties, bras, slips, stockings, other intimate apparel, footwear and gloves. Common materials other than those listed above also include rubber and fur. For some, merely a picture of the fetish object may arise the fetishists, though most prefer or require the actual object. It is not about the person who has worn the object, rather it is about the object itself. Examples of animate fetish objects include hair, legs and buttocks.
Fetishism excludes cross-dressing and objects specially designed for sexual use such as vibrators and dildos.
The sexual acts of fetishists are characteristically depersonalized and objectified, with the focus being exclusively on the fetish. Non-fetishists may at various times become aroused by a particular body part or an object and make it a part of their sexual interaction with another person, but they do not fixate on it. In general, the fetishist can only become sexually aroused and orgasmic when the fetish is being used. In other instances, a response may occur without the fetish, but at a diminished level. When the fetish object is not present, the fetishist fantasizes about it. The diagnostic criteria for fetishism includes:
Other features of fetishism include:
Some disorders such as mental retardation and dementia have similar or even the same symptoms. The clinician, therefore, in her diagnostic attempt needs to rule out other potential disorders to establish a precise diagnosis.
Common types of fetishism:
The cause of fetishistic behavior as a pattern of sexual gratification cannot be explained easily.
Some theorists believe that fetishism develops from early childhood experiences, in which an object was associated with a particularly powerful form of sexual arousal or gratification. Other learning theorists focus on later childhood and adolescence and the conditioning associated with masturbation activity. Studies show that fetishists have poorly develop social skills, are isolated in their lives and have a diminished capacity for establishing intimacy.
Behavioral learning models suggest that a child who is the victim or observer of inappropriate sexual behaviors learns to imitate and is later reinforced for the behavior. Compensation models suggest that these individuals are deprived of normal social sexual contacts and thus seek gratification through less socially acceptable means. In the far more common cases, involving males, the patterns suggest that causes stem from doubts about ones own masculinity, potency, and a fear of rejection and humiliation. By his fetishistic practices and the mastery over an inanimate object, the individual apparently safeguards himself and also compensates for some of his feelings of inadequacy.
Almost always the treatment must be long-term if it is to be effective. Treatment approaches have included traditional psychoanalysis, hypnosis, cognitive and behavior therapy as well as pharmacotherapy. Some prescription medicines help to decrease the compulsive thinking associated with the paraphilias. This allows concentration on counseling without as strong a distraction from the paraphiliac urges. Increasingly, the evidence suggests that combining drug therapy with cognitive behavior therapy can be effective, although research on the outcome of these therapies has been incomplete and often appear not to have been successful. More recently, a class of drugs called antiandrogens that drastically lower testosterone levels temporarily have been used in conjunction with these forms of treatment. The drug lowers the sex drive in males and reduces the frequency of sexually arousing mental imagery. This helps the individual concentrate on counseling. Increasingly, the evidence suggests that combining drug therapy with cognitive behavior therapy can be effective.
The level of sex drive is not consistently related to the behavior of paraphiliacs and that high levels of circulating testosterone do not predispose a male to paraphilias. That said, hormones such as medroxyprogesterone acetate (Depo-Provera) and cyproterone acetate help decrease the level of circulating testosterone thus reducing sex drive and aggression and resulting in reduction of frequency of erections, sexual fantasies and initiations of sexual behaviors including masturbation and intercourse. Hormones are typically used in tandem with behavioral and cognitive treatments. Antidepressants such as fluoxetine (Prozac) have also successfully decreased the sex drive but have not effectively targeted sexual fantasies.
Research suggests that cognitive-behavioral models are effective in treating paraphiliacs: Aversive conditioning involves using negative stimuli to reduce or eliminate a behavior. Covert sensitization entails the patient relaxing, visualizing scenes of deviant behavior followed by a negative event such as getting his penis stuck in the zipper of his pants. Assisted aversive conditioning is similar to covert sensitization except the negative event is made real most likely in the form of a foul odor pumped in the air by the therapist. The goal is for the patient to associate the deviant behavior with the foul odor and take measures to avoid the odor by avoiding said behavior.
Thought stopping is another technique used to control fetishism. The therapist first determines the patient's other types of other attractions and fantasies. The therapist asks the patient to think about the fetish fantasy; once the fantasy is conjured, the therapist yells, "Stop!" At this point the patient immediately switches to the earlier agreed upon fantasies. This process is repeated several times in the presence of the therapist. Another technique used to control fetishism is fantasy reshaping, a modification of the thought-stopping process.
Reconditioning techniques center on immediate feedback to the patient so behavior will change right away. For example, a person might be connected to a biofeedback machine that is connected to a light and taught to keep the light within a specific range of color while the person is exposed to sexually stimulating material. Or masturbation training might focus on separating pleasure in masturbation and climax from the deviant behavior.