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I am wondering about the development of sexual fetishes, not necessarily in its meaning of having a sexual affection for inanimate objects, but in its broader meaning of any type of sexual abnormality. As far as I know, such preferences develop through conditioning; i.e. in a state of arousal something not related to sex is perceived and assosiated with one's feelings. For example, one might experience a leather outfit while being aroused and develop a fetish for them.

This is quite a harmless example, but many fetishes may actually be harmful and an individual may want to prevent its development. For the sake of argument, a castration fetish could be considered extremely dangerous, leading to potential self harm at some point in the future.

Would a person who experiences arousal from such a fetish be able to prevent it from emerging? As an example, one could avoid masturbation while thinking of the unwanted fetish. This on the other hand would lead to repression of these unfulfilled desires and could possibly backfire.

Can the development of sexual preferences be actually stopped and/or influenced, and if so, what would be the best way to do so?

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A bit of background on me: I’m a clinical psychologist and have worked with many sexual disorders, ranging from paedophile, to gender identity disorder. I am however no expert in any of these, so my answer is based on my own clinical experience and reading of the literature.

Most of my colleagues, and me, think that the general answer is: no – there is not much you can do to stop the development of a fetish. The most common fetish I encounter is SM / bondage. Most of my patients that have this fetish; feel that they had this inclination very early in life, and seldom are they traceable to specific events or experiences in their life.

Same goes with paedophilia. Here I think things are a bit more complicated, as there seems to be two kinds of people (that enter therapy that is, and as such come in contact with me). One group seem to be born with this fetish, if you can call it that. They don’t know why, and how they developed it, and many of them have poor insight into their condition.

On the other hand, there are the ones that spontaneously develop an interest in adulthood. They usually descript their fetish more as a curiosity toward the subject. And most of them never develop into a pure disorder (at least they don’t act on their impulses), and drops it after a while. These people usually develop the fetish during periods of stress.

To build the argument that fetishes are innate. I don’t know if this is a valid comparison to make, but I think most gay people would say that their sexual preference is not something that could be controlled with masturbation-regulation, or whatever. I think most of them would say, that being gay, is just who they are. An assertion supported by the fact that all animals ever closely studied have shown to have a few members of their group who are gay. As such, one could argue that sexual interest seem to very much linked to genetics and biology.

All of the above does not however preclude us from looking for ways to modify a fetish and/or reduce it. When I work with people who are distressed; there are a few things I focus on.

1.Make sure that the fetish is an actual problem. You would be surprised by how often people get panicked by fetish thoughts alone, without the sexual arousal or interest in acting on the fetish. If this is the case, we would work in a metacognitive framework to reduce patient response and thought about the fetish-thoughts. Other times the fetish is not a problem because there actually is nothing wrong with being into “weird” stuff.

  1. If the fetish is a problem. The next step is basic Cognitive Psychology. A lot of people can have quite a lot of change in their problematic fetishes if they are just able to have a good narrative and a good ability to articulate the consequences of the fetish. Sometimes people are not even fully aware of the negative sides of their actions, and the fetish will itself diminish somewhat once they have a fuller understanding of the implications of acting on their desire.

  2. Stimulus control. You don’t start working in a bakery to “satisfy” you need for food, when you are trying to lose weight. For the same reason one should avoid situations that trigger the problematic lusts. I once had a paedophile that wanted to work in a kindergarden – thinking that he would get fulfilled his need just by watching the kids, so that he would feel less need to act on impulses later. Same as with the old catharsis theory from Freud, the mind doesn’t seem to work that way.

  3. Establish overriding associations. Sometimes it can help to try to associate the destructive fetish with something negative. For instance one could try to associate rape with going to jail, being beaten up, or something else negative. This is quite hard to do, and there are no good mainstream guides on this. It’s kind of the opposite to when people overcome their fears be associating something scary with something positive (like when you try to imagine that you are friends with the ghost, instead of its victim). We often find that a good way to remove something from the brain, is to overwrite it.

  4. Reduce other stressors in life. Often fetishisms pop up in response to overwhelming stress from other parts in a persons’ life. An example could be a male that gets fired by a female boss, and starts to really dig in on fantasies about raping and murdering women. Another example would be children that gets messed up by a horrible upbringing, and start feeding their aggressive and dominant sexual fantasies (sex, dominance and aggression are linked in the mind for many people).

  5. Learn coping strategies. Here one needs to be creative. This could range from not searching for related porn, all the way to masturbating instead of acting on an impulse. There are no “one answer fits all”, and needs to problem-solve with the person to find out what’s optimal, what’s necessary, and what’s possible.

One last note. Your question was mostly focused on the “development” of fetishes, and how to stop them. My answer was more a general answer to treatment of fetish disorders after they developed. But I do think that most of these points are relevant. When it comes to development of fetishes, I would say that my point 5 is most relevant – Try to reduce other stress, and try to create a happy life for the individual in general, and one significantly reduce the chance of antisocial behaviour of all kind, even destructive fetishes. Other than that, remember that you never change anybody, yourself or others, by force. They need to want it.

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  • $\begingroup$ Is there a fundamental difference between your Type 1 and Type 2 paedophilic patients -- the ones with poor insight into their condition, and the ones that develop an interest in adulthood? Perhaps the Type 1s are less introspective/self-reflective, or maybe just less verbose in general? $\endgroup$ – DJG Jun 28 '16 at 7:51

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