Rekers, G. A. Sexual problems: Behavior modification.
Chapter 17 in B. B. Wolman, J. Egan, & A. 0. Ross (Eds.),
Handbook of Treatment of Mental Disorders in Childhood and
Adolescence.
Englewood Cliffs, N. J.: Prentice-Hall, 1978.

Fetishism

It has been hypothesized that sexual deviations are
learned in a gradual process occurring during
"masturbation to a memory," that the memory need not
have been sexually stimulating at the initial
time of experience, and that the memory may be altered by
psychological processes of recall.

Perhaps more important than the initiation of deviant
interests is the process by which they change, or develop
from more normal interests during regular masturbation to
fantasy. This is because fantasies, based on memory, are
subject to their usual psychological processes of recall
with the result that distortion and selection of cues take
place. In addition, a particular cue initially given the
slightest emphasis becomes more and more dominant because
of the positive feedback involved in the conditioning
process; the more sexually stimulating it becomes, the
more emphasis it is given in a masturbatory fantasy and
consequently, by conditioning it becomes still more
stimulating. Other sexual stimuli are, in the
meanwhile, being Reconditioned so that sexual interest becomes
more and more specific
(McGuire et al., 1965, p. 186).

The majority of the earlier attempts to treat adult
fetishism by avoidance therapy also involved the
pairing of the fetishistic object with the noxious
drug effect. The general consensus now, however, is
that electric shock is preferable as the avoidance
stimulus since (1) the temporal contiguity between
the deviant response and aversive stimulus is more
easily controlled; (2) shock eliminates the medical risks
attendant with apomorphine administration; (3) shock
procedures do not require the expense and inconvenience
of hospitalization; and (4) shock is comparatively less
personally offensive to the patient and administering staff
(Rachman & Teasdale, 1969).



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