Fetishism refers to the use of certain non-living objects as stimuli for sexual arousal and satisfaction, often serving as a preferred or exclusive means. Common fetish objects include women's hair, plush fabrics, women's shoes, gloves, underwear, bras, menstrual belts, and similar items, often used or soiled. The prevalence of this disorder has not been reported.

bubble_chart Etiology

The etiology of this disease remains unclear. Although numerous hypotheses exist, none have been confirmed. Some reports indicate that certain patients exhibit abnormal temporal lobe EEG activity, and a few cases have even been reported as epilepsy. However, these findings are limited to a minority of cases and cannot explain all instances. A more clinically plausible explanation is the theory of conditioned reflexes. Sexual impulses toward the opposite sex may have been suppressed in some way, making them difficult to express—such as feeling shy around women or developing an irrational fear of intercourse. By chance, certain unrelated objects become associated with sexual arousal, forming a conditioned reflex. Repeated reinforcement of this association leads to the development of fetishism.

bubble_chart Clinical Manifestations

Fetishism typically begins during adolescence, almost exclusively in males, most of whom are heterosexual. The objects that can elicit sexual arousal are varied, but each patient is usually fixated on only a few types, with women's underwear and high heels being the most common. Patients go to great lengths to collect their preferred objects, even risking theft. If they take a liking to a particular woman's item, they will spy for an opportunity to obtain it, often hoarding these trophies. One reported case involved a man who stalked women, cut off their braids with scissors, fled home, and stored them meticulously, labeling each with dates and times—eventually amassing as many as 31 braids. Contact with these objects produces sexual pleasure, so they are often used during masturbation or intercourse. Merely seeing or imagining these items can heighten sexual arousal.

The diagnostic criteria for fetishism in CCMD-2-R are: ① Meeting the diagnostic criteria for sexual deviation; ② Over a period of at least six months, recurrent use of a non-living object to satisfy strong sexual desires and fantasies of sexual arousal, with the fetish object being a major source of sexual stimulation or a fundamental condition for achieving sexual satisfaction; ③ Having acted on these impulses.

bubble_chart Treatment Measures

Negler (1957) reported psychoanalytic therapy, and Marks and Gelder (1967) reported aversion therapy, both of which can be used.

bubble_chart Prognosis

Some adolescent fetishism is often temporary, with symptoms disappearing on their own after adulthood and marriage when normal heterosexual sexual activity is established. The prognosis is poorer for single and lonely men, chronic alcoholics, and patients with obstructed normal sexual activity.