DAVID FOLK THOMAS: Welcome to our webcast. I'm David Folk Thomas. 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. Filewich. 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 Rosenberg. 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. FILEWICH, 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 FOLK THOMAS: Ken, do you agree or disagree? Or add to that, if you like.
KEN ROSENBERG, MD: I absolutely agree.
DAVID FOLK THOMAS: Fifty points.
KEN ROSENBERG, MD: I think that what Dr. Filewich 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 FOLK THOMAS: It's almost like there's a compulsion.
KEN ROSENBERG, MD: Absolutely. Like there's no other way to have an orgasm except with a shoe or with a bra or a stocking.
DAVID FOLK THOMAS: 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. FILEWICH, 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 ROSENBERG, 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. FILEWICH, 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 FOLK THOMAS: You said shy people might tend toward fetishism. It seems like you always hear about guys having fetishes. Do women have fetishes?
KEN ROSENBERG, MD: It is a male disorder.
DAVID FOLK THOMAS: Why is it a male disorder?
KEN ROSENBERG, 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 FOLK THOMAS: 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. FILEWICH, 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 FOLK THOMAS: So it could be like a crutch to aid their sexual expression?
KEN ROSENBERG, 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. FILEWICH, PhD: Vaginismus.
KEN ROSENBERG, MD: Right.
DAVID FOLK THOMAS: 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 ROSENBERG, 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. Filewich 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. FILEWICH, PhD: One of the theories that Dr. Rosenberg 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 FOLK THOMAS: If somebody had a fetish of any kind, when is it a problem, when is it not a problem?
KEN ROSENBERG, 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. FILEWICH, 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 FOLK THOMAS: 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. FILEWICH, 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 ROSENBERG, 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 FOLK THOMAS: We're almost out of time. Go ahead.
KEN ROSENBERG, 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 FOLK THOMAS: Also, I had read somewhere in the research about shock therapy, odor therapy.
ROBERT J. FILEWICH, PhD: Yes, absolutely.
DAVID FOLK THOMAS: Is that a radical treatment?
ROBERT J. FILEWICH, 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 FOLK THOMAS: Like "A Clockwork Orange."
ROBERT J. FILEWICH, 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 FOLK THOMAS: 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 ROSENBERG, 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. FILEWICH, 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 FOLK THOMAS: In five seconds -- we're almost out of time -- who do they go to if they decide they need treatment?
KEN ROSENBERG, 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 FOLK THOMAS: Okay, great. Gentlemen, thank you very much. We've been talking fetishism with Robert J. Filewich and Dr. Ken Rosenberg. I hope you've learned about it. Thanks for watching the webcast. I'm David Folk Thomas. We'll see you next time.
5 Comments
Joining me are two experts who are going to help us put it into perspective. On my left is Robert J. Filewich. 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 Rosenberg. 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. FILEWICH, 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 FOLK THOMAS: Ken, do you agree or disagree? Or add to that, if you like.
KEN ROSENBERG, MD: I absolutely agree.
DAVID FOLK THOMAS: Fifty points.
KEN ROSENBERG, MD: I think that what Dr. Filewich 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 FOLK THOMAS: It's almost like there's a compulsion.
KEN ROSENBERG, MD: Absolutely. Like there's no other way to have an orgasm except with a shoe or with a bra or a stocking.
DAVID FOLK THOMAS: 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. FILEWICH, 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 ROSENBERG, 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. FILEWICH, 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 FOLK THOMAS: You said shy people might tend toward fetishism. It seems like you always hear about guys having fetishes. Do women have fetishes?
KEN ROSENBERG, MD: It is a male disorder.
DAVID FOLK THOMAS: Why is it a male disorder?
KEN ROSENBERG, 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 FOLK THOMAS: 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. FILEWICH, 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 FOLK THOMAS: So it could be like a crutch to aid their sexual expression?
KEN ROSENBERG, 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. FILEWICH, PhD: Vaginismus.
KEN ROSENBERG, MD: Right.
DAVID FOLK THOMAS: 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 ROSENBERG, 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. Filewich 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. FILEWICH, PhD: One of the theories that Dr. Rosenberg 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 FOLK THOMAS: If somebody had a fetish of any kind, when is it a problem, when is it not a problem?
KEN ROSENBERG, 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. FILEWICH, 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 FOLK THOMAS: 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. FILEWICH, 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 ROSENBERG, 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 FOLK THOMAS: We're almost out of time. Go ahead.
KEN ROSENBERG, 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 FOLK THOMAS: Also, I had read somewhere in the research about shock therapy, odor therapy.
ROBERT J. FILEWICH, PhD: Yes, absolutely.
DAVID FOLK THOMAS: Is that a radical treatment?
ROBERT J. FILEWICH, 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 FOLK THOMAS: Like "A Clockwork Orange."
ROBERT J. FILEWICH, 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 FOLK THOMAS: 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 ROSENBERG, 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. FILEWICH, 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 FOLK THOMAS: In five seconds -- we're almost out of time -- who do they go to if they decide they need treatment?
KEN ROSENBERG, 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 FOLK THOMAS: Okay, great. Gentlemen, thank you very much. We've been talking fetishism with Robert J. Filewich and Dr. Ken Rosenberg. I hope you've learned about it. Thanks for watching the webcast. I'm David Folk Thomas. We'll see you next time.