Sexual fetishism
Encyclopedia
Sexual fetishism, or erotic fetishism, is the sexual arousal
a person receives from a physical object, or from a specific situation. The object or situation of interest is called the fetish, the person a fetishist who has a fetish for that object/situation. Sexual fetishism may be regarded, e.g. in psychiatric medicine, as a disorder of sexual preference or as an enhancing element to a relationship causing a better sexual bond between the partners. Arousal from a particular body part is classified as partialism
.
. Sometimes, the word fetish may be thought synonymous to "sexual fetish" (for example, when used in pornography based on sexual fetishes).
If a sexual fetish causes significant psychosocial distress for the person or has detrimental effects on important areas of their life, it is diagnosable as a paraphilia
in the DSM
and the ICD
. Many people embrace their fetish rather than attempting treatment to rid themselves of it.
In a review of the files of all cases over a 20-year period which met criteria for non-transvestic fetishes in a teaching hospital, 48 cases were identified, and the objects of their fetishes included clothing (58.3%), rubber and rubber items (22.9%), footwear (14.6%), body parts (14.6%), leather jackets and vests, and leather items (10.4%), and soft materials and fabrics (6.3%).
The existential
approach to mental disorders developed in the 1940s and influenced a view that fetishes had complex personal meanings beyond the general categories of psychoanalytical treatment. For instance, the Austrian neurologist and logotherapist
Viktor Frankl
once noted the case of a man with a sexual fetish involving, simultaneously, both frogs and glue. However, Frankl's logotherapy is but one of dozens of psychological systems or methods of psychotherapy
that compete with psychoanalysis
.
The concept of spiritual love is not accepted globally because it is impossible to fully define what exactly is "spiritual love." Mental phenomena, attitudes, and social class are all things that can be obsessed over, but it is hard to prove that they would be a sexual obsession. It is also hard to incorporate any "idea" into a sexual act or stimulation. However, a mental obsession, such as an idea or excessive thought, can be progressed into a "plastic love." For example, role playing. If a person has a mental obsession with cowboys, their partner could dress up as a cowboy to make it a real thing or "plastic love."
or imprinted
or the result of a strong emotional (e.g., traumatic) or physical experience. Often, these experiences were experienced in early childhood. For example, an individual who has been physically abused could either have a sexual obsession with intercourse, or they could be completely terrified by even the idea of being touched. It is assumed that those who have been sexually abused create an obsession with being touched or touching others, and possibly even abuse someone else. Physical factors like genetic disposition are another common possible explanation. In the following, the most important theories are presented in chronological order:
Alfred Binet suspected fetishism was the pathological result of associations. Accidentally simultaneous presentation of a sexual stimulus and an inanimate object, he argued, led to the object being permanently connected to sexual arousal
.
The sexologist Magnus Hirschfeld
followed another line of thought when he proposed his theory of partial attractiveness in 1920. According to his argument, sexual attractiveness never originates in a person as a whole but always is the product of the interaction of individual features. He stated that nearly everyone had special interests and thus suffered from a healthy kind of fetishism, while only detaching and overvaluing of a single feature resulted in pathological fetishism. Today, Hirschfeld's theory is often mentioned in the context of gender role specific behavior: females present sexual stimuli by highlighting body parts, clothes or accessories; males react to them.
Sigmund Freud believed that sexual fetishism in men derived from the unconscious fear of the mother's genitals, from men's universal fear of castration, and from a man's fantasy that his mother had had a penis but that it had been cut off. He did not discuss sexual fetishism in women.
In 1951, Donald Winnicott
presented his theory of transitional objects and phenomena, according to which childish actions like thumb sucking and objects like cuddly toys are the source of manifold adult behavior, amongst many others fetishism.
The use of a transitional object in infancy is a healthy experience (Winnicott, 1953). To understand the origin of a fetish object and of fetishism, the infant’s use of the transitional object and of transitional phenomena in general must be studied (Winnicott, 1953).
In his article ‘Transitional objects and phenomena’, Winnicott says about fetish: “Fetish can be described in terms of a persistence of a specific object or type of object dating from infantile experience in the transitional field, linked with the delusion of a maternal phallus” (Winnicott, 1953). In other words, a specific object or type of object, dating from an experience during the period where the mother gradually pulls back as an immediate provider of satisfaction of the child’s desires, persists as a characteristic in adult sexual life.
