Sexual fetishism

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Sexual fetishism
Classification and external resources
ICD-10 F65
ICD-9 302.81
MeSH D005329

Sexual fetishism or erotic fetishism is a sexual focus on a nonliving object, nongenital body part or a specific situation. The object or situation of interest is called the fetish; the person who has a fetish for that object/situation is a fetishist.[1] A sexual fetish may be regarded as a non-pathological aid to sexual excitement, or as a mental disorder if it causes significant psychosocial distress for the person or has detrimental effects on important areas of their life.[2][3] Sexual arousal from a particular body part can be further classified as partialism.[4]

The term sexual fetishism may be used to describe arousal from erotic imagery on the Internet, such as upskirt, downblouse, nude in public, embarrassed nude female and other sensuous scenarios.

Overview[edit]

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").[5] 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. Fétichisme was first used in an erotic context by Alfred Binet in 1887.[6][7]

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.[2][3] Many people embrace their fetish rather than attempting treatment to rid themselves of it, especially in an age where they can easily find communities of like-minded people via the internet.[vague]

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%).[8]

Types[edit]

Alfred Binet, a French psychologist, lawyer and hypnotist, proposed that fetishes be classified as either "spiritual love" or "plastic love".[6] "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 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.[citation needed] 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.[9] However, Frankl's logotherapy is but one of dozens of psychological systems or methods of psychotherapy that compete with psychoanalysis.

Psychological origins and development[edit]

Early psychology assumed that fetishism either is being conditioned or imprinted or the result of a strong emotional (possibly traumatic) or physical experience. Often, these experiences occurred 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. Physical factors like genetic disposition are another common possible explanation. The following are some of the theories 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.[10]

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.[11]

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 onto 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.[12]

Prevalence[edit]

The prevalence of fetishism is not known with certainty.[13] The majority of fetishists are male.[13] In a 2011 study, 30% of men reported fetishistic fantasies, and 24.5% had engaged in fetishistic acts. Of those reporting fantasies, 45% said the fetish was intensely sexually arousing.[14] In a 2014 study, 26.3% of women and 27.8% of men acknowledged any fantasies about "having sex with a fetish or non-sexual object". A content analysis of the sample's favorite fantasies found that 14% of the male fantasies involved fetishism (including feet, nonsexual objects, and specific clothing), and 4.7% focused on a specific body part other than feet. None of the women's favorite fantasies had fetishistic themes.[15] Another study found that 28% of men and and 11% of women reported fetishistic arousal (including feet, fabrics, and objects "like shoes, gloves, or plush toys").[16] 18% of men in a 1980 study reported fetishistic fantasies.[13]

Fetishism to the extent that it becomes a disorder appears to be rare, with less than 1% of general psychiatric patients presenting fetishism as their primary problem.[13] It is also uncommon in forensic populations.[13]

Diagnosis[edit]

The ICD-10 defines fetishism as a reliance on non-living objects for sexual arousal and satisfaction. It is only considered a disorder when fetishistic activities are the foremost source of sexual satisfaction, and become so compelling or unacceptable as to cause distress or interfere with normal sexual intercourse.[2] The ICD's research guidelines require that the preference persists for at least six months, and is markedly distressing or acted on.[17]

Under the DSM-5, fetishism is sexual arousal from nonliving objects or specific nongenital body parts, excluding clothes used for cross-dressing (as that falls under transvestic disorder) and sex toys that are designed for genital stimulation. In order to be diagnosed as fetishistic disorder, the arousal must persist for at least six months and causes significant psychosocial distress or impairment in important areas of their life. In the DSM-IV, sexual interest in body parts was distinguished from fetishism under the name partialism (diagnosed as Paraphilia NOS), but it was merged with fetishistic disorder for the DSM-5.[3]

Some[who?] demand that the diagnosis be abolished completely to no longer stigmatize fetishists, e. g. project ReviseF65. Others[who?] demand that it be specified even more to prevent scientists from confusing it with the popular use of the term fetishism. And other researchers[who?] argue that it should be expanded to cover other sexual orientations, such as a sexual attraction to words or fire. Most physicians[who?] 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[edit]

