Sexual fetishism

The basic idea of sexual fetishism is sexual arousal and satisfaction through an inanimate object, the fetish. The concrete definitions are not only differing but even contradictory:

In psychology, fetishism is a paraphilia, a sexual psychological disorder. The diagnosis of fetishism is justified only if the additional criteria of paraphilia are fulfilled, above all only if the affected person suffers or harms other people. According to the International Statistical Classification of Diseases and Related Health Problems (ICD), fetishism is the fixation on an inanimate object, while according to the Diagnostic and Statistical Manual of Mental Disorders (DSM), fetishism is the fixation on an inanimate object or a body part.

In common speech, any fixation on a singular inanimate object, body part, body feature or sexual practice is called fetishism. Here, fetishism is an uncommon sexual orientation.

Word origin, history and modern use
The etymology of "fetishism" can be found in the article fetishism.

Fetishism was introduced as a psychological scientific term in 1887 by Alfred Binet and meant sexual admiration of an inanimate object. By then, fetishism was considered pathological. In time, the term's meaning was extended, e. g. in 1912 Richard von Krafft-Ebing referred to fetishism as the admiration of body parts. In 1927 Sigmund Freud published his psychoanalytic view of fetishism which reached non-scientific readers also and made the term popular.

With the Kinsey report and sexual revolution, scientists parted more and more with the idea of fetishism being an illness. As a consequence, the diagnostic criteria for paraphilia—and with that at the same time for fetishism—were made more precise and strict. During that process, the two major diagnostic manuals ICD and DSM diverged in their interpretation: While today ICD has returned to the original idea of inanimate objects only, DSM still includes body parts. Today, the scientific term fetishism still is subject to discussions about scientific relevance and political correctness.

In some cases, "fetishism" has been used to name aspects of a nation's predominant ideal of beauty, e.g. the preference for small feet in old China or the modern western preference for big breasts. Yet, a formal social scientific concept of fetishism has never been introduced. Nor has it been shown that a change in the ideal of beauty goes together with a change in number or type of fetishists. However, it must be noted that all features which do not form a part of an ethnic group's predominant ideal may preferredly be called fetishes.

In modern popular culture, "fetishism" is widely spread and has gained a much broader meaning. Usually it is used to name any sexual preference which is perceived as unusual: overweight, race and hair color are examples for physical features that popularly are considered fetishes (fat fetishism, racial fetish, redhead fetishism). Often, "fetish" is used in combination with BDSM or even to name sadomasochistic practices although basically these two orientations have nothing in common. The tendency to call more and more sexual preferences fetishism has long been target of parody.

"Fetishism" in its sexual meaning must not be confused with the original anthropological concept of fetishism or socio-philosophical concepts derived from this one, e. g. Karl Marx's "commodity fetishism". Here, fetishism names the god-like admiration of objects which has nothing to do with any sexual interests whatsoever.

The coexistence of all these contradictory interpretations often causes misunderstandings and can even lead to wrong diagnosis and treatment.

Psychological origins and development
There are many theories about the psychological how, when and why of fetishism, but only few facts. Many fetishists state that they have had fetishistic desires as long as they can remember. Some fetishists can trace back their desire to a specific event. Modern psychology assumes that fetishism either is being conditioned or imprinted or the result of a traumatic experience. But also physical factors like brain construction and heredity are considered possible explanations. In the following, the most important theories are presented in chronological order:

In 1887, psychologist Alfred Binet introduced the term fetishism, suspecting that it was the pathological result of associations. Accidentally simultaneous presentation of a sexual stimulus and an inanimate object, thus his argument, led to the object being permanently connected to sexual arousal. About 1900, sexual psychologist Havelock Ellis brought up the revolutionary idea that already in early childhood erotic feelings emerged and that it was the first experience with its own body that determined a child's sexual orientation. Psychiatrist Richard von Krafft-Ebing consented to Binet's theory in 1912, recognizing that it predicted the observed wide variety of fetishes but unsure why these particular associations persisted over the whole of a lifetime while other associations changed or faded. In his eyes, the only possible explanation was that fetishists suffered from pathological sexual degeneration and hypersensitivity.