Before this transitional phase, the child believes that his own wish creates the object of his desire (specifically the qualities of his mother that fulfill his needs), which brings with it a sense of satisfaction. During this phase the child gradually adapts to the (frustrating) realization that the object cannot be controlled to serve the child's needs.
The transitional object is always the result of a gratifying relationship with the mother, specifically with the maternal body. It stands for the satisfying qualities that the object (the mother/ father) of the first relationship the child has. The child adapts to the impact of the realization that the mother is not always there to ‘bring the world to him’ through fantasizing about the object of his desire while using an object (a teddy bear, a piece of cloth). He creates an illusion of the previous object. In relation to the transitional object the infant passes from (magical) omnipotent control to control by manipulation (involving muscle eroticism and co-ordination pleasure).
In opposition to this, the fetish represents the impossibility of pleasure with the body of the mother or the paternal body in the case of females. Fetishism, although less abundant in occurrence in the female psyche, or of a different nature, is not the monopoly of men. The transitional object may eventually develop into a fetish object and so persist as a characteristic of the adult sexual life (Winnicott, 1953). Normally, the child gains from the experience of frustration during the transitional phase, although the infant can be disturbed by a close adaptation to need that is continued too long or is not allowed its natural decrease.
Behaviorism
traced fetishism back to classical conditioning
and came up with numerous specialized theories. The common theme running through all of them is that sexual stimulus and the fetish object are presented simultaneously causing them to be connected in the learning process. This is similar to Binet's early theory, though it differs in that it specifies association to classical conditioning and leaves out any judgment about pathogenicity. The super stimulus theory stressed that fetishes could be the result of generalization. For example, it may only be shiny skin that arouses a person at first, but in time more common stimuli, such as shiny latex, may have the same effect. The problem with such a theory was that classical conditioning normally needs many repetitions, but this form would require only one. To account for this the preparedness theory was put forward; it stated that reacting to an object with sexual arousal could be the result of an evolutionary process, because such a reaction could prove to be useful for survival. In pointing to how conditioned sexual behavior can persist over time, one may cite how, in 2004, when quails were trained to copulate with a piece of terry cloth, their conditioning was sustained through ongoing repetition.
Because classical conditioning seemed to be unable to explain how the conditioned behavior is kept alive over many years, without any repetition, some behaviorists came up with the theory that fetishism was the result of a special form of conditioning, called imprinting
. Such conditioning happens during a specific time in early childhood in which sexual orientation is imprinted into the child's mind and remains there for the rest of his or her life.
Various neurologists pointed out that fetishism could be the result of neuronal cross links between neighboring regions in the human brain. For example, in 2002 Vilayanur S. Ramachandran
stated that the region processing sensory input from the feet lies immediately next to the region processing sexual stimulation.
Today, psychodynamics has parted with the idea of proposing one explanation for all fetishes at the same time. Instead, it focuses on one form of fetishism at a time and the patients' individual problems. Over the past decades, various case studies have been published in which fetishism could successfully be linked to emotional problems. Some argue that a lack of parental love leads to a child projecting its affection to inanimate objects, others state in consent with Freud's model of psychosexual development
that premature suppression of sexuality could lead to a child getting stuck in a transitory phase. One of Freud’s defense mechanisms, displacement, is the redirection of an impulse onto a substitute target. Someone who feels uncomfortable with their sexual desire for a real person may therefore substitute a fetish.
It must be noted that a correct diagnosis in terms of the ICD manual stipulates hierarchical proceeding. That is, first the criteria for F65 must be fulfilled, then those for F65.0. As criteria are not repeated in substages this can be mistakable to laymen or medics that have not been educated in the use of this manual. Furthermore, it must be noted that according to the ICD, an addiction to specific parts or features of the human body and even "inanimate" parts of corpses, under no circumstances are fetishism, even though some of them may be forms of paraphilia
.
According to the DSM-IV-TR
, fetishism is the use of nonliving objects as a stimulus to achieve sexual arousal or satisfaction. (This only applies if the objects are not specifically designed for sexual stimulation (e.g., a vibrator).) The corresponding DSM-code
for fetishism is 302.81; the diagnostic criteria are basically the same as those of the ICD. In the DSM manual, all diagnostic criteria are given in the corresponding section of the text book, i. e., here no hierarchical processing is needed.
