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DAVID FO. TO.: Welcome to our webcast. I'm David Fo.
To.. The topic today is fetishism. Now, you've probably heard people say,
"Oh, this person has a foot fetish," or, "This guy likes that.
It's kind of a fetish."
What really is fetishism? It's kind of like if
think the object of your desire should be a person, but maybe the object of
your desire really is more an object than that person. We're going to get to
the bottom of the whole fetish deal.
Joining me are two experts who are going to help us put it into
perspective. On my left is Robert J. F.. He is a clinical psychologist
specializing in anxiety disorders. He's also the Executive Director for the
Center for Behavior Therapy in White Plains, New York. Sitting next to Robert
is Dr. Ken Ro.. He's a psychiatrist affiliated with New York Presbyterian
Hospital and Cornell University Medical Center in New York City. He's in
private practice in New York, as well, specializing in substance abuse and
sexual disorders. Gentlemen, thanks for joining us.
Let's start with you, Robert. Right off the bat, give us the technical
definition of a fetish.
ROBERT J. F., PhD: A fetish is an object. Fetishism is really a disorder
whereby a person is experiencing extreme difficulties in their lives because
of the fact that they like these particular objects to provide for them a
great deal of sexual arousal. The only way they can achieve this type of
sexual satisfaction is with an inanimate object, a non-living object.
DAVID FO. TO.: Ken, do you agree or disagree? Or add to that, if you like.
KEN RO., MD: I absolutely agree.
DAVID FO. TO.: Fifty points.
KEN RO., MD: I think that what Dr. F. said is right on. The important
point is that it interferes in your life, right? That it's not just something
you like to do or you want to do, but something you have to do.
DAVID FO. TO.: It's almost like there's a compulsion.
KEN RO., MD: Absolutely. Like there's no other way to have an orgasm
except with a shoe or with a bra or a stocking.
DAVID FO. TO.: I mentioned in the introduction having a foot fetish. That
seems to be the one everybody talks about. "This person has a foot
fetish." Technically, is that a fetish, if the foot is part of a person
-- it's not inanimate?
ROBERT J. F., PhD: Technically, it's not really, truly a fetish. It's what
we call a partialism, a part of the body that's an extremely important part
to achieve sexual arousal. But you could actually extend it out somewhat when
you talk about shoes.
KEN RO., MD: I've had patients who love shoes, and shoes are the essential
object. In fact, they meet women who send them their shoes. That's their
entrée. I had a patient who -- some people give you their business cards --
this woman detected in some incredible way that he had a foot fetish and she
sent him shoes. She sent him a pair, and of course they became an item. Of
course, he was only interested in the foot. And one of the reasons that he's
only really interested in the shoes that she sends him -- one of the reasons
he might have this problem to begin with -- is because a lot of these people
are really quite shy and find it really difficult to maintain normal sexual
relationships in a healthy way with another human being. So they then
gravitate to particular objects to go ahead and satisfy themselves.
ROBERT J. F., PhD: Right. People talk about sexual addicts or people being
obsessed with sex, and really they're obsessed with dysfunctional sex. Their
everyday sex lives with their partners, if they have partners, are actually
quite boring and mundane. They have a hard time maintaining an erection. They
have a hard time maintaining intimacy, so they really don't suffer from too
much sex, they just have too much bad sex or dysfunctional sex. By
"bad," I'm not casting a judgment, I'm just saying for them it
becomes a compulsion that interferes in their lives.
DAVID FO. TO.: You said shy people might tend toward fetishism. It seems
like you always hear about guys having fetishes. Do women have fetishes?
KEN RO., MD: It is a male disorder.
DAVID FO. TO.: Why is it a male disorder?
KEN RO., MD: It's an interesting question. Nobody really knows the answer
to that, but most of the time it is. Maybe it's a genetic component, maybe
it's the testosterone, maybe it's various things, but really, research hasn't
borne out what the real reason is.
DAVID FO. TO.: I've heard before men are more visual. Would it come to
that because they see and object and they are more fixated on it than a woman
might be?
ROBERT J. F., PhD: It could be that. It could be that men are less
socialized. They have more difficult times in social situations than women.
Women find social situations a lot easier. They talk with each other more.
They experience emotions and feelings a lot more, so they're able to go ahead
and develop more healthy, adult sexual relationships than men are, so men will
turn to an object to go ahead and satisfy their sexual desire because they
find it really difficult to connect with a person who they have a sexual
desire for.
DAVID FO. TO.: So it could be like a crutch to aid their sexual
expression?
KEN RO., MD: Maybe, but it's so interesting because, actually, women have,
on average, more sexual disorders than men, so it's so interesting that
fetishism is a male disorder, whereas the estimates are 41 percent of women
have a lifetime prevalence of sexual disorders, 31 percent of men. So women
are over it by 10 percent, but they, of course, have more disorders like
anorgasmia and --
ROBERT J. F., PhD: Vaginismus.
KEN RO., MD: Right.
DAVID FO. TO.: Let's say somebody has -- take the average man who has,
say, a shoe fetish -- foot fetish, shoe fetish, whatever. How does he develop
that? He doesn't just one day wake up and say, "Hm, I think I'll get a
fetish," look through the book and pick that. How does something like
that manifest?
KEN RO., MD: It's controversial. No one knows. I mean, there are lots of
theories, and you could pick the one that appeals to you the most. There's a
learning theory, and this is the kind of area Dr. F. specializes in. One
could take more of a Freudian approach, that it's a childhood experience or a
disturbed childhood experience that someone's trying to rework and replay. I
see patients who developed some kind of weird relationship with their sister
or with their sister's underwear, and ultimately, of course, they become
obsessed with panties.
