Fetishistic Disorder - Causes, Symptoms, Diagnosis, and Treatment

Introduction:

Fetishistic disorders are a type of obsessive compulsive disorder that manifests in the form of sexual behaviors. They include sexual arousal that is not caused by another person but rather by an object or activity. In fetishistic disorders, the individual may feel sexual arousal even when no one else is present. This can be caused by particular objects or situations and is often accompanied by strong urges to engage in these activities.

What Is Fetishistic Disorder?

Fetishistic disorder is when a person experiences persistent and intense sexual attraction to non-living objects or non-genital body parts, involving severe distress and impairment. The person with a fetishistic disorder experiences persistent dependence on non-living objects for sexual arousal. Though most people have different kinds of fetish and are sexually attracted to different things, it is considered a disorder only when it causes severe distress and interferes with normal functioning in day-to-day activities. Some may also find it difficult to get sexually aroused without fetishistic objects. In other terms, people who do not exhibit clinical impairment are not considered to have a disorder.

There are two types of object fetishes:

• Form Fetishes - In this type of fetish, people are attracted to the object's shape (ball, stick, high-heeled shoes).

• Media Fetish - In this type of fetish, people are attracted to the object's material (silk, animal fur, leather).

What Causes Fetishistic Disorder?

• Neurological Connection - The idea that foot fetishes are caused by the same neurological process that causes genitals to be fetishized is based on the fact that the two regions in the brain are very close. In simple terms, the area in the brain that processes sensory information from the feet and the region that processes sensory information from the genital organs are near each other. Studies have shown that the brain may have some "neural crosstalk" between these two areas, which may explain why other body parts are less likely to be fetishized than the feet.

• Underlying Paraphilic Disorders - Some underlying paraphilic disorders could be why people get sexually aroused with nonliving objects.

• Childhood Trauma and Child Abuse - Traumatic incidences in the past may scar the mind and could be the cause of fetishistic behavior. Some doctors also believe childhood experiences in which the object associated caused powerful sexual arousal could also be a reason. While some medical practitioners also believe experiences later in adulthood or people during their adolescence (when puberty hits) to be the more reasonable cause.

• Accidental Exposure to Pornographic Content in Early Childhood - Behavioral learning models and accidental exposure to pornographic content and witnessing inappropriate sexual behaviors may make children imitate the incident.

• Abnormal Brain Development - Some doctors believe abnormal prenatal or postnatal brain growth and development to be the most common reason for fetishistic disorder.

• Different Cultural Beliefs, Sexual Interests - Differences in the way people practice sexual activities.

• Sexual Abstinence for Too Long - Medical doctors believe fetishistic behaviors to be a compensation mechanism as they are deprived of sexual activities for too long.

What Are the Signs and Symptoms of Fetishistic Disorder?

• Sexual arousal or orgasm is achieved only when the object is being used.

• Feeling shame and embarrassment of not getting sexually aroused in the absence of the object (sexual performance anxiety) causing relationship tensions to rise.

• For some, just a picture of the object is enough to achieve sexual arousal, while some feel the need to see and feel the object to achieve sexual arousal.

• Some need to hold, rub, taste, and smell the object.

• Severe distress and impairment with daily functioning activities.

• Some people may ask their partners to wear the object to get sexually aroused.

• Abnormal and unusual behaviors at the workplace or getting sexually excited on just seeing the object.

How to Diagnose Fetishistic Disorder?

There are instances when people may not realize whether their fetish is normal or a disorder. For this, the following criteria are essential to understand whether the person is suffering from a severe fetish disorder or not:

• The person has recurrent, intense sexual arousals, fantasies, urges, or behaviors involving nonliving objects (such as female undergarments, shoes, and attraction towards non-genital body parts).

• Fetishistic behaviors, fantasies, and sexual urges cause severe distress and impairment in social, occupational, or personal functioning.

• Objects such as vibrators or devices used for tactile genital stimulation are not considered fetish objects.

• Behavioral traits like cross-dressing are not considered fetishistic behaviors.

• An unhealthy fetish is when a person is so consumed by his fetish that he does not find his partner attractive and cannot get sexually aroused without the object.

What Is the Treatment for Fetishistic Disorder?

A combination of therapy-based and medication-based treatment reduces the symptoms of the fetishistic disorder. However, the combination treatments suggested may not work in every case and would need different approaches like self-control and sexual abstinence in cases where it causes severe impairment.

• Cognitive Therapy for Fetishistic Disorder - This method is effective for people with underlying paraphilic traits and behaviors. It includes methods like sensitization (repeated exposure to triggering events), conditioning, and reconditioning methods (relaxation techniques to relieve tension and anxiety). These techniques help the person in a more positive approach.

• Positive Reinforcement and Self-Regulation Techniques - This helps the person learn self-control while being exposed to the fetishistic object.

• Medications - Medications to reduce the sex drive and sexual urges may be prescribed by a qualified medical doctor or a clinical therapist in severe cases of impairment and distress associated with the fetish.

• Aversive Conditioning in Fetishistic Disorder - In this method, the patient is repeatedly exposed to the fetish object and then made to associate it with a negative event.

• Temporary Fetish Disorder - It is when the frequency and intensity of fetishistic behaviors are low and usually do not cause severe distress, impairment, or discomfort to others. It may require therapies to control the fetish and work on their sexual performance anxiety and relationship problems. This also helps the person cope with his feelings in a healthy manner.

• Severe Fetishistic Disorders - It may require a combination of drug therapy and cognitive behavioral therapy. Cognitive therapies help the person to focus on the counseling and become less distracted with fetishistic thoughts.

Conclusion:

Fetishistic disorders are usually diagnosed based on the signs and symptoms. There are no medical and clinical investigations to confirm the diagnosis. Though it is considered normal to a certain extent, it is termed a disorder only if the obsession makes it impossible for a person to get sexually aroused without the object. A combination of cognitive-behavioral techniques, self-regulation techniques, and relaxation techniques helps reduce the symptoms.