Both definitions are the result of lengthy discussions and multiple revisions. Still today, arguments go on whether a specific diagnosis fetishism is needed at all or if paraphilia
as such is sufficient. Some demand that the diagnosis be abolished completely to no longer stigmatize fetishists, e. g. project ReviseF65
. Others demand that it be specified even more to prevent scientists from confusing it with the popular use of the term fetishism. And other researchers argue that it should be expanded to cover other sexual orientations, such as an addiction to words or fire. Most physicians would not say that a man who finds a woman attractive because she is dressed in high heels, lacy stockings or a corset has an abnormal fetish.
.
Cognitive behavior therapy primarily focuses on helping patients tune in to automatic thoughts that affect patients' mood and behavior. As patients become more aware of their automatic thoughts, they learn to alter irrational thoughts and resolve contradictions that lead to distress. A common goal of cognitive therapy in the treatment of fetishes is helping the patient realize the irrationality of identifying with a disliked fetish, a form of cognitive globalization that often leads to self-judgment.
The following is not cognitive behavior therapy and should not be confused with it: One therapeutic technique is aversive conditioning, which entails presenting patients with a displeasing stimulus with the fetish as soon as sexual arousal
starts. Another therapeutic technique is called thought stopping, in which the therapist asks the patient to think of the fetish and suddenly cries out "stop!". The patient will be irritated, their line of thought broken. After analyzing the effects of the sudden break together, the therapist will teach the patient to use this technique by him or herself to interrupt thoughts about the fetish and thus avoid the undesired behavior.
s, especially male testosterone
and female estrogen
. By cutting down the level of sex steroids, sexual desire is diminished. Thus, in theory, a person might gain the ability to control their fetish and reasonably process their own thoughts without being distracted by sexual arousal. Also, the application may give the person relief in everyday life, enabling them to ignore the fetish and get back to daily routine. Other research has assumed that fetishes may be like obsessive-compulsive disorders, and has looked into the use of psychiatric drugs (serotonin reuptake inhibitors and dopamine blockers) for controlling paraphilias that interfere with a person's ability to function.
Although ongoing research has shown positive results in single case studies with some drugs, e. g. with topiramate
, there is not yet any medicament that tackles fetishism itself. Because of that, physical treatment is only suitable to support one of the psychological methods.
However, the visual map of fetishes linked below flags several clusters as having a number of women admirers, such as corsetry and some of the medical-related fetishes. The preferences of women fetishists are not necessarily a mirror image of those of male fetishists; just because many men are attracted to women in high heels, it does not necessarily mean there are many women attracted to men in construction boots.
The book Female Perversions, which also discussed corsetry and self-cutting
, in part discusses "female transvestism". It gives examples both of women who became excited by dressing in a "butch
" way, i.e. analogous to male transvestite fetishism, and of women who were aroused by dressing in a very "femme
" way, which is referred to as homeovestism.
Sexual arousal
Sexual arousal, or sexual excitement, is the arousal of sexual desire, during or in anticipation of sexual activity. Things that precipitate human sexual arousal are called erotic stimuli, or colloquially known as turn-ons. There are many potential stimuli, both physical or mental, which can cause...
a person receives from a physical object, or from a specific situation. The object or situation of interest is called the fetish, the person a fetishist who has a fetish for that object/situation. Sexual fetishism may be regarded, e.g. in psychiatric medicine, as a disorder of sexual preference or as an enhancing element to a relationship causing a better sexual bond between the partners. Arousal from a particular body part is classified as partialism
Partialism
Partialism refers to a sexual interest with an exclusive focus of a specific part of the body. Partialism is categorized as a paraphilia in the DSM-IV-TR of the American Psychiatric Association...
.
Overview
The word fetish derives from the French fétiche, which comes from the Portuguese feitiço (“spell”), which in turn derives from the Latin facticius (“artificial”) and facere (“to make”). A fetish is an object believed to have supernatural powers, or in particular, a man-made object that has power over others. Essentially, fetishism is the attribution of inherent value or powers to an object. The terms "erotic fetish" and "sexual fetish" were first introduced by Alfred BinetAlfred Binet
Alfred Binet was a French psychologist who was the inventor of the first usable intelligence test, known at that time as the Binet test and today referred to as the IQ test. His principal goal was to identify students who needed special help in coping with the school curriculum...