Sexologist Magnus Hirschfeld followed another line of thought when he proposed his theory of partial attractiveness in 1920. According to his argumentation, sexual attractiveness never originated in a person as a whole but always was 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.

Havelock Ellis' theory of erotic symbolism, according to which unusual sexual practice symbolically replaced normal sexual intercourse, and his thoughts about erotic thoughts in children, had laid the foundations for psychoanalyst Sigmund Freud. In 1927, Freud stated that fetishism was the result of a psychological trauma. A boy, longing to see his mother's penis, averts his eyes in horror when he discovers that she has none. To overcome the resulting castration anxiety he clings to the fetish as a substitute for the missing genital. Freud never commented on the idea of female fetishists.

In 1951, Donald Winnicott presented his theory of transitional objects and phenomena, according to which childish actions like thumbsucking and objects like cuddly toys are the source of manifold adult behavior, amongst many others fetishism.

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 pathogeneity. The superstimulus 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 affect. 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 life.

Various neurologists pointed out that fetishism could be the result of neuronal crosslinks between neighboring regions in the human brain. For example, in 2002 Vilaynur 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.

Types of fetishes


Above all, it must be noted that there is no reliable data available on frequency and distribution of fetish objects. Indications offered here are derived from the number of hospital treatments due to accidents, the number of interest groups, especially in the world wide web, and the number of erotic and pornographic offers in the media; all of these data are subject to systematic errors and thus have no empirical force.

Fetishism is extremely varied and encompasses many types of objects. Though in theory each object can become a fetish, the common assumption that there is a fetishist for each and everything seems to be wrong: Most fetishes reported are either body parts, clothes or objects similar to clothes (e.g. jewels and casts). Fetishes that are not directly related to the human body seem to be extremely rare, if present at all. Commonly fetishized items appear to be shoes, lingerie, and specific materials such as satin, leather or fur.

Also, a number of sports and sports activities can serve as a sexual fetish, both homoerotic and heteroerotic. Swimming, Gymnastics, Bodybuilding to name few. Combat sports, like wrestling, boxing, kickboxing, Mixed Martial Arts are all another pretty spread fetish, both homosexual and heterosexual. Both the type of sports activity, athletes and bodies of athletes themselves as well as sportswear (e.g. swimming trunks, wrestling singlets, etc) can all serve as fetishes.

Shoes
According to the number of erotic offers, shoes—often in combination with a desire for feet—are among the top of the list of commonly fetishized items. Most often, a preference for high-heeled female shoes is reported, but admirers for nearly all kind of footwear can be found on the internet. Even a desire for sneakers or sports socks can be found.

Outsiders tend to spot inner coherence between shoe fetishism and sadomasochism, e. g. because kissing someone's shoes is a submissive act, but from a systematic point of view, there is none.
 * Boot fetishism
 * Shoe fetishism

Hosiery and bodywear
Women's hosiery is another commonly fetishized item. Some prefer stockings while others prefer pantyhose (tights). Fetishists often have favorite colors or deniers, or specific features such as seams, reinforced toes/heels, or "fishnet" material. And not to forget kneehigh socks (cableknits, tubes, soccer, baseball etc...). Those are combined with different types of uniforms (schoolgirl, soccer, etc...).

Spandex leggings and leotards are similarly fetishized, as are tight, shiny garments made of leather, rubber, or PVC. The Japanese term "zentai" refers to a spandex suit covering the entire body. For other fetishists, tight jeans are the object of interest.

One basis of this fetish is that the material forms a "second skin" that acts as a fetishistic surrogate for the wearer's own skin. Another basis is that the woman wearing them receives autoerotic pleasure from the tightness or silkiness. Other fetishists associate the tightness with corsetry or bondage.


 * Corset fetishism
 * Jeans fetishism
 * Navel Fetishism
 * Pantyhose fetishism
 * Parka fetish
 * Second skin
 * Sock fetishism
 * Spandex fetishism
 * Stocking fetishism
 * Zentai skin tight suits

Lingerie and evening wear
Satin and lace items such as slips, nightdresses, and undergarments are often fetishized, as well as other silk items such as evening gowns, skirts, and scarves. Sometimes, as with hosiery fetishism, there is a transvestic component. Many men find the tactile sensations caused by the wearing of silk or satin lingerie arousing; some wear panties under their male clothes, whereas others may wear a full set of lingerie. Due to the taboo nature of this fetish, the possibility of getting caught often heightens the fetishists' enjoyment.

