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To understand what is meant by kink and fetishes, one must be able to differentiate between these subjects as they are different sexual behaviors.

A kink is defined as an unusual sexual taste, preference or behavior, and a fetish is described as a psychologically necessary object or body part, that is often non-sexual in nature, which may be physically present of fantasized about in order to achieve sexual gratification.

In other words, a kink has to do with unconventional sexual fantasies, concepts, or practices whereas fetishism has to do with a fixation on features of the body, situations, objects, and activities.

An example to help offer a better idea of the difference between a kink and a fetish is that the former may involve roleplay where the sexual partners play certain roles, such as doctor and nurse, in order to make the sexual encounter more exciting and interesting, and the former may involve an individual needing to be tied up and blindfolded, or needing to smell shoes in order to be able to become sexually aroused.

Are kink and fetishism a psychological problem?

The important take-home message regarding kink and fetishism is that these are absolutely normal sexual practices as long as they do not negatively impact the individual's work and social life, and the sexual acts are performed with a consenting adult.

Up until 2012, the DSM-IV classification used to describe psychiatric and psychological pathologies included fetishism as a mental health condition and included this subject under the classification of paraphilias, which was used to describe abnormal behaviors that could potentially lead to mental health conditions. What was noted though was that not all individuals who performed these otherwise unusual sexual acts endangered themselves or others, that they would function normally, and be able to meet all their personal and social obligations.

With the new DSM-V classification that was published in 2013, fetishism was no longer defined as a pathology and rather fetishistic disorder was added which is defined as an individual who performs fetishism-based sexual acts but produces physical or psychological harm to themselves or those who are unwilling participants in the acts. To qualify for this diagnosis, the affected individual must perform fetishistic acts that result in harm for longer than six months. The definition of this disorder also only includes inanimate objects and doesn't address the use of the human body in fetishistic practices.

What if these sexual acts lead to harm?

If kink and fetishism lead to harm to the individual or their sexual partners or results in illegal activities, then psychological and medical intervention is warranted.

The person in question would be advised to undergo psychological counseling which includes aversion therapy, covert sensitization, and orgasm reconditioning. Anxiety due to increased stressors will also need to be addressed as this may lead to sexual addiction which may be the cause of the fetishistic disorder.

Medical intervention in the form of anti-depressants that help to reduce the person's anxiety levels as well as hormonal therapies to reduce sexual arousal may be considered for patients who fulfill the criteria for a fetishistic disorder. 

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