ROBERT J. F., PhD: One of the theories that Dr. Ro. is referring to is
that during your sexual stage of development, if during that time you are
experiencing, say, your sister, playing with her feet, or whatever, or
watching her get dressed with her underclothes, then that can maybe become
connected and associated in some way. There are other people that will say
that your childhood experience was one such that you were really
under-socialized, and therefore when you grow up and you develop relationships
with the opposite sex, that you're feeling really inhibited about doing that,
you develop a sense of shyness, and the only way, really, to get sexual
gratification is to go ahead and seek objects that are associated with some
sexual act with a person of the opposite sex or same sex that you're
attracted to but are too shy to go ahead an have an encounter with.
DAVID FO. TO.: If somebody had a fetish of any kind, when is it a problem,
when is it not a problem?
KEN RO., MD: It's a problem when it's the only thing that they can do or
when it gets them in trouble. Many people with fetishistic problems don't
come to treatment because they want to, they come to treatment because they
have to, because their girlfriend says, "You know, I want you to be with
me, not with my clothing or not with my shoe." Or they get in trouble
with the law, or their caught in someone's house or in a dormitory going
through the girl's underwear.
ROBERT J. F., PhD: If you go next door and you go into your neighbor's
house in the middle of the night to steal underwear out of their drawer,
you're going to get caught by the police and then you're going to have to go
to court, and know you're going to have to seek treatment. Or you could have
a situation where you're at work and you're watching the secretary shoes or
her nylons, and you begin to start becoming sexually aroused there, and it
preoccupies you to interfere with your job, and now you're in jeopardy of
losing your job because you're not performing well or you're actually engaging
in some sort of masturbatory behavior underneath your desk.
DAVID FO. TO.: And you don't want that to happen. There are no desks here
on the set, by the way. Let me ask this, then. If somebody has a fetish that
has caused problems such as the examples you just explained, what do they do
for treatment? What is the treatment for somebody seeking that treatment?
ROBERT J. F., PhD: The main goal is trying to reduce the arousal that
accompanies the particular object. That's really hard to do, because people
develop these fantasies and they don't get rid of them so easily. In fact,
often the bad news is that sometimes they never lose the fantasy, that the
shoe, the bra, the underwear is what turns them on the most. But you try to
expand their repertoire and you try to give them some other options and you
try to improve their sex lives so that they have the option of having
intercourse or oral sex or manual sex, and there's other things they can do.
KEN RO., MD: And if you subscribe to the fact that it really, truly is an
inability to be assertive or an underdevelopment of social skills, then you
teach them assertiveness skills and you teach them socialization skills. You
help them interact with people in a social way that they begin to feel
comfortable so they can go out on a date, so they can begin to become
communicative with a person as opposed to just an object.
DAVID FO. TO.: We're almost out of time. Go ahead.
KEN RO., MD: Medications also have an important role, because if you look
at fetishism as a compulsive sexual act, you want to give someone an
anticompulsive medicine like Prozac, Zoloft, the SSRIs, those kinds of
antidepressants that have anticompulsive effects.
DAVID FO. TO.: Also, I had read somewhere in the research about shock
therapy, odor therapy.
ROBERT J. F., PhD: Yes, absolutely.
DAVID FO. TO.: Is that a radical treatment?
ROBERT J. F., PhD: It's been around for a long time. When you say shock,
it's almost like, "Oh my God, you shock somebody?" But it's really
light finger shock. It's just a little aversive stimulus, and people have
tried it whereby you have them begin to fantasize about having sex, having a
sexual act with a particular object, and you finger-shock them.
DAVID FO. TO.: Like "A Clockwork Orange."
ROBERT J. F., PhD: It's like "A Clockwork Orange." Then, after
you do that, you have them fantasize about having sex with a person in a
normal, healthy, adult way, and you then go ahead and not shock them or give
them a pleasant scene or even a pleasant odor. So you can use odor that's an
aversive odor or shock, or you can use a pleasant odor or a pleasant scene.
So you're really, essentially, punishing the reaction to an object and you're
reinforcing their reaction to a human being.
DAVID FO. TO.: Lastly, for people who do seek treatment, what degree or
what percentage actually succeed and are either cured or, if that's not the
right term, make progress to their goal?
KEN RO., MD: I think the vast majority of people make progress,
unquestionably, because you could really improve someone's sex life with sex
therapy and you can really improve their social skills with therapy in
general. What extent never, ever want to be with their object, never want to
be with that piece of wood or that blanket? Very few lose the desire, but
their behavior is most definitely changed.
ROBERT J. F., PhD: And it changes in any way. You expand their repertoire
in terms of sexual interaction, but you also expand their repertoires in
other areas of their life so it improves them all around as a human being.
They become more social, more assertive, they get their needs met more, and
therefore it lowers their desire to get their needs met just through one
thing.
DAVID FO. TO.: In five seconds -- we're almost out of time -- who do they
go to if they decide they need treatment?
KEN RO., MD: They go to a qualified, licensed professional. Anyone could
call themselves a sex therapist, so you really want to find a good
psychologist or psychiatrist who you trust and is well-referred.
DAVID FO. TO.: Okay, great. Gentlemen, thank you very much. We've been
talking fetishism with Robert J. F. and Dr. Ken Ro.. I hope you've learned
about it. Thanks for watching the webcast. I'm David Fo. To.. We'll see you
next time.
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