“It’s genetic.” they said.
“You’re born with it. You can’t change it”.
Is this true, or is it a myth?
And how can we tell?
There are decades of scientific research on fetishes which point to a clear answer.
This article will review this research, in a fully-referenced, evidence-based answer to the question ‘Can fetishes be changed?’
The short answer is yes. Hundreds – or maybe even thousands – of studies have shown success in changing fetishes.
It’s therefore quite strange that someone might claim something different, but it’s probably well-meaning; sexuality has historically been shamed more than any aspect of humanity, and fetishes have wrongfully received most of that shame. Mostly, this unfounded claim that fetishes can’t be changed might just be a rebellion against the historical shame, and a move towards accepting fetishes as normal non-pathological desires – which is a very good thing. However, implying that you can’t get rid of your fetish is simply not true.
The treatment options are varied, and many different options have been shown to be successful, over thousands of studies and 50+ years of research. In fact, as far back as 1982, Kilmann et al (1982) conducted a review of the research up until that point, and wrote: ‘Almost all of the studies found positive treatment effects’. Laws and O’Donohue (2008), along with a team of other researchers, reviewed many hundreds of studies and made a 650+ page book out of that, as well as their guidance on the best evidence-based methods of treatment (‘Sexual Deviance: Theory, Assessment, And Treatment’). So did Langevin (1983) (‘Sexual Strands: Understanding And Treating Sexual Anomalies In Men’). So did The World Federations of Societies of Biological Psychiatry (2010) (‘Guidelines For The Biological Treatment Of Paraphilias’) In fact, many other researchers have created meta-analyses and systematic reviews of the research, and have come to much the same conclusions (eg Wise, 1985; Stolorow et al, 1988; De Silva, 1993; McConaghy, 1993; Walters, 1997; Krueger & Kaplan, 2002; de Silva, 2007; Thibaut et al, 2010; etc.).
In this article I’ll present the research into fetishes, while trying to work out what might cause someone to not be aware of such a wealth of evidence, and even blatantly ignore it in some cases!
In an extensive review of hundreds of studies, ‘The World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the biological treatment of paraphilias’ (2010) recommends psychotherapy as a first-line treatment for paraphilias (paraphilia is just a fancy word for any sexual desire that isn’t common – a fetish in common language), particularly recommending CBT (cognitive behavioral therapy) where available, as the evidence for that is most reliable (Thibaut et al 2010).
If this is ineffective they then recommend drugs and physiological treatments. There are many more studies on drugs (drug companies have money, and can fund studies on drugs in ways that leave other treatment methods behind).
SSRIs (Selective Serotonin Reuptake Inhibitors) have been shown to selectively reduce paraphilic desires without affecting normal sex drive (Bradford, Greenberg, Gojer, Martindale, & Goldberg, 1995; Kafka, 1994; Kafka & Prentky, 1992; Garcia & Thibaut, 2011). (The reason is beyond the scope of this article).
All other drug treatments attempt to suppress sex drive as their ‘treatment’ – which is like curing an itchy nose by cutting it off! Removing your sex drive is not an adequate treatment in my opinion, it’s overkill. Perhaps this is why some people ask ‘Can you change a fetish?’. Seeing treatments involving removing all sex drive certainly gives a misleading impression.
The oldest and most common approach to eradicate a fetish is a behavioral approach. This deals with the mental association between the fetish and pleasure.
Rachman (1966) showed a group of men pictures of boots alongside naked women, many hundreds of times, theorizing that eventually the men would associate boots with naked women and therefore become aroused just by looking at boots alone. This is a process known as ‘conditioning’, and it turned out to be true – they gave the men a ‘boot fetish’ just by making their brains link boots with arousal. (Then, they removed the fetish by the same method.)
Researchers theorized that if they could make people link their fetish with bad things, they would no longer be aroused, and instead they’d be repulsed. So, they exposed patients to their fetish at the same time as doing something bad – making them feel sick or smell bad things (Laws, 2001), administering pain, giving them a small shock (Wijesinghe, 1977), making them simply imagine bad things (Cautela & Wisocki, 1971;), or any number of unpleasant experiences, and repeating this until the negative association formed. This worked overwhelmingly well, but it was very unethical (and in modern times, we don’t need to resort to such methods) (Gaupp et al, 1971; Langevin, 1983).
Other behavioral methods have also been used, such as ‘orgasmic reconditioning’ and ‘satiation therapy’, to similar success (Marquis, 1970; Marshall, 1979; Laws & Marshall, 1991; Hunter & Goodwin, 1992; Abel et al, 1992; Johnston et al, 1992; Laws, 1995; Marshall et al 1999).
