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The psychology behind sexual fetishes

A fetish is a sexual attraction to an object or situation that is not normally considered to be sexual in nature. Some people may have fetishes of dressing themselves and their partner in furry animal costumes, while others enjoy being dominated by another person, as depicted in Dominos’ BDSM-themed pizza ad of a restrained and gagged leather-clad tongue. Fetishes can involve a sexual attraction to almost anything imaginable — from feet to shoes, body features, certain acts or situations, or the feel of certain fabrics such as leather, rubber, latex or fur. Regardless of what non-living object the person has a fetish for, most fetishes are considered to be atypical sexual preferences.

What is fetishistic disorder?

Paraphilic disorders are those characterized by abnormal sexual behaviors, urges and fantasies involving unusual objects, activities or situations for sexual gratification. Fetishistic disorder is a form of paraphilic disorder that involves objects that are non-sexual in nature. People who have fetishistic disorder have clinically significant distress and/or impairment in important areas of functioning (e.g., occupational, social) due to a preoccupation with engaging in atypical sexual interests.

They may use the object for sexual gratification with or without their partner by touching, smelling, licking or masturbating with it. Many people with fetishistic disorder must have the fetish present to become sexually aroused and cannot have a satisfying sexual experience without it. It is usually a huge problem for them as it not only interferes with important areas of functioning, it also interferes with real intimacy.

Are sexual fetishes pathological?

While fetishistic disorder involves recurrent and intensely arousing fantasies, urges and behaviors involving a sexual attraction to a non-living object and is considered to be a mental disorder, most sexual fetishes are not pathological. In general, sexual fetishes, despite their oddity and abnormality, are no longer recognized as a mental disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association).

People with sexual fetishes are usually not diagnosed with fetishistic disorder unless the sexual fantasy or enacting the fetish causes distress to themselves or others, which is not merely the result of society’s disapproval of their atypical sexual interests. Fetishes are considered to be sexually deviant if they entail causing another person psychological distress, injury or death, or involve unwilling participants or those who are unable to provide consent. Sexual fetishes are considered to be psychologically healthy as long as the other person participating in the behavior is accepting and willing to be involved.

Why is fetishism problematic?

Fetishistic disorder is problematic because it can lead to sexual dysfunction, including the inability to achieve or maintain an erection when the preferred object or body part is unavailable during sexual activity. Even if the person is involved in a reciprocal, meaningful relationship, he or she may prefer to have solitary sexual activity associated with the fetish rather than his or her partner, which can result in damage to intimate relationships.

People with pathological sexual fetishes are also more likely to be involved in the legal system. Paraphilic disorders are generally diagnosed in forensic settings as these individuals may be arrested for sex-related crimes such as child molestation, rape or sexual assault, or for charges related to child pornography.

How do people develop sexual fetishes?

Sex expert and former dominatrix Nichi Hodgson told The Independent that fetishes are often routed in early childhood experiences. “As a former dominatrix, I used to get people coming to me for spanking and caning because they’d received corporal punishment at school, often in a completely un-erotic context. … They’d end up eroticizing the experience as a means of processing the discomfort around it … ,” Hodgson said.

Although no one is innately born with a fetish, many evolve begin early in life due to adolescent curiosity and when a random object becomes paired with pleasure. Sexual fetishes may also result from adverse childhood experiences such as seeing inappropriate sexual behavior or sexual abuse during childhood, according to Kenneth Rosenberg, M.D., a psychiatry professor at Weill Cornell Medical College.

Some psychologists believe that sexual fetishes are behaviors that are learned like language and change over time through sexual experiences. Sex psychologist John Money contended that sexual responses are modified through sexual interactions with others, and that just as individuals can learn a language, they also can learn sexual fetishes.

Prevalence of sexual fetishes

Fetishes are much more prevalent than people probably realize as they can involve just about anything. While a plethora of research has been conducted on the development and etiology of sexual fetishes, much less is known about their prevalence.

One of the few studies to examine the prevalence of unusual sexual fantasies found that sexual fantasies were generally common in a sample of 1,516 adults from the general population. The participants were asked to rank 55 different types of sexual fetishes. The sexual fantasies were classified as statistically rare (2.3 percent or less of the sample), unusual (15.9 percent or less of the sample), common (more than 50 percent of the sample) or typical (84 percent or more of the sample).

The results indicated that only two sexual fantasies out of the 55 were rare for both men and women, while nine others were considered to be unusual. On the other hand, 30 sexual fantasies were classified as common for one or both genders and five were considered to be typical.

Sexual fetishes and the brain

Sexual fetishes are the brain’s attempt to work out trauma, woundedness or some other associations from the past, according to Mark Laaser, Ph.D., and Tim Clinton, Ed.D. They called the area of the brain underlying sexual fetishes and paraphilias the “arousal template.” These early sexually arousing experiences lay the neural tracts for later excitement and become locked in the brain, said Daniel G. Amen, M.D., a clinical neuroscientist and brain imaging specialist at Amen Clinics.

Amen noted that three brain areas are involved in paraphilias, including the prefrontal cortex (PFC), the anterior cingulate gyrus (ACG) and basal ganglia (BG), and limbic (i.e., emotional) structures (i.e., cingulated cortex, septal nuclei, hypothalamus, hippocampus and amygdala), which work together to reinforce the reoccurrence of sexual behavior. As a result of dysfunction in the PFC, for example, people with paraphilias exhibit problems in executive function including disinhibition (controlling) of behavior and lack of impulse control, while overactivity in the ACG and BG is associated with compulsive behaviors, Amen said.

In addition, the limbic system plays an important role in regulating sexual arousal, motivation, memory and reinforcement and the control of sexual function. The release of neurotransmitters such as dopamine in the nucleus accumbens (pleasure center) and hippocampus plays an important role in activating the reward circuitry in the brain and is responsible for motivating nearly all human behaviors — even sexual ones.

As a behavioral addiction, such as those involving a sexual fetish, becomes established in the brain, the person may have difficulty controlling his or her compulsive sexual behaviors. Professional help may be necessary when patients feel like their sexual activities are starting to take over their lives.

The Sovereign Health Group provides behavioral treatment plans for patients with behavioral and substance addictions, which are individualized to meet each patient’s specific needs. Evidence-based treatment programs are also available for patients with mental illness and co-occurring disorders. Please contact our 24/7 helpline for more information.

About the author

Amanda Habermann is a writer for the Sovereign Health Group. A graduate of California Lutheran University, she received her M.S. in clinical psychology with an emphasis in psychiatric rehabilitation. She brings to the team her background in research, testing and assessment, diagnosis and recovery techniques. For more information and other inquiries about this article, contact the author at news@sovhealth.com.