. Sometimes, the word fetish may be thought synonymous to "sexual fetish" (for example, when used in pornography based on sexual fetishes).
If a sexual fetish causes significant psychosocial distress for the person or has detrimental effects on important areas of their life, it is diagnosable as a paraphilia
Paraphilia
Paraphilia is a biomedical term used to describe sexual arousal to objects, situations, or individuals that are not part of normative stimulation and that may cause distress or serious problems for the paraphiliac or persons associated with him or her...
in the DSM
Diagnostic and Statistical Manual of Mental Disorders
The Diagnostic and Statistical Manual of Mental Disorders is published by the American Psychiatric Association and provides a common language and standard criteria for the classification of mental disorders...
and the ICD
ICD
The International Statistical Classification of Diseases and Related Health Problems is a medical classification that provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or disease...
. Many people embrace their fetish rather than attempting treatment to rid themselves of it.
In a review of the files of all cases over a 20-year period which met criteria for non-transvestic fetishes in a teaching hospital, 48 cases were identified, and the objects of their fetishes included clothing (58.3%), rubber and rubber items (22.9%), footwear (14.6%), body parts (14.6%), leather jackets and vests, and leather items (10.4%), and soft materials and fabrics (6.3%).
Types
Alfred Binet, a French psychologist, lawyer and hypnotist, proposed that fetishes be classified as either "spiritual love" or "plastic love". "Spiritual love" occupied the devotion for specific mental phenomena, such as attitudes, social class, or occupational roles; while "plastic love" referred to the devotion exhibited towards material objects such as animals, body parts, garments, textures or shoes.The existential
Existential therapy
Existential psychotherapy is a philosophical method of therapy that operates on the belief that inner conflict within a person is due to that individual's confrontation with the givens of existence. These givens, as noted by Irvin D...
approach to mental disorders developed in the 1940s and influenced a view that fetishes had complex personal meanings beyond the general categories of psychoanalytical treatment. For instance, the Austrian neurologist and logotherapist
Logotherapy
Logotherapy was developed by neurologist and psychiatrist Viktor Frankl. It is considered the "Third Viennese School of Psychotherapy" after Freud's psychoanalysis and Adler's individual psychology. It is a type of existentialist analysis that focuses on a will to meaning as opposed to Adler's...
Viktor Frankl
Viktor Frankl
Viktor Emil Frankl M.D., Ph.D. was an Austrian neurologist and psychiatrist as well as a Holocaust survivor. Frankl was the founder of logotherapy, which is a form of Existential Analysis, the "Third Viennese School of Psychotherapy"...
once noted the case of a man with a sexual fetish involving, simultaneously, both frogs and glue. However, Frankl's logotherapy is but one of dozens of psychological systems or methods of psychotherapy
Psychotherapy
Psychotherapy is a general term referring to any form of therapeutic interaction or treatment contracted between a trained professional and a client or patient; family, couple or group...
that compete with psychoanalysis
Psychoanalysis
Psychoanalysis is a psychological theory developed in the late 19th and early 20th centuries by Austrian neurologist Sigmund Freud. Psychoanalysis has expanded, been criticized and developed in different directions, mostly by some of Freud's former students, such as Alfred Adler and Carl Gustav...
.
The concept of spiritual love is not accepted globally because it is impossible to fully define what exactly is "spiritual love." Mental phenomena, attitudes, and social class are all things that can be obsessed over, but it is hard to prove that they would be a sexual obsession. It is also hard to incorporate any "idea" into a sexual act or stimulation. However, a mental obsession, such as an idea or excessive thought, can be progressed into a "plastic love." For example, role playing. If a person has a mental obsession with cowboys, their partner could dress up as a cowboy to make it a real thing or "plastic love."