The problem with the behavioral approach, aside from ethical implications in some of the early, extreme examples, is that it treats the association between the fetish and pleasure, and not the root cause (as noted by Langevin, 1983). This is only useful when the root cause of fetishes remain a mystery, as behavioral solutions do treat the symptoms well, but it would be much better to change the root cause itself.
Again, seeing researchers resort to these methods instead of treating the root cause certainly implies that you can’t get rid of a fetish. But again, this is misleading – and despite that, these methods still work.
Aside from our associations which do shape our sexual desire, the reason why fetishes form is due to a complex interconnected combination of our fears, feelings, and unmet needs – particularly ones formed during childhood (Stoller, 1979; La Torre, 1980; Langevin, 1983; Stoller, 1986; Morin, 1995; Rosen, 1996; Sawyer, 1996; Kaplan, 1997; Lowenstein, 2002; Siegel, 2011; Baumeister, 1988 & 2014).
Essentially, most fetishes incite some emotion within us. Being tied up (bondage) makes you feel totally powerless and vulnerable – turning these emotions into sexual pleasure. Cuckolding is about inadequacy – it makes you feel inadequate, inferior, and excluded. These emotions get turned into pleasure by people who have these fetishes, so that they don’t feel these emotions, but instead feel arousal. (See: ‘The Psychology Behind The Cuckold Fantasy‘)
The reason why has been explained in numerous ways – as a method of protection (Siegel, 2011), as an escape from self-awareness (Baumeister 1988 & 2014), as a fantasy of revenge over the emotions that hurt us (Stoller 1979 & 1986), or as a way to affirm ourselves (Morin, 1995). The explanation differs depending on whether we are a victim of these emotions (such as with masochism and ‘submissive’ fetishes) (Kernberg, 1988) or whether we are acting these emotions onto someone else (such as with sadism and ‘dominant’ fetishes) (Stoller, 1979).
Essentially, by experiencing these emotions in a safe environment, and recreating hurtful experiences either as the victim or the victor, we’re able to overcome them in some way. The exact reason why is untestable and unproveable, but it doesn’t quite matter which explanation to listen to – they all explain the same thing. They also all point towards the same treatment, regardless of the explanation – that by acknowledging and dealing with these emotions inside of us, and meeting the unmet needs, the fetish stops being arousing, as there is no longer as much pain to turn into pleasure.
Psychodynamic or ‘insight-oriented’ therapy has therefore been used to successfully treat fetishes along these lines. (Bemporad, Dunton, & Spady, 1976; Stoller, 1979; Goldberg & Wise, 1985; Sawyer, 1996; Tan & Zhong, 2001; Fink, 2003; Wiederman, 2003).
Cognitive, Social, Humanistic Approaches
When someone engages in a sexual desire that is distressing, harmful to themselves or others, impairs their life, or causes shame, there’s probably other reasons beyond being aroused. It’s not normal to sacrifice those things for the sake of sexual fulfilment, and most people wouldn’t do that. Sometimes cognitive distortions can be involved, sometimes it can attempt to make up for unfulfilled social deficiencies, and sometimes it can be a faulty attempt to meet other needs. (La Torre, 1980; De Silva, 2007; Laws & O’Donohue, 2008; Thibaut et al, 2010; Baumeister, 2014). Therefore, these other forms of psychotherapy are useful in addressing unique additional factors.
No Treatment At All
Both Langevin (1983) and Siegel (2011) describe fetishes spontaneously changing without treatment, over the natural course of life. As we change and grow as people, we might overcome the fears and feelings that once controlled us, and therefore our sexual desires change with us as we go through life. It does, therefore, appear that fetishes can even change without any formal intervention. Laws and O’Donahue (2008) make multiple suggestions for exactly why this happens.
Walters (1997) notes a lack of research on this ‘spontaneous remission’, writing: ‘The lack of research on spontaneous remission in the paraphilias may reflect an untested assumption on the part of some investigators that people do not get over paraphilic behavior without some type of formal intervention. This is an assumption, however, that requires empirical testing; for if it can be demonstrated that a certain portion of the paraphilias improve without professional assistance then the argument that paraphilias are essentially chronic, progressive conditions will need to be revised.’ Essentially, there is a lack of empirical research about fetishes changing without intervention – but note that with an intervention, it isn’t even a question.
Thibaut et al (2010) write about paraphilias co-occurring with psychotic illnesses, saying ‘In some cases, the paraphilia is secondary to the psychotic illness and subsides when the psychosis is successfully treated, whilst in other cases, the paraphilia is independent of the psychosis and may need treatment in its own right (Smith and Taylor 1999; Baker and White 2002)’. Again, asking whether fetishes can be removed isn’t even a question among psychologists.