According to the World Health Organization, fetishistic fantasies are common and should only be treated as a disorder when they impair normal functioning or cause distress.[2] Goals of treatment can include elimination of criminal activity, reduction in reliance on the fetish for sexual satisfaction, improving relationship skills, or attempting to remove deviant arousal altogether.[18] The evidence for treatment efficacy is limited and largely based on case studies, and no research on treatment for female fetishists exists.[18]

Cognitive behavioral therapy is one popular approach. Cognitive behavioral therapists teach clients to identify and avoid antecedents to fetishistic behavior, and substitute normal fantasies for ones involving the fetish.[18] Aversion therapy can reduce fetishistic arousal in the short term, but is unlikely to have any permanent effect.[18]

Antiandrogens and selective serotonin reuptake inhibitors (SSRIs) may be prescribed to lower sex drive. Cyproterone acetate is the most commonly used antiandrogen, except in the United States, where it may not be available. A large body of literature has shown that it reduces general sexual fantasies. Side effects may include osteoporosis, liver dysfunction, and feminization.[18] Case studies have found that the antiandrogen medroxyprogesterone acetate is successful in reducing sexual interest, but can have side effects including osteoporosis, diabetes, deep vein thrombosis, feminization, and weight gain. Some hospitals use leuprolide acetate and goserelin acetate to reduce libido, and while there is presently little evidence for their efficacy, they have fewer side effects than other antiandrogens.[18] A number of studies support the use of SSRIs, which may be preferable over antiandrogens because of their relatively benign side effects.[18] None of these drugs cure sexual fetishism, but they can make it easier to manage.[18]

Relationship counselers may attempt to reduce dependence on the fetish and improve partner communication using techniques like sensate focusing. Partners may agree to incorporate the fetish into their activities in a controlled, time-limited manner, or set aside only certain days to practice the fetishism.[18] If the fetishist cannot sustain an erection without the fetish object, the therapist might recommend orgasmic reconditioning or covert sensitization to increase arousal to normal stimuli (although the evidence base for these techniques is weak).[18]

Other animals[edit]

Human fetishism has been compared to Pavlovian conditioning of sexual response in other animals.[19][20][21] Sexual attraction to certain cues can be artificially induced in rats. Both male and female rats will develop a sexual preference for neutrally or even noxiously scented partners if those scents are paired with their early sexual experiences.[19] Injecting morphine or oxytocin into a male rat during its first exposure to scented females has the same effect.[19] Rats will also develop sexual preferences for the location of their early sexual experiences, and can be conditioned to show increased arousal in the presence of objects such as a plastic toy fish.[19][20] One experiment found that rats which are made to wear a Velcro tethering jacket during their formative sexual experiences exhibit severe deficits in sexual performance when not wearing the jacket.[19] Similar sexual conditioning has been demonstrated in gouramis, marmosets and Japanese quails.[19]

See also[edit]

References[edit]