Psychological origins and development
Early psychology assumed that fetishism either is being conditionedClassical conditioning
Classical conditioning is a form of conditioning that was first demonstrated by Ivan Pavlov...
or imprinted
Imprinting (psychology)
Imprinting is the term used in psychology and ethology to describe any kind of phase-sensitive learning that is rapid and apparently independent of the consequences of behavior...
or the result of a strong emotional (e.g., traumatic) or physical experience. Often, these experiences were experienced in early childhood. For example, an individual who has been physically abused could either have a sexual obsession with intercourse, or they could be completely terrified by even the idea of being touched. It is assumed that those who have been sexually abused create an obsession with being touched or touching others, and possibly even abuse someone else. Physical factors like genetic disposition are another common possible explanation. In the following, the most important theories are presented in chronological order:
Alfred Binet suspected fetishism was the pathological result of associations. Accidentally simultaneous presentation of a sexual stimulus and an inanimate object, he argued, led to the object being permanently connected to sexual arousal
Sexual arousal
Sexual arousal, or sexual excitement, is the arousal of sexual desire, during or in anticipation of sexual activity. Things that precipitate human sexual arousal are called erotic stimuli, or colloquially known as turn-ons. There are many potential stimuli, both physical or mental, which can cause...
.
The sexologist Magnus Hirschfeld
Magnus Hirschfeld
Magnus Hirschfeld was a German physician and sexologist. An outspoken advocate for sexual minorities, Hirschfeld founded the Scientific Humanitarian Committee, which Dustin Goltz called "the first advocacy for homosexual and transgender rights."-Early life:Hirschfeld was born in Kolberg in a...
followed another line of thought when he proposed his theory of partial attractiveness in 1920. According to his argument, sexual attractiveness never originates in a person as a whole but always is the product of the interaction of individual features. He stated that nearly everyone had special interests and thus suffered from a healthy kind of fetishism, while only detaching and overvaluing of a single feature resulted in pathological fetishism. Today, Hirschfeld's theory is often mentioned in the context of gender role specific behavior: females present sexual stimuli by highlighting body parts, clothes or accessories; males react to them.
Sigmund Freud believed that sexual fetishism in men derived from the unconscious fear of the mother's genitals, from men's universal fear of castration, and from a man's fantasy that his mother had had a penis but that it had been cut off. He did not discuss sexual fetishism in women.
In 1951, Donald Winnicott
Donald Winnicott
Donald Woods Winnicott was an English paediatrician and psychoanalyst who was especially influential in the field of object relations theory. He was a leading member of the British Independent Group of the British Psychoanalytic Society, and a close associate of Marion Milner...
presented his theory of transitional objects and phenomena, according to which childish actions like thumb sucking and objects like cuddly toys are the source of manifold adult behavior, amongst many others fetishism.
The use of a transitional object in infancy is a healthy experience (Winnicott, 1953). To understand the origin of a fetish object and of fetishism, the infant’s use of the transitional object and of transitional phenomena in general must be studied (Winnicott, 1953).
In his article ‘Transitional objects and phenomena’, Winnicott says about fetish: “Fetish can be described in terms of a persistence of a specific object or type of object dating from infantile experience in the transitional field, linked with the delusion of a maternal phallus” (Winnicott, 1953). In other words, a specific object or type of object, dating from an experience during the period where the mother gradually pulls back as an immediate provider of satisfaction of the child’s desires, persists as a characteristic in adult sexual life.
Before this transitional phase, the child believes that his own wish creates the object of his desire (specifically the qualities of his mother that fulfill his needs), which brings with it a sense of satisfaction. During this phase the child gradually adapts to the (frustrating) realization that the object cannot be controlled to serve the child's needs.
The transitional object is always the result of a gratifying relationship with the mother, specifically with the maternal body. It stands for the satisfying qualities that the object (the mother/ father) of the first relationship the child has. The child adapts to the impact of the realization that the mother is not always there to ‘bring the world to him’ through fantasizing about the object of his desire while using an object (a teddy bear, a piece of cloth). He creates an illusion of the previous object. In relation to the transitional object the infant passes from (magical) omnipotent control to control by manipulation (involving muscle eroticism and co-ordination pleasure).
In opposition to this, the fetish represents the impossibility of pleasure with the body of the mother or the paternal body in the case of females. Fetishism, although less abundant in occurrence in the female psyche, or of a different nature, is not the monopoly of men. The transitional object may eventually develop into a fetish object and so persist as a characteristic of the adult sexual life (Winnicott, 1953). Normally, the child gains from the experience of frustration during the transitional phase, although the infant can be disturbed by a close adaptation to need that is continued too long or is not allowed its natural decrease.
