01/02/2016 11:39 GMT | Updated 31/01/2017 05:12 GMT

Understanding Sexual Fetishes

Thanks to the 50 Shades of Grey phenomena, last year saw the fetish scene sail as close to the mainstream as it has ever done, with the series' first movie the eleventh most popular global film, and EL James's re-telling of her first novel, Grey, becoming the fastest selling adult title of all time. The talk at the time was that fetishists would be stepping out of the quiet shadows and into the spotlight, but it's not worked out quite like that, and in 2016 we are still as a society ignorant of the colourful world of fetish.

This month saw the ninth International Fetish Day go by in a perfect analogy of the fetish scene. If you're reading this and you have a particular predilection, then you are likely to have noted the day with a wry smile on your face. However, if you're not one of the estimated 2-4% of people with a fetish, then I doubt you'll have even heard of it, potentially thinking somewhat pejoratively of those with a fetish.

This level of social ignorance lends the scene a certain mysterious intrigue, but it can also have a real world problem of alienating and stigmatising fetishists. I work with a lot of people who fall into this category, and have been closely studying and researching their idiosyncratic behaviour, whilst analysing why my patients have these desires. The results, combined with a century of psychological theory, help me to work with the patient to understand why they act the way they do.

Much research has been undertaken to best comprehend the underlying desire behind fetishes, and there is no general black and white consensus, with, ironically, many shades of grey. Here we explore some of the theories I have found most compelling when working directly with patients with fetishes.

Classical Conditioning and Behaviourism

This is where sexual stimulus and the fetish object are presented at the same time, leading the person to create a connection between the two. It is Pavlovian in its origins, and a direct development of the famous Pavlov's Dog experiment, where the nineteenth century physiologist, Ivan Pavlov recognised that his dogs would salivate when he rang a bell, if he had previously linked the bell to food. Most of my patients fall into this area, and this conditioning is amongst the most simple to work with.


This is a specific type of Classical Conditioning, and occurs in early childhood. It usually occurs around a particular traumatic episode, which is then stamped into the child's psyche. One patient of mine was very young when his father walked in to see him giving his mother a foot massage. His dad reacted very angrily, and shouted at him that he 'shouldn't' had done this, leading to a strong emotional connection between feet and sex, which now manifests as a foot fetish.


This theory suggests that when children are not given enough emotional support by their parents this can transfer their adult desire onto inanimate objects. I am currently seeing a patient who had highly emotionally unavailable parents, who were cold and distant. However, his aunt gave him a sense of warmth and maternal love that he was unused to, and he would often massage his aunt's feet, in an entirely non-sexual affectionate way. This emotionally closeness gave him a sense of security, and he has since displaced this familial bonding with a sexualised foot fetish in his adult life.


It's impossible to talk about fetish, without referring back to Freud. Whilst this thinking was instrumental in establishing the entire structure of psychological understanding, his theories on fetishes, including a man's fear of castration and his mother's genitals, are not so universally accepted now. From a personal standpoint, the patients I see rarely have underlying Freudian causes.


Finally, one theory is that nurture isn't at play here at all, and it is all in fact nature, with crossed wires in the brain creating links between sex and objects. We sometimes see children displaying very early but non-threatening sexual signs when they are young, sometimes pre-school, as their exploratory minds attempt to make sense of themselves. I have had patients come to me as parents with kids displaying relatively innocent signs of sexuality, and when we work through the potential causes we simply don't see any - they are just that way.

The key thing to consider when understanding the psychodynamics of fetishes is that there are a multitude of potential factors, and, more so than almost any other branch of sexual psychology, individuals develop in very unique ways.

One of the most interesting things to consider is that, just because a fetish is in place it doesn't always stay with the individual. Additionally, almost of all my clients with fetishes are clear in their wishes that they don't wish to lose it, but they want to be able to live a full and happy life, usually with a partner, than accommodates their fetish. We find that working through any shame that they feel can normalise their emotional anxiety, and the patient can find a happy balance with their fetish.

Dr Becky Spelman is a TV psychologist with a Harley Street practice at