  1. ^ "Common Misunderstandings of Fetishism". K. M. Vekquin. Retrieved 24 May 2010. 
  2. ^ a b c d "Fetishism, F65.0". The ICD-10 Classification of Mental and Behavioural Disorders: Clinical descriptions and diagnostic guidelines. World Health Organization. p. 170. Retrieved 2 March 2014. 
  3. ^ a b c American Psychiatric Association, ed. (2013). "Fetishistic Disorder, 302.81 (F65.0)". Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. American Psychiatric Publishing. p. 700. 
  4. ^ Milner, J. S., & Dopke, C. A. (1997). Paraphilia Not Otherwise Specified: Psychopathology and theory. In D. R. Laws and W. O'Donohue (Eds.), Sexual deviance: Theory, assessment, and treatment. New York: Guilford.
  5. ^ Harper, Douglas. "fetish (n.)". Online Etymology Dictionary. Retrieved 2 March 2014. 
  6. ^ a b Binet, A. (1887). "Du fétichisme dans l’amour" [=Fetishism in love] in: Revue Philosophique, 24, pp. 143–167
  7. ^ "Du Fétichisme dans l'amour". Retrieved 14 August 2009. 
  8. ^ Chalkley, A. J., & Powell, G. E. (1983). "The clinical description of forty-eight cases of sexual fetishism" in: British Journal of Psychiatry, 142, pp. 292–295
  9. ^ Frankl, Viktor Emil (2004) On the Theory and Therapy of Mental Disorders. London: Routledge ISBN 0-415-95029-5; p. xxiii
  10. ^ Winnicott, D. W. (1953) Übergangsobjekte und Übergangsphänomene: eine Studie über den ersten, nicht zum Selbst gehörenden Besitz. (German) Presentation 1951, 1953. In: Psyche 23, 1969.
  11. ^ Koksal, F., et al. (2004) "An animal model of fetishism." In: Behavior Research and Therapy. 2004 Dec;42(12):1421–34.
  12. ^ webspace.ship.edu/cgboer/freud.html
  13. ^ a b c d e Darcangelo, S. (2008). "Fetishism: Psychopathology and Theory". In Laws, D. R., O'Donohue, W. T. Sexual Deviance: Theory, Assessment, and Treatment, 2nd edition. The Guilford Press. p. 110. 
  14. ^ Ahlers, C. J., Schaefer, G. A., Mundt, I. A., Roll, S., Englert, H., Willich, S. N., & Beier, K. M. (2011). "How unusual are the contents of paraphilias? Paraphilia‐associated sexual arousal patterns in a community‐based sample of men". The Journal of Sexual Medicine 8 (5): 1362–1370. 
  15. ^ Joyal, C. C., Cossette, A., & Lapierre, V. (2014). "What Exactly Is an Unusual Sexual Fantasy?". The Journal of Sexual Medicine 12 (2): 328–340. 
  16. ^ Dawson, S. J., Bannerman, B. A., & Lalumière, M. L. (2014). "Paraphilic interests: An examination of sex differences in a nonclinical sample". Sexual Abuse: A Journal of Research and Treatment. 
  17. ^ The ICD-10 Classification of Mental and Behavioural Disorders: Diagnostic Criteria for Research. World Health Organization. 1993. p. 165. Retrieved 2 March 2014. 
  18. ^ a b c d e f g h i j Darcangelo, S., Hollings, A., Paladino, G. (2008). "Fetishism: Assessment and Treatment". In Laws, D. R., O'Donohue, W. T. Sexual Deviance: Theory, Assessment, and Treatment, 2nd edition. The Guilford Press. p. 122-127. 
  19. ^ a b c d e f Pfaus, J. G., Kippin, T. E., Coria-Avila, G. A., Gelez, H., Afonso, V. M., Ismail, N., & Parada, M. (2012). "Who, what, where, when (and maybe even why)? How the experience of sexual reward connects sexual desire, preference, and performance". Archives of Sexual Behavior 41 (1): 31-62. 
  20. ^ a b Zamble, E., Mitchell, J. B., & Findlay, H. (1986). "Pavlovian conditioning of sexual arousal: Parametric and background manipulations". Journal of Experimental Psychology: Animal Behavior Processes 12 (4): 403–411. 
  21. ^ Akins, C. K. (2004). "The role of Pavlovian conditioning in sexual behavior: A comparative analysis of human and nonhuman animals". International Journal of Comparative Psychology 17 (2): 241–262. 

Further reading[edit]

  • Bienvenu, Robert, The Development of Sadomasochism as a Cultural Style in the Twentieth-Century United States, 2003, Online PDF under Sadomasochism as a Cultural Style
  • Gates, Katharine (1999). Deviant Desires: Incredibly Strange Sex. Juno Books. ISBN 1-890451-03-7. 
  • Kaplan, Louise J. (1991). Female Perversions: The Temptations of Emma Bovary. New York: Doubleday. ISBN 0-385-26233-7. 
  • Love, Brenda (1994). The Encyclopedia of Unusual Sex Practices. Barricade Books. ISBN 1-56980-011-1. 
  • Steele, Valerie (1995). Fetish: Fashion, Sex, and Power. Oxford University Press. ISBN 0-19-509044-6. 
  • Utley, Larry; Autumn Carey-Adamme (2002). Fetish Fashion: Undressing the Corset. Green Candy Press. ISBN 1-931160-06-6.