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According to the World Health Organization, fetishistic fantasies are common and should only be treated as a disorder when they impair normal functioning or cause distress. Goals of treatment can include elimination of criminal activity, reduction in reliance on the fetish for sexual satisfaction, improving relationship skills, or attempting to remove deviant arousal altogether. The evidence for treatment efficacy is limited and largely based on case studies, and no research on treatment for female fetishists exists.
Cognitive behavioral therapy is one popular approach. Cognitive behavioral therapists teach clients to identify and avoid antecedents to fetishistic behavior, and substitute non-fetishistic fantasies for ones involving the fetish. Aversion therapy can reduce fetishistic arousal in the short term, but is unlikely to have any permanent effect.
Antiandrogens and selective serotonin reuptake inhibitors (SSRIs) may be prescribed to lower sex drive. Cyproterone acetate is the most commonly used antiandrogen, except in the United States, where it may not be available. A large body of literature has shown that it reduces general sexual fantasies. Side effects may include osteoporosis, liver dysfunction, and feminization. Case studies have found that the antiandrogen medroxyprogesterone acetate is successful in reducing sexual interest, but can have side effects including osteoporosis, diabetes, deep vein thrombosis, feminization, and weight gain. Some hospitals use leuprolide acetate and goserelin acetate to reduce libido, and while there is presently little evidence for their efficacy, they have fewer side effects than other antiandrogens. A number of studies support the use of SSRIs, which may be preferable over antiandrogens because of their relatively benign side effects. None of these drugs cure sexual fetishism, but they can make it easier to manage.
Relationship counselers may attempt to reduce dependence on the fetish and improve partner communication using techniques like sensate focusing. Partners may agree to incorporate the fetish into their activities in a controlled, time-limited manner, or set aside only certain days to practice the fetishism. If the fetishist cannot sustain an erection without the fetish object, the therapist might recommend orgasmic reconditioning or covert sensitization to increase arousal to normal stimuli (although the evidence base for these techniques is weak).
Antiandrogens are used in more severe cases. Similar to physical castration, they work by reducing androgen levels, and have thus been described as chemical castration. The antiandrogen cyproterone acetate has been shown to substantially reduce sexual fantasies and offending behaviors. Medroxyprogesterone acetate and gonadotropin-releasing hormone agonists (such as leuprolide acetate) have also been used to lower sex drive. Due to the side effects, the World Federation of Societies of Biological Psychiatry recommends that hormonal treatments only be used when there is a serious risk of sexual violence, or when other methods have failed. Surgical castration has largely been abandoned because these pharmacological alternatives are similarly effective and less invasive.
Selective serotonin reuptake inhibitors (SSRIs) are used, especially with exhibitionists, non-offending pedophiles, and compulsive masturbators. They are proposed to work by reducing sexual arousal, compulsivity, and depressive symptoms. However, supporting evidence for SSRIs is limited.
Human fetishism has been compared to Pavlovian conditioning of sexual response in other animals. Sexual attraction to certain cues can be artificially induced in rats. Both male and female rats will develop a sexual preference for neutrally or even noxiously scented partners if those scents are paired with their early sexual experiences. Injecting morphine or oxytocin into a male rat during its first exposure to scented females has the same effect. Rats will also develop sexual preferences for the location of their early sexual experiences, and can be conditioned to show increased arousal in the presence of objects such as a plastic toy fish. One experiment found that rats which are made to wear a Velcro tethering jacket during their formative sexual experiences exhibit severe deficits in sexual performance when not wearing the jacket. Similar sexual conditioning has been demonstrated in gouramis, marmosets and Japanese quails.
Possible boot fetishism has been reported in two different primates from the same zoo. Whenever a boot was placed near the first, a common chimpanzee born in captivity, he would invariably stare at it, touch it, become erect, rub his penis against the boot, masturbate, and then consume his ejaculate. The second, a guinea baboon, would become erect while rubbing and smelling the boot, but not masturbate or touch it with his penis.
The Cleveland steamer is a colloquial term for a form of coprophilia, where someone defecates on their partner's chest.
The term received news attention through its use in a U.S. Congress staff hoax email and being addressed by the United States Federal Communications Commission.
Coprophilia (from Greek "κόπρος, kópros—excrement" and "φιλία, philía—liking, fondness"), also called scatophilia or scat (Greek: "σκατά, skatá-feces"), is the paraphilia involving sexual arousal and pleasure from feces. In the "Diagnostic and Statistical Manual of Mental Disorders" (DSM), published by the American Psychiatric Association, it is classified under 302.89 – Paraphilia NOS (Not Otherwise Specified) and has no diagnostic criteria other than a general statement about paraphilias that says "the diagnosis is made if the behavior, sexual urges, or fantasies cause clinically significant distress or impairment in social, occupational, or other important areas of functioning". Furthermore, the DSM-IV-TR notes, "Fantasies, behaviors, or objects are paraphilic only when they lead to clinically significant distress or impairment (e.g. are obligatory, result in sexual dysfunction, require participation of nonconsenting individuals, lead to legal complications, interfere with social relationships)".
