Fetishism
- MKN-10: Fetishism F65
According to MKN-10, a fetish is an "inanimate object" that is an important source of sexual stimulation or is necessary for achieving a satisfactory sexual response.
In this sexual deviation, the subject's erotic interest is focused only on a certain symbol of a sexual partner. It may be a specific part of the body and its specific quality, a part of clothing (lingerie, shoes), or it may have nothing to do with an erotic object at all (such as fur, rubber, etc.). Fetishistic fixations also include cases of sexual intercourse with animals, in which the animal has a specific erotic value for the deviant. Rare cases include fetishes for unattractive things, such as chairs, urine, and foul-smelling waste (coprophilia, urophilia, mysophilia). Fetishes for fire (pyrophilia) and dead bodies (necrophilia) are also rare.
Fetishistic fixations are also the basis of many sexual addictions, such as addiction to prostitution, pornographic magazines, video programs, erotic phone calls, and the like.
It seems that only a very small number of fetishists have problems with their deviation. Usually, this deviation has the nature of some harmless quirks and peculiarities. In young men, the interest in fetishism can be very urgent. They may then commit thefts of clothing and other items. Other fetishistic fixations can also lead to conflict with the law. For example, when a coprophile asks randomly contacted girls to provide him with a stool sample. Or when a pyrophile sets serial fires of stacks and buildings instead of harmless candle, lamp or "witch" burning. Similarly, zoophilic practices may not be without consequences for the attacked animal.
Various "sexual addictions" also bear elements of fetishism. In practice, we mainly encounter men addicted to various erotic audio or audiovisual programs. Such individuals compulsively consume erotic phone lines, pornography in books, magazines, and on the internet. We also know men addicted to prostitution. Sometimes such addiction drives them to spend considerable sums of money on such "hobbies" and can complicate their lives.
Transvestism has its fetishistic form. We then speak of fetishistic transvestism (MKN-10: F65.1). These men get a considerable erotic excitement from wearing women's underwear and dresses. They satisfy themselves with various autoerotic practices. This deviation is indirectly related to transsexuality. A typical fetishistic transvestite usually has a heterosexual orientation and does not think about changing his gender.
Fetishism has a strong compulsive component. Because it is not always well controlled by rational mechanisms, in cases of highly urgent fetishistic behaviors (sexual addiction, stealing clothing and other fetishes, coprophilia, transvestitism), it is sometimes necessary to use medication to effectively reduce sexual activity. However, the emphasis is on psychotherapy aimed at teaching the patient alternative sexual practices.
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Author: doc. MUDr. Jaroslav Zvěřina, CSc. (Head of the Department of the 1st Faculty of Medicine and General University Hospital in Prague (VFN))"
