Friday, September 11, 2009



A: Over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual urges, or behaviours involving the use of nonliving objects (eg. female undergarments)
B: The fantasies, sexual urges, or behaviours cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
C: The fetish objects are not limited to articles of female clothing used in cross dressing (as in Transvestic Fetishism) or devices designed for the purpose of tactile stimulation (eg. a vibrator).

Note that DSMIV-TR( American Psychiatric Association Diagnostic Criteria) idea of 'fetish' excludes sex toys. This implies a desire to address deviance as 'minority'. However it's critical to note that the psychiatric 'diagnosis' defines this as 'clinically significant social, occupational or other important areas of functioning."

It should be noted here that over the years I've seen dozens of fetish cases and they're never black and white. Ironically a man working with a pornography organization was let go when he told a woman his fetish object which was 'unusual' to say the least. He was 'let go' because this object was too deviant for what most might describe as a deviant organization. He saw me to discuss this but quickly had another job and had learned mostly that while co workers might wish him to 'share' about his personal life, the particular woman he'd shared with wanted his job. Another man who was very successful and prominent had a rather innocuous fetish but sharing it with a new girlfriend was deeply humiliated. When he came to see me I asked if the girlfriend was what he wanted and shortly thereafter he met another woman not at all bothered by his relatively minor deviation and they actually went on to marry. I made both men aware of the resources for treatment and discussed the options. In other cases the 'fetish' attachment caused marital problems as the fetishism took time from the marriage the partner felt was to be 'shared'. Some of the cases were best addressed with a 'sexual addiction' paradigm. In some of the use of antidepressants medications, specifically SSRI's was highly beneficial whereas in other cases psychologist colleagues have employed combined behavioural individual and group psychotherapy processes with success. I've not really seen the benefit of 'analysis' of the reason but rather felt the more Skinnerian approach to these 'linked' associations beneficial in my experience. I think what was more surprising is that over the years as I became open to listening and less judgemental, older too I found that the private lives of others were more complex than I'd previously believed. There are probably more fetishistic behaviours and thoughts out there but none cause 'clinical distress'. A man told me of his being turned on by scars and happily involved with a woman who fortunately for their relationships had several scars from an accident. It seemed to work for them and I'd be none the wiser if over the years patients and even friends hadn't asked me 'what do you think about....." or "I've a friend who.....what do you think?" I even met a world traveller who collected fetish objects and told me the $ value of each and truthfully I was impressed. Collecting baseball cards wasn't at all in the league.

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