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A fetish is a non-sexual, sometimes inanimate object that triggers intense sensations of sexual desire. Feet are a common fetish, but there are people who get turned on by shoes, boots, underwear, latex and rubber garments, noses, ears, earlobes, well-defined abs, urine, feces, menstrus, semen, people with certain physical characteristics, and a long list of other more esoteric objects. Fetishes usually begin in adolescence and continue throughout life. 

Psychoanalysts theorize that in males fetishes arise as a way of dealing with uncertainties about the ability to use the penis in sexual relationships. In females, fetishes arise as a result of complex social interactions in which the woman is unable to express sexual excitement. A fetish basically makes it easier for a woman to let others (or herself) know she is "turned on," or at least that's how psychoanalytic theory explains it.

Fetishism that causes emotional distress or uncontrolled behavior is classified as a paraphilia, a dysfunctional interest in non-genital sex. Fetishism isn't a disorder unless it starts interfering with the rest of your life. Being turned on by feet, for example, wouldn't be considered a psychological illness. Being turned on by feet and spending one's life savings on foot models, or taking off shoes from people waiting seated on benches while waiting for the bus, or spending 18 hours a day watching foot porn would be considered a psychological disorder.

Some people are completely normal except for their fetish. More commonly there is a second psychological issue, such as substance abuse, drug addiction, eating disorders, anxiety disorders, or personality disorders. Fetishes don't cause personality disorders but personality disorders can make living with a fetish more difficult. If you have a problem with anger management, delayed gratification, or appropriate relationships, you will have more difficulty dealing with a fetish.

Psychologists aren't inclined to fix what's not broken, but if you aren't happy with your life because of your fetish, or if you have trouble avoiding breaking the law to satisfy your fetish, then are a number of possible interventions.

  • Sex Addicts Anonymous and other 12-step groups offer a safe place to discuss issues of living with fetishes.
  • Social skills training helps people with fetishes develop the communication abilities they need to acquire sex partners for activities that don't involve the fetish.
  • Individual psychotherapy focuses on finding the causes for a fetish. This approach requires a verbally fluent patient and a therapist who is aware of the possibilities of transference, in which the patient transfers obsession with the fetish for obsession with the therapist.
  • Assertive training helps people ask for the relationships they want.
  • Antidepressants help people deal with social anxiety and fear of sexual encounters (although they can also cause loss of libido in women and erectile dysfunction in men).
  • Orgasmic reconditioning is a process in which the patient masturbates to an image of the fetish, and then substitutes an image of genitalia appropriate for sexual orientation just before orgasm.

The important thing to understand about fetishes is that if you can have a "normal" sex life, too, and you aren't doing dangerous, illegal, or immoral things to enjoy your fetish, then you may not need treatment. If you do need treatment, then it's not all about the fetish. You need to understand what drives your interest in the fetish, and you also need to have the social skills to engage in genital sexual relationships. No one should tell you that you should never indulge a fetish (unless psychotherapy reveals that you need to quit the fetish completely), but if you re always indulging your fetish, then you need psychological assistance.

Fetishes themselves are a matter between consenting adults. It's only when force is involved, or the fetish becomes an obsession, that intervention is medically required. Developing a full range of sexual expression, however, will enrich your life.


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