Beatriz Gil

Fetishes
1. Fetishism
★ Alfred Binet first described fetishism

Sole sexual desire or intense interest for an object or part of the human body
★ Implies the worship of inanimate objects…given a sexual connotation

Partialism used to refer to body parts

★ Abnormal or deviant sexual practices change over time, one’s social environment, and culture

2. DSM-V criteria for fetishistic disorder

★ Over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual urges, or

behaviors involving the use of nonliving objects (e.g. female undergarments)

★ The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in

social, occupational, or other important area of functioning

★ The fetish objects are not limited to articles of female clothing used in cross-dressing (as in

Transvestic Disorder) or devices designed for tactile genital stimulation (e.g. vibrators)
3. Fetishism Categorization
★ Should a fetish only be categorized if the inanimate object or body part is absolutely necessary for

sexual stimulation in an individual?

4. Assessment and Personality characteristics
★ Assessment tools:

personality scales, depression inventories, sex interest inventories

None are definitive; used in conjunction with structured interview
★ Characteristics: Inappropriate social skills, depressed, emotionally estranged, insecure, dependant,

inadequate male (female), introvert (secluded or isolated from others), low self-esteem
5. Development of fetishes
★ We do not know how fetishes develop

★ The feet and genitals are represented in close proximity in the somatosensory cortex in the brain

★ Research based on podophilia and retifism (foot/shoe fetishism)

Not clinical patients with diagnoses

Foot Fraternity Members (US mail order organization)
89% white
88% homosexual/12% bisexual
★ 80% reported NO negative events in childhood

★ 45% reported pleasurable events leading to fetish

★ Developed around age 12 (average)

★ 30% masturbated in adolescence to feet/footwear

★ Over 50% had few friends in childhood

★ Some listed father’s feet as an object of arousal

6. Fetishism comorbidity
★ 2-3 paraphilias is common

★ Diagnoses of OCD and impulse control disorders

★ Substance abuse and mood disorders

★ Antisocial personality in adolescence

★ Linked with body art and piercing

7. Fetishism theories
★ Psychoanalytic theories-early childhood complexes that have not been resolved

★ Classical conditioning-association of one stimulus with another

★ Operant conditioning-reinforcement

★ Social theories (attachment)-problems with intimate relationships/poor attachment with caregivers

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8.criminality of fetishism
★ Usually not an issue

★ Can be lassified as a sex offense if acted in a criminal manner (methods used to experience fetish)

9. Treatment of fetishism
★ Psychoanalysis-resolving childhood conflicts

★ Cognitive-behavioral treatment techniques-change thought patterns

★ Electroconvulsive therapy-pair pain with fetish object/subject (not effective with S & M!) - shock

★ Most effective treatment is one that is catered to the individual with the fetish

10. Types
Foot Fetishism (martialism)
★ Podophilia-sexual arousal for the lower extremities (feet) or anything that covers them

★ Retifism (named after Nicolas-Edme Rétif, a French novelist)-sexual arousal to footwear

★ Foot Fraternity Research

58% said unworn footwear was not exciting (connection with a living person)
Research “solely” (hehe!) on fetishism in homosexual males which limits generalizability
Transvestic Disorder
★ We discussed this in detail in previous lecture, rare for an adolescent to cross-dress and pass

themselves off as a woman… GG Allin

Apotemnophilia
★ Sexual arousal by fantasizing about being or becoming an amputee (rare paraphilia)

★ Three forms:

Devotees-nonamputees that are sexually drawn to disabled persons

Pretenders-nonamputees that are aroused by pretending to be an amputee
Wannabes-compulsion to become amputees (the “true” apotemnophilics)
★ Theories:

Attracted to the self (individualistic)

Rare form of body dysmorphic disorder? Not based on similar belief system, as individuals do
not feel others see them as incomplete
Not at home in their own sexual body (compared to transvestism)
★ Crazy stories:

British surgeon amputated the healthy legs of two patients (Both men alive and healthy report
being happier)
Self-amputations: unlicensed surgeries in other countries, homemade guillotine, log splitter,
industrial “accidents”, gunshot wounds, cigar cutters, chainsaw “slips”, wood chippers, laying
on train tracks
Some resulted in gangrene, followed by death
Hypoxyphilia or Asphyxiophilia
★ Sexual arousal dependent on deliberate hypoxia (deprivation of oxygen)