In other cases, "fuzzy" materials such as fur or Angora sweaters are fetishized.


 * Fur fetishism / Doraphilia
 * Panty fetishism
 * Silk/Satin fetishism
 * Transvestic fetishism

Leather and latex
Leather is another commonly fetishized item by both heterosexual and homosexual fetishists. It is commonly associated with motorcycle gangs, kinky sex, and the leather subculture.

Another "hard" material for fetish clothing is rubber. This can range from items such as cloaks to thin, tight and shiny clothing. While rubber, at least natural rubber, is made from latex, in this context "latex" usually refers to the thinner materials. PVC is also used to make similar garments.

The rubber fetish can focus on conventionally sexy items such as gowns and skintight garments as well as seemingly unlikely items such as gas masks.


 * Diaper fetishism
 * Latex and PVC fetishism
 * Leather fetishism
 * Mask fetishism
 * Rubber fetishism

Another item that fetishist do not wear, but in fact they climb into is a vacrack. Normally the person inside is completely naked in order to benefit from the total body enclosure experience.

Partialism
Other fetishistic attachments can be to specific parts of the body, such as head or body hair, legs, feet, neck, fingernails, moles or breasts, or specific shapes of the body, rather than to the person as an individual. This might explain foot binding in China in pre-modern times, extensive corset use in the West in the 19th century, and breast implants in the contemporary United States and elsewhere (e.g., Brazil).
 * Breast fetishism
 * Breast expansion fetish
 * Ear fetishism
 * Freckle fetishism
 * Foot fetishism
 * Hair fetishism
 * Hand fetishism
 * Navel fetishism
 * Nose fetishism
 * Ass/Buttocks fetishism

Accessories
Sometimes the attraction, rather than being toward clothes that are in close contact with the body, is toward jewelry or similar accessories, such as braces, eyeglasses, gloves, cigarettes, etc.


 * Body piercing
 * Eyeglasses fetishism
 * Glove fetishism
 * Smoking fetishism
 * Diaper Fetishism

Medical and disability
There also exist fetishes related to medical procedures and devices, as well as to disabled persons and orthopedic equipment such as crutches and plaster casts.


 * Abasiophilia (disability)
 * Amputee fetishism
 * Anesthesia fetishism
 * Medical fetishism

Fluid and excretory
Another cluster of fetishes is centered around dirt and fluids, bodily or otherwise.
 * Emetophilia (vomiting)
 * Fecal fetishism
 * Erotic lactation
 * Saliromania (messy/disheveled)
 * Sneezing fetishism
 * Spitting fetishism
 * Urolagnia (urine fetishism)
 * Wet and messy fetishism
 * Bukkake (semen)

Cultural factors
Sometimes, whole cultures can develop the fetish to such an extent that it is no longer perceived as a fetish, but merely as a normal sexual desire; for example the commonplace "fetishes" for lingerie, or women lacking body hair.

Sometimes what a culture covers up eroticises the boundaries of what remains exposed. For example, a woman's ankle was considered erotic in late-Victorian England.

In this regard, there can be said to be a degree of fetishistic arousal in the average person who responds to particular bodily features as sign of attractiveness. However, fetishistic arousal is generally considered to be a problem only when it interferes with normal sexual or social functioning. Sometimes the term "fetishism" is used only for those cases where non-fetishist sexual arousal is impossible.

Women and fetishism
Most of the material on fetishism is in reference to heterosexual men, with most of the objects fetishized being high-femme items such as lingerie, hosiery, and heels. Until recently there was little mention of women ever having fetishes.

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. Given the male's more visual nature, 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 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 gave examples both of women who became excited by dressing in a "butch" way, i.e. the mirror image of male transvestic fetishism, and of women who became aroused by dressing in a very "femme" way, or parallel to male transvestic fetishism.

