What's in a Fetish? Traumatic Sexual Experiences Often Shape Arousal Patterns

Oct. 28, 2009 — -- What might seem mundane to some -– a person's feet or the sound of somebody's sneeze -– can be a real turn on for others.

Take the Texas man, for instance, who was arrested last month after investigators learned he had been blowing pepper into an employee's face to make her sneeze. The man, whose identity was not revealed at the time of his arrest, told authorities that he finds a woman's sneeze to be sexually arousing.

A man in Malaysia was arrested earlier this year for stealing more than 70 pairs of panties from women to satisfy his underwear fetish. And, in Florida, a 35-year-old man is awaiting sentencing after confessing that his foot fetish led him to break into the homes of sleeping children so he could touch their feet.

Sneezes, underwear and feet are among the many objects of arousal experienced by patients suffering from paraphilia, the medical term for the sexual deviance triggered by objects or situations that are not typically considered erotic, medical professionals say.

"If it's out there, somebody somewhere is sexually attracted to it," said Joseph Plaud, the director of Applied Behavioral Consultants in Whitinsville, Mass., and a practicing clinical psychologist.

Plaud, who has never encountered a person with a sneezing fetish, said the most common fetishes he treats are those stemming from specific parts of a body.

"I've seen it all by now but the most common fetishes involve human body parts, like feet, hands or elbows," Plaud said.

Fetishes involving women's underwear is also not unusual, said Plaud, explaining that they are likely attractive to people because of their proximity to a woman's genital region.

"It's that sexual excitement via association," said Plaud, adding that feet are often the object of fetishes because they lead to a leg, which leads to genitals.

He's also familiar with hair and leather fetishes.

An estimated 2 to 4 percent of males have a fetish arousal pattern, said Washington, D.C., psychologist Barry McCarthy, who authored the 2008 book "Men's Sexual Health."

While it is commonly believed that men alone develop fetishes, more and more women have been seeking treatment in recent years, psychologists told ABCNews.com.

"Fetishes usually develop in childhood or adolescence and are controlled by this combination of high secrecy, high eroticism and high shame," McCarthy said. "It's a poisonous combination.

"There are some men who are extremely erotically charged to full-length boots on women and would not be charged by anything else. Usually, this is due to an experience in childhood that, for whatever reason, gave a powerful sexual charge to that object that the man then masturbated to exclusively."

Sources for Fetishes Planted During Childhood, Adolescence

Dr. Mark Schwartz, a practicing psychologist in St. Louis, said patients who develop fetishes have often been victims of sexual trauma earlier in life.

"Usually, when someone has a bizarre arousal pattern, there has been something in their past that has made them susceptible to something deviant, or something unusual occurred," Schwartz said.

Schwartz said that individuals who are molested as children by a predator who used a pillow to keep them from screaming might later develop a fetish for erotic asphyxiation.

"In the first 10 years of someone's life, there is hardwiring of sexual arousals and then, at puberty, it sort of turns on," Schwartz said. "Then, over time, [the fetish] gets cemented through the repetition of masturbation to the arousing object and it becomes relatively permanent."

The permanency of an individual's fetish can sometimes be made worse by the Internet, a place where there is often a group or chat room dedicated to even the most outlandish sexual desires, he said.

"I treated a patient who would try to strangle somebody in order to get aroused; he went online and 25 people came back to him and shared pictures of themselves doing the same thing and the fetish became more normative," Schwartz said.

Can Fetishes Be Treated?

While some sexual variance can be healthy in a relationship, fetishes can become a problem when they interfere with the ability to enjoy intimate, interactive sexual activity, McCarthy said.

"A lot of women will say that when they have a partner with a fetish arousal, that he's not really there during sex," McCarthy said. "He's there physically but he's not really there."

But fetishes don't have to be permanent and are often treatable to the degree that the individual is able to go on and have a healthy sex life.

Schwartz said that when he treats patients with fetishes, he revisits the original trauma that triggered the fetish.

"By reactivating that original trauma and getting in that high susceptible state, we are able to change some of the core arousal patterns," Schwartz said. "You can begin to see where the arousal came in and, in the future, when it comes to your conscious mind, you think back to the traumatic event."

McCarthy, who described fetishes as a sort of "sexual heroin," said that they can be much like an addiction to drugs.

"People give up heroin because they realize it's really hurting their lives," he said. "What a person with a fetish has to understand is the value of intimate sex. While it won't be highly erotically charged, it will fit more into the reality of his life."