Behaviorism
Behaviorism
Behaviorism , also called the learning perspective , is a philosophy of psychology based on the proposition that all things that organisms do—including acting, thinking, and feeling—can and should be regarded as behaviors, and that psychological disorders are best treated by altering behavior...
traced fetishism back to classical conditioning
Classical conditioning
Classical conditioning is a form of conditioning that was first demonstrated by Ivan Pavlov...
and came up with numerous specialized theories. The common theme running through all of them is that sexual stimulus and the fetish object are presented simultaneously causing them to be connected in the learning process. This is similar to Binet's early theory, though it differs in that it specifies association to classical conditioning and leaves out any judgment about pathogenicity. The super stimulus theory stressed that fetishes could be the result of generalization. For example, it may only be shiny skin that arouses a person at first, but in time more common stimuli, such as shiny latex, may have the same effect. The problem with such a theory was that classical conditioning normally needs many repetitions, but this form would require only one. To account for this the preparedness theory was put forward; it stated that reacting to an object with sexual arousal could be the result of an evolutionary process, because such a reaction could prove to be useful for survival. In pointing to how conditioned sexual behavior can persist over time, one may cite how, in 2004, when quails were trained to copulate with a piece of terry cloth, their conditioning was sustained through ongoing repetition.
Because classical conditioning seemed to be unable to explain how the conditioned behavior is kept alive over many years, without any repetition, some behaviorists came up with the theory that fetishism was the result of a special form of conditioning, called imprinting
Imprinting (psychology)
Imprinting is the term used in psychology and ethology to describe any kind of phase-sensitive learning that is rapid and apparently independent of the consequences of behavior...
. Such conditioning happens during a specific time in early childhood in which sexual orientation is imprinted into the child's mind and remains there for the rest of his or her life.
Various neurologists pointed out that fetishism could be the result of neuronal cross links between neighboring regions in the human brain. For example, in 2002 Vilayanur S. Ramachandran
Vilayanur S. Ramachandran
Vilayanur Subramanian "Rama" Ramachandran, born 1951, is a neuroscientist known for his work in the fields of behavioral neurology and visual psychophysics...
stated that the region processing sensory input from the feet lies immediately next to the region processing sexual stimulation.
Today, psychodynamics has parted with the idea of proposing one explanation for all fetishes at the same time. Instead, it focuses on one form of fetishism at a time and the patients' individual problems. Over the past decades, various case studies have been published in which fetishism could successfully be linked to emotional problems. Some argue that a lack of parental love leads to a child projecting its affection to inanimate objects, others state in consent with Freud's model of psychosexual development
Psychosexual development
In Freudian psychology, psychosexual development is a central element of the psychoanalytic sexual drive theory, that human beings, from birth, possess an instinctual libido that develops in five stages. Each stage — the oral, the anal, the phallic, the latent, and the genital — is characterized...
that premature suppression of sexuality could lead to a child getting stuck in a transitory phase. One of Freud’s defense mechanisms, displacement, is the redirection of an impulse onto a substitute target. Someone who feels uncomfortable with their sexual desire for a real person may therefore substitute a fetish.
Modern theory and treatment
Psychologists and medical practitioners regard fetishism as normal variations of human sexuality. Even those orientations that are potential forms of fetishism are usually considered unobjectionable as long as all people involved feel comfortable. Only if the diagnostic criteria presented in detail below are met is the medical diagnosis of fetishism justified. The leading criterion is that a fetishist is ill only if he or she suffers from the addiction, not simply because of the addiction itself.Diagnosis
According to the ICD-10-GM, version 2005, fetishism is the use of inanimate objects as a stimulus to achieve sexual arousal and satisfaction; in most cases said object is required for sexual gratification. The corresponding ICD code for fetishism is F65.0. The diagnostic criteria for fetishism are as follows:- Unusual sexual fantasies, drives or behavior occur over a time span of at least six months. Sometimes unusual sexual fantasies occur and vanish by themselves; in this case any medical treatment is not necessary.
- The affected person, their object or another person experience impairment or distress in multiple functional areas. Functional area refers to different aspects of life such as private social contacts, job, etc. It is sufficient for the diagnosis if one of the participants is being hurt or mistreated in any other way.
