Dear Lee, (on sexual paraphilia)

I was contacted today by a therapist I know, asking for information pertaining to sexual fetishism, pertaining to their client, asking whether fetishes are learned behavior or something we are born with...Sexual fetishes come in 3 major scales- partialisms, paraphilia, and debilitating paraphilia.A partialism means you like something, and prefer it to other choices. IE someone who thinks high heels are sexy, would prefer to have sex with someone in heels, but has the capacity to be sexual with folks not wearing heels.A paraphilia is something that has a focus, a draw, and has a major effect on ones life or sexual choices. IE someone who only dates women who wear heels, will spend money on heels, and only masturbates to high heel porn.A debilitating paraphilia is when this has gone to a debilitating extreme. IE someone will steal heels, would rather have sex with the heel than the people they are with, will miss work to go to a shoe sale, have lost relationships over the obsession, and/or are sexually inable to have any relationships not intertwined with their paraphilia.The bulk of folks I meet with debilitating paraphilias usually had some sort of trauma or extreme experience (positive or negative) that imprinted the power of their fetish object upon them. People I have met include:

• a guy whose first erection happened to be while watching the cannibal episode of bugs bunny, and became sexually intertwined with he ideas of sexuality and cannibalism roleplaying.
• a woman who was going through a horrible abusive breakup and on her first night as a single woman wore a corset out with a halloween costume, and now is obsessed with extreme tight lacing and constantly being more wasp-waisted.
• a man who as a teen had a group of women sexually mock him in his underwear, and is now solely reliant sexually on having sex with dressed women while he is clothed.

These are folks with debilitating paraphilia- their sexual desire gets in the way of their functionality in the world at large and forming lasting bonds with others for their own sake... friendships, sexually, business-wise, etc.Now, partialisms and low to mid-line paraphilias come in a wide array of experiences and causes. Some are from positive reinforcement. Some strange cooincidences of childhood. Some evolved over the years (a friend of mine who started out wanting to just be a helpful guy, and now is sexually drawn towards erotic service to the level of himself receiving no climax without express permission- but it does not get in the way of holding down a job, its just his tastes).It has been argued that some mental disorders pair easier with the evolving of paraphilia and obsession or hyper-focus in general. For example I know many individuals with Asperger's who are drawn towards formal Dominant/submissive relationship dynamics and contracts, or rope bondage... because both have *rules*- and folks with aspergers find comfort in rules. OCD and other compulsive disorders can filter easily into the paraphilia scale as well.So as to whether fetishism is learned or born behavior- I would say that fetishism is often trauma or extreme experience related, but this is not always a bad thing. Authors like Lorraine Gamman (Female Fetishism) have argued that anorexia and bulemia are the female response version in women to what most object paraphilia is in men- a desire to control body experience and environment after an unpleasant or undesired experience, bonded with a pleasure release (orgasm in the case of men, chemical release from food in the case of women).Brett Kahr (Someone's Been Sleeping in my head) argued in his plenary speech at the AASECT conference a year+ ago, that not just all paraphilias, but all sexual fantasies are tumors of the spirit, a response to suffering and pain, every single one. I think this is shite personally. I get his argument- I for one can acutely place my sexualized desire for eating food off the ground to my period as a street punk where I had to eat whatever I could get, and its attachment to happy memories of me eating food off the floor at home- creating a negative emotional pain to a positive experience from childhood, and voila- fetish. Kahr would argue that I need to obliterate that desire, or at least find that root cause, highlight it, and in doing so bring my suffering to light and be able to treat it.However, I wonder, especially in the case of learning disabled adults as you work with, if this is the best route. In the case of debilitating paraphilia, I see the value of the highlight, examine, source, removal approach. However, for the rest of the scale, what wrong does someone liking feet really have on the world? Is it so wrong to find pleasure in alternate sources and routes?My big question would be, is the clients issue derrived from the fetish, or are there other underlying factors that are actually at play that are causing a symptom or part of their life to be currently blown out of proportion? Are they being overly drawn to their paraphilia because they are currently suffering from depression, mania, psychotic issues, etc- and the fetish is a thing that is actually stable and comfort-giving in their world? If it is, why remove the thing that provides stability and comfort. Why not make an ally of the fetish, and use it as a doorway to the real issues beneath.Oftentimes alt-sex folks are read as their alt-sex being the issue. It's big, its easy, its up front. I see a lot of therapists demonize the kink, bdsm, multiple partnerships etc... instead of looking for the real underlying clauses for their mental disease underneath. I would urge you to examine whether this might be the case.Hope that helps :)-Lee