Fetishism

A fetish exists if you repeatedly  become sexually aroused in response to an object that is in not typically related to normal sexual behavior.  Fetishism is one of the many types of behaviors called paraphilias.  Paraphilias are strong reoccurring sexual urges and fantasies typically involving nonhuman objects or involving the suffering or humiliation of yourself or another person.

The DSM-IV-TR, the standard resource used for psychological and psychiatric diagnosing, includes Fetishism (the use of non-sexual or nonliving objects or part of a person's body to gain sexual excitement), Exhibitionism (the recurrent urge or behavior to expose one's normally private body parts to others), and Frotteurism (the recurrent urges or behavior of touching or rubbing against a non consenting person) in the category of paraphilias.  Each of these three paraphilias are discussed below.  For additional "paraphilias", visit the link List of Paraphilias on the website PsychologistAnywhereAnytime.

If you have a fetish you are sexually aroused by non-human objects.  If it is a true fetish, you need to have the fetish item present in order to become sexually excited.  The most frequent fetishes involve lingerie and underwear, specific materials such as leather, latex, fur and rubber, specific articles of clothing such as socks, nylons, panty-hose, shoes or boots, and bodily items such as hair, urine or body odors.

Fetish behavior is so common that in its milder forms it is frequently viewed as not a problem.  However, a fetish can be vicious in nature and can physically and psychologically harm the person with the fetish as well as other persons (for example in masochism, sadism, and frotteurism).

While there are many theories about what causes fetishism, there is little factual evidence.  What we do know is that fetishism is typically found in males much more frequently than in females, and, typically, fetishism starts in late childhood or adolescence and tends to be life-long unless the exhibitionist enters treatment.

Treatment of Fetishism

In benign mild cases of fetishism, when the fetish does not cause a major problem for the person or their partner, treatment may not be necessary.  However, in those situations where the fetish significantly impacts on the person or their partner and where the potential for negative consequences poses a concern, the need for therapy is great.  I have found the most effective treatment methods for fetishism, as well as other paraphilias, include reality therapy, cognitive therapy, traditional psychotherapy, behavioral therapy and medication in combination with therapy.

Exhibitionism involves the exposing of naked parts of the body to other people. In exhibitionism, the exhibitionist tries to draw the attention of others by showing a body part, or parts, that would, in normal situations, not be exposed. Typically, the part(s) of the body exposed are the female breasts, buttock, or genitalia and for the male, the buttock or genitals.

Female exhibitionists may seek employment where the condition can be exploited, such as in a strip bar.  A women may exhibit herself in a variety of ways including undressing in front of a window, wearing see through clothing, very revealing dresses, or short skirts with no underwear. Men typically exhibit themselves by exposing their genitals.

Frequently the social and sexual relationships in the exhibitionists life may suffer and the exhibitionist behavior can become the major sexual activity in the individual's life. Additionally, an exhibitionist who engages in illegal behavior is at risk for lifetime employment problems especially since people with exhibitionism were specifically excluded by Congress from the provisions of the Americans with Disabilities Act (ADA).

There is no consensus on the cause of exhibitionism and causal factors appear to depend on the individual person with each case being different.  We do know that In the U.S., about 50% of all exhibitionists are married and that typically a male is the exhibitionist and the victim is typically a woman, a child, or an unsuspecting stranger. 

My experience has been that exhibitionists rarely seek help on their own and are likely to get professional assistance only when their behavior has brought them into conflict with sexual partners or the legal system.

Treatment of Exhibitionism

I believe that several different types of therapy are helpful in treating exhibitionism.  The treatment methods are the same at those used in treating other paraphilias.  They include traditional psychotherapy, reality therapy, cognitive therapy, behavior therapy (aversion and positive condition approaches), medications and hormonal treatment.  Social skills training can also be helpful in treating an exhibitionist.  Couples therapy is valuable in those cases where the exhibitionist is married and the marriage and family relationships have been impacted by the exhibitionism. Twelve-step programs with their emphasis on social support, healthy spirituality, and cognitive restructuring can also be very helpful.

In frotteurism the person derives sexual pleasure or gratification from rubbing, especially the genitals, against another non-consensual person.  This commonly takes place in a public setting such as a mall, elevator, busy sidewalk, and on public transportation vehicles such as a bus or train.

Typically, this paraphilia is found in males with the victims being female. The frotteur rubs his genital area against the victim's thighs or buttocks or he fondles a woman's genitalia or breasts.  Frotteurs typically act out in crowded places that allow for escape or allow the frotteur to claim that the touching was accidental.

As with other paraphilias, the cause of frotteurism appears to depends on the individual and their life circumstances.

Treatment of Frotteurism

As with other paraphilias, for treatment to be successful the frotteur must want to modify existing patterns of behavior.  Treatment methods are the same as those used with fetishes and exhibitionism described above.

For more information about a fetish and fetishism, please click on the linked websites listed below.

For more information about exhibitionism, please click on the linked websites listed below.

For more information about frotteurism, please click on the linked websites listed below.

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