Methods: strangulation, smothering, chest compressions, inhalation of volatile substances

★ Autoerotic asphyxiation (AEA)

Solitary practice of oxygen deprivation

Hanging most dangerous form
Comorbidity with transvestism, pornography, S & M
Ariel Castro’s death? → kidnapped women and held them captive (about the age of his
daughter) he was caught, sentenced and found him hanging in his cell.
Nymphomania
★ Associated with females

★ Excessive desire for sexual stimulation and gratification

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★ Early Treatments:
Caustics applied to genitals
Bled with leeches
Cold-water douches/baths
Moderate diet
★ Causes: Life events, Menstrual cycle, Frequent masturbation

★ Double standard; outdated term

Hybristophilia
★ Potentially predatory paraphilia in which sexual arousal, facilitation, and attainment of orgasm are

contingent on being with a partner who is a criminal

★ Prison groupies

Modern Genital Modi cation

★ Ear piercing to castration

★ Motivations:

Subculture membership and resistance

Sel-expression
Personal status passage (right of passage)
Spiritual practice
Sadomasochism
★ Paraphilia involving the receiving and giving pain

Sadist-inflicts pain
Masochist-receives pain
★ Five features of S & M

Dominance and submission-control of one partner over another

Role-playing-not reality
Consensuality-play and honor limits
Sexual context-erotic nature
Mutual definition-agree on parameters

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Sexually Motivated Homicide, Rape and Stalking
1. Necrophilia
★ Sex with the dead

★ 3 types:

Fantasizing about sex with the dead

Sex with an already dead person*
Necrosadistic offender-kills to have sex with the dead
★ Dr. Carl Von Cosel (type 2)

AKA Carl Tanzler

Count Von Cosel
2. Sexually motivated homocide
★ Lust murder: fatal violence necessary for sexual gratification

★ Characteristics: white, young (age 20-40), triad (bed wetting, fire starting, & animal torture)

★ Organized vs. disorganized

High IQ Below average IQ

Socially adequate Socially inadequate
Charming, charismatic Strange, weird or bizarre
Skilled work preferred Unskilled work; change jobs
High birth order status Low birth order status
Sexually competent Sexually incompetent
Lives with partner Lives alone
Uses alcohol Minimal use of alcohol
Follow crime in media Minimal interest in media
Controlled mood during crime Anxious mood during crime
3. Examples of Lust Killers
★ Organized Killers

Ted Bundy
John Gacy
Chris Wilder (Beauty Queen Killer)
Kenneth Bianchi (with cousin Buono were hillside stranglers)
★ Disorganized Killers

Arthur Shawcross (Genesee River Killer)

Richard Chase (Vampire of Sacramento)
Jeffrey Dahmer
4. Rape myths
★ Rape is a crime controlled by an uncontrollable sex drive

★ A woman can resist rape if she truly wishes

★ Strangers commit rapes

★ Many women falsely cry rape

★ All women want to be raped

★ It can’t happen to me

5. Stalking typologies
1. Domestic
★ Previous relationship with the victim

Power/anger: hatred, revenge, domination

Obsessional: psychological disorder, irrational though processes (ex: stalked therapists)
Nuisance: harassment to get attention

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2. Stranger
★ No previous relationship with victim

Power/anger: hatred, revenge, domination

Obsessional: psychological disorder, irrational though processes (ex: stalked therapists)
Nuisance: harassment to get attention
Sexual predator: its the most dangerous
Erotomanía: believes the victim is in love with them (ex. Celebrity stalkers)
3. Factitious
★ “victims” who falsely report being stalked

★ False Victimization: satisfies feelings of loneliness/rejection; want attention

★ Hero Fantasy: want to “catch” their predator

6. Russel Williams
★ Escalation from fetishism to sexually motivated homicide

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Disentangling Attraction to Children and Child Sexual Abuse: Following
the Science to Strengthen Prevention Efforts

1. What comes to mind when you hear the word pedophile?

2. Pedophile
★ Someone that commits child sexual abuse

★ Cure for pedophilia, the one that comes up is killing ——

3. Attraction to Children and Child sexual Abuse

★ This is not the reality

★ There is abuse by people who are not attracted to children - opportunistic for example - there’s a
large proportion os people attracted to children that don’t offend.