Some of the fetishes where a generally male attribute is being fetishized are:


 * Foreskin fetish
 * Muscle fetishism / sthenolagnia
 * Sock fetishism
 * Suit and Tie fetishism

Medical aspects
Most of the sexual orientations popularly called fetishism are regarded normal variations of human sexuality on behalf of psychologists and medics. Even those orientations that are potential forms of fetishism are usually considered unobjectionable as long as all involved persons feel comfortable. Only if the diagnostic criteria presented in detail below are met, the medical diagnosis of fetishism is justified. The leading thought is that a fetishist is not ill because of his or her addiction but because he or she suffers from it.

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. The corresponding ICD code for fetishism is F65.0. The diagnostic criteria for fetishism are as follows: 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.
 * 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, her 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.

According to the DSM-IV, fetishism is the use of inanimate objects or parts of the human body as a stimulus to achieve sexual arousal and satisfaction. The corresponding DSM-code for fetishism is 302.81, the diagnostic criteria are the same as those of the ICD. That means that ICD and DSM diverge in their interpretation of fetishism with respect to body parts. This can lead to misunderstandings when evaluating publications that come from different countries and use different diagnostic manuals. 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 longsome 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 then again, ever and anon researchers argue that it should be expanded to cover other sexual orientations, such as an addiction to words or fire.

Treatment
There are two possible treatments for fetishism: cognitive therapy and psychoanalysis. Both may be supported by an additional medicamentous treatment.

Cognitive therapy
Cognitive therapy seeks to change the patient's behavior without analyzing how and why it shows up. It is based on the idea that fetishism is the result of conditioning or imprinting. The therapy is not able to change the patient's sexual preference itself but can only suppress the resulting unwanted behavior.

One possible therapy is aversive conditioning: the patient is being confronted with his fetish and as soon as sexual arousal starts, exposed to a displeasing stimulus. It is reported that in earlier times painful stimuli such as electric shocks have been used as aversive stimulus. Today a common aversive stimulus are photographs that show unpleasing scenes such as penned in genitals. In a variant called assisted aversive conditioning, an assistant releases abominable odors as aversive stimulus.

Another possible therapy is a technique called thought stop: the therapist asks the patient to think of his fetish and suddenly cries out "stop!". The patient will be irritated, his line of thought broken. After analyzing the effects of the sudden break together, the therapist will teach the patient to use this technique by himself to interrupt thoughts about his fetish and thus prevent undesired behavior.

Psychoanalysis
Psychoanalysis tries to spot the traumatic unconscious experience that caused the fetishism in first instance. Bringing this unconscious knowledge to conscience and thus enabling the patient to work up his trauma rationally and emotionally shall relieve the him from his problems. As opposed to cognitive therapy, psychoanalysis tackles the cause itself.

There are versatile attempts at this analyzing process, including talk therapy, dream analysis and play therapy. Which method will be chosen depends upon the problem itself, the patient's attitude and reactions to certain methods and the therapist's education and preference.

Strictly speaking, in psychoanalysis a fetish is the last thing a small boy sees before discovering that women do not have a penis. The erotic excitement of a boy's first observation of a girl or woman undressing becomes traumatic when he discovers that castration is a real threat after all. What had become increasing arousal is suddenly turned to horror. The child then fixates on the moment of heightened arousal just before the trauma. This is usually an undergarment or feet, but it could be anything.

In the strictest definition, secondary sexual displays—such as breasts and buttocks—cannot be considered fetishes.

Medication
Medicamenteous treatment comprises various forms of drugs that inhibit the production of sex steroids, above all male testosterone and female estrogen. By cutting the level of sex steroids, sexual desire is diminished. Thus, the patient gains the ability to concentrate on his fetish and reasonably process his own thoughts without being distracted by sexual arousal. Also, the application may give the patient relief in everyday's life, enabling him to ignore his fetish and get back to daily routine.

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.

Surgery
In few cases, brain surgery has turned out to be a remedy for fetishism. It must be noted, however, that these surgical engagements were always due to other diagnosis like epilepsy and the relief of fetishism was a mere side effect. Though some consider brain construction a possible cause for fetishism, surgery is never considered a possible treatment.