Although there may be no connection between coprophilia and sadomasochism (SM), the limited data on the former comes from studies of the latter. A study of 164 males in Finland from two SM clubs found that 18.2% had engaged in coprophilia; 3% as a sadist, 6.1% as a masochist, and 9.1% as both. 18% of heterosexuals and 17% of homosexuals in the study pool had tried coprophilia, showing no statistically significant difference between heterosexuals and homosexuals. In a separate article analyzing 12 men who engaged in bestiality, an additional analysis of an 11-man subgroup revealed that 6 had engaged in coprophilic behavior, compared with only 1 in the matched control group consisting of 12 SM-oriented males who did not engage in bestiality.
Mysophilia relates to soiled or dirty material or people. Mysophiliacs may find dirt, soiled underwear, feces, or vomit to be sexually arousing.
It is possible for people with mysophilia to be aroused by unclean locales, such as an alleyway, or a dirty room/bathroom; wearing the same clothing for many days at a time; or not bathing, from mere days to several weeks.
Salirophilia is a sexual fetish or paraphilia that involves deriving erotic pleasure from soiling or disheveling the object of one's desire, usually an attractive person. It may involve tearing or damaging their clothing, covering them in mud or filth, or messing their hair or makeup. The fetish does not involve harming or injuring the subject, only their appearance.
It is related to wet and messy fetishism, bukkake, omorashi, mysophilia, urolagnia and coprophilia, but extends to other areas such as forcing the partner to wear torn or poorly fitting clothing and other actions which would render them normally unattractive.
The fetish sometimes manifests itself in the defacing of statues or pictures of attractive people, especially celebrities or fictional characters. It is common to refer to the practice involving ejaculating on a photo as "facepainting". The fetishist finds this sexually exciting, rather than mere vandalism. They sometimes form collections of defaced art for future enjoyment. A video of the fetishist ejaculating on a picture of someone or a photo depicting the result is known colloquially as a "tribute".
The term comes from the French for soiling, "salir". In cases where the fetish is obsessive it is called saliromania. It is frequently confused with salophilia, an attraction to salt or salty things (especially body sweat) that derives from the Latin for salt, "sal".
Wet and messy fetish (WAM), also known as sploshing, is a form of sexual fetishism whereby a person becomes aroused when copious amounts of a substance are applied to the naked skin, face, or to clothing. Several websites are dedicated to WAM.
Many people with WAM fetishes are drawn to the tactile sensations of wet or messy substances against their skin. Other individuals simply prefer the visual appeal of others getting wet or messy with products that have different textures, consistencies and colours. A subject will often be pelted with cream pies (sometimes using shaving foam rather than real cream pie filling), have slime dumped on them, or sit on cakes. Another common theme is the pouring of substances inside clothing while it is being worn; clothing chosen for this can vary from swimsuits or underwear to full outfits. Normal street clothes, either casual or office wear, are commonly featured in WAM productions, but many other types of outfits, from wedding attire to industrial overalls or more specialist fetishwear such as PVC, latex, or leather items may be used. White items are particularly popular with some fans of this fetish.
Messy substances most commonly focused on by WAM participants include whipped cream, raw eggs, milk, lotion (see lotion play), paint, oil, mud, pudding, chocolate sauce, fruit juice, beer, shaving foam, custard, baked beans, treacle, ketchup, ice cream, peanut butter, slime, and cake batter, among others.
A fetish for bodily fluids such as feces, urine, vomit, semen, and female ejaculate is not considered part of WAM. The former three are typically considered coprophilia, urophilia, and emetophilia; urophilia is somewhat commonly found in mainstream pornography. The latter two are also somewhat mainstream.
WAM fetish videos (made by both fans and commercial producers) may include nudity and sexual acts, while others may only feature fully clothed participants. Videos can be seen frequently public video hosting sites like YouTube. Some of these videos are flagged but most of them remain available despite the sexual undertones, mainly because a large majority of wet and messy videos posted publicly do not include nudity and are therefore considered suitable for all audiences to view. Indeed, not only is much WAM video content indistinguishable in any easily defined sense from the kind of slapstick featured in mainstream entertainment, but scenes of slimings or pieings from the mainstream media are often compiled and marketed by producers towards a WAM fetishist target audience.
There is some crossover between the wet and messy fetish and clothing destruction fetishes. Some WAM productions will see models start out fully dressed, usually in quite smart outfits such as formal dresses or suits; they will then be covered in messy substances, after which their messy clothes are cut up, typically with scissors, leaving them naked or nearly so.
WAM is sometimes also combined with bondage, where a subject is first restrained or chained up and then hosed down or messed up. Wet and Messy fetishism lends itself well to domination/submission role-playing.
"Cake Sitting" (the act of deliberately sitting on a large cake or gateaux, either clothed or nude) is often considered a sub-fetish in its own right, but may be linked to the Crush fetish. While participants who sit on cakes for pleasure will do so for the tactile sensory experience, or as part of submissive role-playing, those who enjoy watching the act will often focus specifically on the crushing of the dessert as a visual stimulus for a sexual reaction.
Coprophobia is fear of or aversion to feces or defecation
Unlike coprophilia or coprophagy, coprophobia appears to be unknown in the animal world, with the exception of humans. In fact, the attitude to feces and defecation has become a cultural taboo.
One approach to changing people's behaviors and stopping open defecation is the community-led total sanitation approach. In this process "live demonstrations" of flies moving from food to fresh human feces and back are used. This can "trigger" villagers into action.
Waterborne diseases are diseases caused by pathogenic microorganisms that most commonly are transmitted in contaminated fresh water. This is one particular type of fecal-oral transmission.
Neglected tropical diseases also contains many diseases transmitted via the fecal-oral route.