Fetishism

What is fetishism?

Fetishism is a sexual disorder. People with this disorder are sexually aroused by an object or part of a person's body, such as the feet. Common fetishes include women's underclothes, stockings, and shoes.

What is the cause?

The exact cause of this disorder is not known. Experts think it may be caused by differences in the brain or nervous system. It might also be related to things such as sexual abuse or a family history of mental illness.

Fetishism generally starts during childhood or the teen years. Most people with this disorder are male.

What are the symptoms?

When a person has this disorder, the fetish must be present in order for the person to become sexually excited. They may masturbate while holding, rubbing, looking at, or smelling the fetish. They may ask a partner to wear the fetish during sex. The fetish may even replace sexual activity with a partner.

How is it diagnosed?

Your healthcare provider will ask about your symptoms, relationships, medical history, and substance abuse history. He or she may also ask if someone close to you has a history of mental illness. Your provider may also do a physical exam and order tests to rule out medical conditions as a cause of your symptoms.

You may be diagnosed with fetishism if:

• You have fantasies, urges, or behaviors that cause distress.
• The disorder causes problems in school, on the job, or in relationships.

How is it treated?

Both therapy and medicines may be used to treat this disorder.

Different kinds of conditioning therapy may be used to treat this disorder:

• Biofeedback therapy. You are connected to a machine that gives you feedback with light or sound. You try to keep feedback within a certain range while you are exposed to sexually exciting material.
• Covert sensitization. You first relax and picture scenes that excite you. Then you imagine something negative, such as getting your penis stuck in the zipper of your pants.
• Assisted aversive conditioning. In this form of therapy, the negative event is real rather than imagined. For example, your therapist sprays a bad smell such as ammonia in the air. The goal is for you to link your actions with something negative and avoid both.

SSRI medicines such as fluoxetine (Prozac) increase the brain chemical serotonin. Low levels of serotonin in the brain result in an increased sex drive. SSRI’s help to reduce obsessive thoughts and compulsive behaviors. SSRI’s also help reduce sexual impulses.

When should I seek help?

Many normal men are sexually aroused by women's underwear, such as garter belts and stockings. You may request that your partner keep these items on during sexual activity. This is not fetishism unless you are unable to perform sexually if your partner is not wearing the items.

If your symptoms seriously interfere with your daily life, seek help from your healthcare provider or a mental health professional. Fetishism can be part of a more severe sexual disorder.

For more information, contact:

• National Alliance for the Mentally Ill (NAMI)
  Phone: 1-800-950-NAMI
  Web site: http://www.nami.org
• Mental Health America
  Phone: 1-800-969-6642
  Web site: http://www.mentalhealthamerica.net