It must be noted that a correct diagnosis in terms of the ICD manual stipulates hierarchical proceeding. That is, first the criteria for F65 must be fulfilled, then those for F65.0. As criteria are not repeated in substages this can be mistakable to laymen or medics that have not been educated in the use of this manual. Furthermore, it must be noted that according to the ICD, an addiction to specific parts or features of the human body and even "inanimate" parts of corpses, under no circumstances are fetishism, even though some of them may be forms of paraphilia
Paraphilia
Paraphilia is a biomedical term used to describe sexual arousal to objects, situations, or individuals that are not part of normative stimulation and that may cause distress or serious problems for the paraphiliac or persons associated with him or her...
.
According to the DSM-IV-TR
Diagnostic and Statistical Manual of Mental Disorders
The Diagnostic and Statistical Manual of Mental Disorders is published by the American Psychiatric Association and provides a common language and standard criteria for the classification of mental disorders...
, fetishism is the use of nonliving objects as a stimulus to achieve sexual arousal or satisfaction. (This only applies if the objects are not specifically designed for sexual stimulation (e.g., a vibrator).) The corresponding DSM-code
DSM-IV Codes
Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision, also known as DSM-IV-TR, is a manual published by the American Psychiatric Association that includes all currently recognized mental health disorders...
for fetishism is 302.81; the diagnostic criteria are basically the same as those of the ICD. In the DSM manual, all diagnostic criteria are given in the corresponding section of the text book, i. e., here no hierarchical processing is needed.
Both definitions are the result of lengthy discussions and multiple revisions. Still today, arguments go on whether a specific diagnosis fetishism is needed at all or if paraphilia
Paraphilia
Paraphilia is a biomedical term used to describe sexual arousal to objects, situations, or individuals that are not part of normative stimulation and that may cause distress or serious problems for the paraphiliac or persons associated with him or her...
as such is sufficient. Some demand that the diagnosis be abolished completely to no longer stigmatize fetishists, e. g. project ReviseF65
ReviseF65
ReviseF65 is a committee that is working to get sexual sadism, masochism, fetishism and transvestic fetishism abolished from the World Health Organization's list of psychiatric diagnoses, ICD...
. Others demand that it be specified even more to prevent scientists from confusing it with the popular use of the term fetishism. And other researchers argue that it should be expanded to cover other sexual orientations, such as an addiction to words or fire. Most physicians would not say that a man who finds a woman attractive because she is dressed in high heels, lacy stockings or a corset has an abnormal fetish.
Treatment
There are two possible treatments for fetishism: cognitive behavior therapy and psychoanalysisPsychoanalysis
Psychoanalysis is a psychological theory developed in the late 19th and early 20th centuries by Austrian neurologist Sigmund Freud. Psychoanalysis has expanded, been criticized and developed in different directions, mostly by some of Freud's former students, such as Alfred Adler and Carl Gustav...
.
Cognitive behavior therapy
Cognitive behavior therapy seeks to change a person's behavior without analyzing how and why it has shown up. Rather than focusing on the origins of fetishes, cognitive behavior therapy is built on the empirical study of interventions that alleviate the distress associated with them.Cognitive behavior therapy primarily focuses on helping patients tune in to automatic thoughts that affect patients' mood and behavior. As patients become more aware of their automatic thoughts, they learn to alter irrational thoughts and resolve contradictions that lead to distress. A common goal of cognitive therapy in the treatment of fetishes is helping the patient realize the irrationality of identifying with a disliked fetish, a form of cognitive globalization that often leads to self-judgment.
The following is not cognitive behavior therapy and should not be confused with it: One therapeutic technique is aversive conditioning, which entails presenting patients with a displeasing stimulus with the fetish as soon as sexual arousal
Sexual arousal
Sexual arousal, or sexual excitement, is the arousal of sexual desire, during or in anticipation of sexual activity. Things that precipitate human sexual arousal are called erotic stimuli, or colloquially known as turn-ons. There are many potential stimuli, both physical or mental, which can cause...
starts. Another therapeutic technique is called thought stopping, in which the therapist asks the patient to think of the fetish and suddenly cries out "stop!". The patient will be irritated, their line of thought broken. After analyzing the effects of the sudden break together, the therapist will teach the patient to use this technique by him or herself to interrupt thoughts about the fetish and thus avoid the undesired behavior.