★When making that distinction, we miss

Situational offenses
Other risk factors (e.g., impulsivity, hypersexuality, empathy, substance use, etc.
CSA perpetrated by other youth
————————————————————————————————————————
Impacts of stigma
Mental health problems
Identity formation and self-acceptance
Primary prevention for those at risk of offending
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4. What we know about child sexual abuse
★ Self-report data suggest 3.7 million children are exposed to CSA each year in US

1 in 4 girls and 1 in 13 boys

★ 90% of CSA perpetrated by someone the child knows and trusts

★ 35-75% of CSA perpetrated by other youth

★ Existing prevention programs largely aimed at preventing victimization

★ Emerging focus on perpetration prevention programs

5. Public health Approach to violent prevention

6. What we know about attraction to children

★ An estimated 1% of the male population is preferentially attracted to prepubescent children -

under the age of 14

Less is known about prevalence in women
★ Attraction to children is typically identified during puberty, remains stable over time

★ Exclusive vs. non-exclusive attraction

★ Not all people attracted to children offend, or even struggle not to offend

★ The abuse is a risk factor to abuse, not to be attracted

Stigma of Attraction to Children

★ Attraction to children is highly stigmatized, even in the absence of a sexual offense

★ Majority (61-90%) believe there is a deterministic relationship with sexually abusing a child

★ High social desirability associated with more punitive attitudes

7. Impact of stigma-related stress on Mental Health

★ Stigma-related stress contributes to increased mental health problems and creates barriers to help-

seeking among people attracted to children

★ Having a stigmatized identity is highly stressful even if the person avoids direct discrimination by

hiding the stigmatized attribute

★ Concealing a stigma can in itself lead to adverse mental health outcomes

8. Psychological mediation framework

★ Stigma-related stress

★ Increased risk of mental health/ interpersonal problems

★ Increased risk of suicidal ideation and behavior

General population People attracted to children

Lifetime ideation 9% e.g., 45%, 86%

Lifetime attempts 3% e.g., 13%, 17%

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It just felt like a moral obligation. I knew that somebody who's at war and throws themselves on a
grenade to save their peers. That's somebody we consider to be a hero. I honestly felt like I was
basically that I was the grenade. I knew I had time. I knew I didn't want to hurt anybody yet. I was
putting it off and seeing if I can figure things out. I was very religious at the time so I was praying
for God to take away the attraction. I begged and begged to have the attractions taken away, but
they never were. That was always in the back of my mind that I was going to someday have to do
what I need to do. Jump on the grenade.

I guess the best way I can describe it is, I don’t know if you’ve seen the movie World War Z, but
its a zombie movie and there’s a part where Brad Pitt gets bit or he thinks he got bit, and he stands
on the edge of a building and he’s looking for signs that he’s turning into a zombie, because if he
was he was gonna jump and if he wasn’t then he wasn’t.

9. Potential Impact of reducing stigma and misinformation

★ Improved mental health and perceived social support in a vulnerable and underserved population

★ Reduced risk factors and increased protective factors for sexual offending

★ Reduced barriers for help-seeking

Help for mental health and interpersonal issues

Help for those who do feel at risk of offending against a child or using CSAM
★ Increased attention on other important aspects of CSA prevention

10. How does Attraction to Children fit in to CSA Prevention Work

★ Attraction to children is one of many risk factors for CSA

Neither necessary nor sufficient

★ More research needed on prevalence and differences in risk and protective

factors among people attracted to children who do and do not offend against
children
e.g., impulsivity, empathy, social support, cognitive distortions

11. Conclusion
★ At least half of CSA is perpetrated by people who are not attracted to children, and many people

who are attracted to children do not offend against children

★ Stigma leads to adverse mental health and social outcomes for people attracted to children,

creates barriers to help-seeking, and hinders prevention

★ Reducing stigma could lead to more effective primary prevention of CSA and improved mental

health and well-being for people attracted to children