Perverse curse or worse? Survival of the fetish

Any regular readers of this blog will no doubt be aware that fetishes refer to the obtaining sexual excitement primarily or exclusively from a non-living (inanimate) object or a particular part of the body that is not conventionally viewed as being particularly sexual in nature (e.g., a sexual attraction by males to feet is more likely to be viewed as a sexual fetish than a sexual attraction towards breasts). Attraction to a very particular body part is typically classed as ‘partialism’. The word ‘fetish’ was first coined by the French psychologist Alfred Binet (1857-1911), who is arguably best known for inventing the earliest IQ tests. Fetishes rarely develop into an offence that harms anyone although offences may include things like theft (of underwear) or cutting hair from an unwilling victim.

Sexual fetishes may also involve some kind of enhancement of a sexual act such as a person being asked to wear a particular piece of clothing by the fetishist during sex (e.g., leather outfit or fishnet stockings). Fetishists (usually male) are often unable to orgasm without the fetish present, and can be established as young as 4 years old. Fetishes in and of themselves are not considered to be disorders of sexual preference unless the fetishistic behaviour causes significant negative detriment and/or psychosocial distress for the individual. If the fetish does cause significant distress it would be diagnosed as a paraphilia in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV).

Furthermore, it is sometimes difficult to draw the line between normal and paraphilic behaviours. Dr Martin Kafka (McLean Hospital, Belmont, USA) pointed out in a recent review about the DSM criteria that fetishes can be “non-clinical manifestations of a normal spectrum of eroticization or clinical disorders causing significant interpersonal difficulties”. The etiology of fetishes is also complicated by the fact that empirical research such as that by Dr Chris Gosselin and Dr Glenn Wilson (Institute if Psychiatry, London, UK) that some fetishists report their behaviour is relaxing rather than arousing (such as some from of fetishistic transvestism).

Psychological research has shown that many fetishes appear to be the result of early imprinting and conditioning experiences in childhood or adolescence (for instance, where sexual excitement and/or orgasm is paired with non-sexual objects or body parts) or as a consequence of strong traumatic, emotional and/or physical experience. Fetishes may in part be influenced by rejection of the opposite sex and/or by youthful arousal being channelled elsewhere (deliberately or accidentally). Some children have been said to associate sexual arousal with objects that belong to an emotionally significant person like a mother or older sister and is known as symbolic transformation. However, there is also evidence that some fetishes have more biological origins such as those people whose fetish results from conditions such as temporal lobe epilepsy.

Empirical research by Gosselin and Wilson has also indicated that the most prevalent body fetishes are for feet, hands, and hair, and that the most prevalent fetish objects are shoes, gloves, and (soiled) underwear. However, there may be differences in relation to sexual orientation. Most fetishism research concerns heterosexual men who have fetishistic desires for feminine items such as high-heeled shoes, lingerie, and hosiery. Among homosexual men, the fetishistic objects tend to be highly masculine.

As with many other sexual disorders, there is very little reliable epidemiological data for fetishism. In a study from the 1950s, only 0.1% of 4,000 patients in private practice were recorded as having fetishism as a primary problem (Curren, 1954). Another study carried out among 561 non-incarcerated sex offenders (and all paraphiliacs) by Dr Gene Abel and colleagues (1998) reported that only 3.4% were diagnosed with fetishism. Another study (1992) led by Dr Gene Abel investigated the comorbidity rates of various paraphilic behaviors in a group of 859 male paraphiliacs. Of the 859 subjects, only 12 were diagnosed with fetishism as either a primary or a secondary diagnosis. In a recent review of fetishism by Dr. Shauna Darcangelo (Forensic Psychiatric Services Commission, Victoria Regional Program, Victoria, British Columbia, Canada), noted that fetishism, transvestic fetishism, and homosexuality have often been linked. Darcangelo’s review also noted that fetishism has also been linked with other psychiatric behaviours including kleptomania, borderline personality disorder, obsessive-compulsive personality, and attention-deficit /hyperactivity disorders.

My favourite study in this area was one that was led by Dr G. Scorolli (University of Bologna, Italy) in 2007 on the relative prevalence of different fetishes (probably because it used an online methodology to collect the large amounts of data). Most studies on fetishistic behaviour are either case studies or small-scale surveys where sample sizes are rarely above 100 participants. Additionally, data from the studies examining rare fetishes are typically from psychiatric patients, sex offenders, and/or those who have sought (or have been referred to) a therapist.