Medication
Various pharmaceutical drugs are available that inhibit the production of sex steroidSex steroid
Sex steroids, also known as gonadal steroids, are steroid hormones that interact with vertebrate androgen or estrogen receptors. Their effects are mediated by slow genomic mechanisms through nuclear receptors as well as by fast nongenomic mechanisms through membrane-associated receptors and...
s, especially male testosterone
Testosterone
Testosterone is a steroid hormone from the androgen group and is found in mammals, reptiles, birds, and other vertebrates. In mammals, testosterone is primarily secreted in the testes of males and the ovaries of females, although small amounts are also secreted by the adrenal glands...
and female estrogen
Estrogen
Estrogens , oestrogens , or œstrogens, are a group of compounds named for their importance in the estrous cycle of humans and other animals. They are the primary female sex hormones. Natural estrogens are steroid hormones, while some synthetic ones are non-steroidal...
. By cutting down the level of sex steroids, sexual desire is diminished. Thus, in theory, a person might gain the ability to control their fetish and reasonably process their own thoughts without being distracted by sexual arousal. Also, the application may give the person relief in everyday life, enabling them to ignore the fetish and get back to daily routine. Other research has assumed that fetishes may be like obsessive-compulsive disorders, and has looked into the use of psychiatric drugs (serotonin reuptake inhibitors and dopamine blockers) for controlling paraphilias that interfere with a person's ability to function.
Although ongoing research has shown positive results in single case studies with some drugs, e. g. with topiramate
Topiramate
Topiramate is an anticonvulsant drug. It was originally produced by Ortho-McNeil Neurologics and Noramco, Inc., both divisions of the Johnson & Johnson Corporation. This medication was discovered in 1979 by Bruce E. Maryanoff and Joseph F. Gardocki during their research work at McNeil...
, there is not yet any medicament that tackles fetishism itself. Because of that, physical treatment is only suitable to support one of the psychological methods.
Gender
Most of the material on fetishism is in reference to heterosexual men, with most of the objects fetishized being highly feminine items such as lingerie, hosiery, and high-heeled footwear. In contrast, for homosexual men most of the objects fetishized tend to be highly masculine.However, the visual map of fetishes linked below flags several clusters as having a number of women admirers, such as corsetry and some of the medical-related fetishes. The preferences of women fetishists are not necessarily a mirror image of those of male fetishists; just because many men are attracted to women in high heels, it does not necessarily mean there are many women attracted to men in construction boots.
The book Female Perversions, which also discussed corsetry and self-cutting
Self-harm
Self-harm or deliberate self-harm includes self-injury and self-poisoning and is defined as the intentional, direct injuring of body tissue most often done without suicidal intentions. These terms are used in the more recent literature in an attempt to reach a more neutral terminology...
, in part discusses "female transvestism". It gives examples both of women who became excited by dressing in a "butch
Butch and femme
Butch and femme are LGBT terms describing respectively, masculine and feminine traits, behavior, style, expression, self-perception and so on. They are often used in the lesbian, bisexual and gay subcultures...
" way, i.e. analogous to male transvestite fetishism, and of women who were aroused by dressing in a very "femme
Butch and femme
Butch and femme are LGBT terms describing respectively, masculine and feminine traits, behavior, style, expression, self-perception and so on. They are often used in the lesbian, bisexual and gay subcultures...
" way, which is referred to as homeovestism.
See also
- Clothing fetishClothing fetishClothing fetish or garment fetish is a sexual fetish that revolves around a fixation upon a particular article or type of clothing, a collection of garments that appear as part of a fashion or uniform, or a person dressed in such a garment....
- Fetish clubFetish clubA fetish club is a nightclub, bar or other entertainment hub which caters to clientele interested in some of fetish fashion, bondage, dominance/submission, and/or sadism and masochism...
- Fetish fashionFetish fashionFetish fashion is any style or appearance in the form of atype of clothing or accessory, created to be extreme or provocative. These styles are not usually worn by the majority of people on any regular basis. They are usually made of materials such as leather, latex or synthetic rubber or plastic,...
- List of paraphilias
- ParaphiliaParaphiliaParaphilia is a biomedical term used to describe sexual arousal to objects, situations, or individuals that are not part of normative stimulation and that may cause distress or serious problems for the paraphiliac or persons associated with him or her...