Scorolli and colleagues examined the content found in fetish discussion groups. Via a search of Yahoo! groups online, the research team located 2,938 groups whose name or description text contained the word ‘fetish’. They then applied a number of inclusion and exclusion criteria.

• First, the identified groups that dealt with sexual topics and discarded groups that used ‘fetish’ in a non-sexual context (e.g., fetish for a rock band).
• Secondly, they excluded groups that used ‘fetish’ to deny that the group was about sex (e.g., a support group for pregnant women stated explicitly that the group did not discuss ‘pregnancy fetish’).
• Thirdly, some groups were excluded because the sexual nature of the topic could not be established with confidence (e.g., there was no description text of what the fetish was).
• Fourthly, groups were excluded if the group discussed ‘sex’ or ‘fetishism’ generically and therefore couldn’t be categorized.
• Fifthly, groups that had no identified members were excluded

Following the application of the inclusion and exclusion criteria, 381 fetish discussion groups were left for analysis. The average number of posts per month within the groups was over 4,000 that included over 150,000 members. The authors argued that figure was inflated, because many fetishists would be subscribed to more than one group. It was estimated (very conservatively in the authors’ opinion), that their sample size comprised at least 5000 fetishists (but was likely to be a lot more). The authors devised a classification scheme whereby fetish preference was assigned to one or more categories. Three main categories were: body, objects and behaviours, and then further sub-divided to describe a:

• Part or feature of the body (e.g., feet, fat people) and body modifications (e.g., tattoos).
• Object associated with some part of the body (e.g., shoes).
• Object not associated with some part of the body (e.g., candles).
• Person’s own behaviour (e.g., biting fingernails).
• Behaviour of other persons (e.g., smoking).
• Behaviour requiring interaction with others (e.g., humiliation role-play).

Approximately 70% were assigned to just one of these categories. The relative frequency of each fetish was estimated by taking into account (a) the number of groups devoted to the particular fetish, (b) the number of individuals participating in the fetish groups and (c) the number of messages exchanged within the group forum. Their results showed that body part fetishes were most common (33%), followed by objects associated with the body (30%), preferences for other people’s behavior (18%), own behavior (7%), social behavior (7%), and objects unrelated to the body (5%). Feet (and objects associated with feet) were by far the most common fetishes.

From this brief overview it’s evident that research is biased towards small-scale studies with biased samples. Therefore, as Dr Shauna Darcangelo concludes in her recent literature review, in order to increase the understanding surrounding fetishistic behaviour, future empirical research needs to focus on large, population-based, representative samples.

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Abel, G.G., Becker, J.V., Mittelman, M., Cunningham-Rathner, J., Rouleau, J.L. & Murphy, W.D. (1988). Multiple paraphilic diagnoses among sex offenders. Bulletin of the American Academy of Psychiatry and the Law, 16, 153-168.

Abel, G. G., & Osborn, C. A. (1992). The paraphilias: The extent and nature of sexually deviant and criminal behavior. Psychiatric Clinics of North America, 15, 675-687.

Chalkley, A.J. & Powell, G.E. (1983). The clinical description of forty-eight cases of sexual fetishism. British Journal of Psychiatry, 142, 292–295.

Curren, D. (1954). Sexual perversion. Practitioner, 172, 440-445.

Darcangelo, S. (2008). Fetishism: Psychopathology and Theory. In Laws, D.R. & O’Donohue, W.T. (Eds.), Sexual Deviance: Theory, Assessment and Treatment (Second Edition) (pp.108-118). New York: Guildford Press.

Gosselin, C. & Wilson, G. (1980). Sexual variations. London: Faber & Faber.

Kafka, M. (2010). The DSM diagnostic criteria for fetishism. Archives of Sexual Behavior, 39, 357–362

Milner, J. S., & Dopke, C. A. (1997). Paraphilia not otherwise specified: Psychopathology and theory. In D. R. Laws & W. O’Donohue (Eds.), Sexual deviance: Theory, assessment, and treatment (pp. 393-423). New York: Guilford Press.

Scorolli, C., Ghirlanda, S., Enquist, M., Zattoni, S. & Jannini, E.A. (2007). Relative prevalence of different fetishes. International Journal of Impotence Research, 19, 432-437.

Wiederman, M.W. (2003). Paraphilia and fetishism. The Family Journal, 11, 315-321.

Wilson, G. & Gosselin, C. (1980). Personality characteristics of fetishists, transvestites and sadomasochists. Personality and Individual Differences, 1, 289–295.