Self-help is also effective, and can provide results similar to therapist-led psychotherapy (Marrs, 1995; Sbraga, Pickett, & West, 2005; Laws & O’Donohue, 2008). That is the purpose of this website: if you have a cuckold fetish and want to change, you’re in the right place. (I give information on behavioral, psychodynamic, cognitive, social, and humanistic approaches, because a combined approach is recommended by nearly all reviews of the research).
Criticisms Of Research
The research is by no means flawless. Ideally, the best forms of studies are randomized, controlled, double-blind trials. This is a method of testing which is most reliable, for it eliminates bias. However, as Langevin (1983) noted, it is very hard to do this with fetishes, and perhaps even unethical. Much of the research has lacked controls, randomization, or double-blind features, which makes it hard to be certain of it. Although they do exist, they are not the majority.
Furthermore, hardly anyone actually seeks treatment for their fetish. There’s such a lot of shame and secrecy around it that these people stay hidden. Most of the research is actually done on sex offenders, who offend in some fetishistic way (exhibitionism, pedophilia, rape motivated by sadistic fantasies, voyeurism, etc) because that’s when researchers can actually get hold of these people. Any study done only on sex offenders is less reliable – because studies should usually be done on a group which represents the general population.
Kilmann et al (1982) noted that the problems with the research involved the lack of an adequate follow-up period and the reliance on verbal reports – problems noted by Langevin (1983) in his extensive book on treating fetishes. Of course, if a treatment approach is successful, the effects need to still be present 5-10 years after the treatment occurs – otherwise, it might just be temporary. Studies with only a 1-year follow-up period are therefore not certain – if treatment is successful after 12 months, how can you be sure it will still be successful after 10 years?
One study was done over 25 years, on 7,275 people, and found good evidence for long-term success (89.9% success rate at 5 years, 87.8% success rate at 25 years, of those still participating at that time),(Maletzky & Steinhauser, 2002). But this too was imperfect and open to criticism; it only focused on CBT, and again only studied sex offenders, all of whom were male, with no control group for ethical reasons. Given the large time frame, many participants were not available for follow-up – and perhaps this could affect the data. Also, treatment methods evolved so much in that time frame that there was no consistent, standardised method – all participants received something slightly different, which makes it difficult to evaluate one specific method.
Similarly, verbal reports are not 100% reliable – if someone says the treatment worked, how can you be sure they’re telling the truth? It would be unlikely, but possible, for them to lie, so phallometric data (where a device is attached to the penis to measure any slight hint of an erection in response to viewing their previous fetish) is more reliable. But, again, more difficult, rarer, more expensive, and potentially degrading. The 25-year study above did use these erection-measuring devices, as well as polygraph tests, but only some participants were available to do so – and again, this might affect the data.
Still, this is no reason to completely discard those studies which don’t have those aspects and decide that fetishes can’t be changed. That would be silly. Rather, it is best to use these objections to weigh the research fairly.
It is also valid to question at what point ‘evidence’ becomes ‘proof’, and whether the research on fetishes has crossed that point. This is a subjective evaluation beyond the scope of this article – but a valid argument to make. It would certainly fair to say that we have enough mediocre studies, but need more high-quality studies. It is not valid, however, to say that fetishes cannot be changed, or that the evidence doesn’t say they can.
Why Has This Knowledge Not Found Some Members Of The Public?
Upon seeing psychologists resort to trying to remove the sex drive from their patients with drugs, and even the idea of treating it like a biological (not psychological) issue, could be why a few people have assumed that fetishes cannot be changed, or have some sort of biological cause. Fortunately, no research review recommends drug therapy on its own, and some discourage drug therapy for anything other than court-mandated cases, and psychological treatments are more widely encouraged.
In the behavioral research, seeing people treating the symptoms and not the cause is certainly discouraging, and the [incorrect] implication is that the root cause can’t be changed, or is unknown. Perhaps, again, this might be why a few people have contradictory opinions.
The insight-oriented approach seems to imply that something is ‘wrong’ with people with fetishes – when really, everyone has unique fears, deep-rooted emotions, and unmet needs, and only in some cases does it drive sexual desires to be outside the realms of societal acceptance. The knowledge that fetishes are normal might make some people rebel against this approach, thinking it’s old-fashioned or kink-shaming, when really, this is a misconception. (See: ‘What’s Wrong With Having A Fetish?’)
Over the recent human history, fetishes have been treated like a mental illness – quite literally. Sexuality has been kept secret and shamed by our societal standards, which have repeatedly shunned and frowned upon any non-normal (‘paraphilic’) behaviors.
Perhaps some people have ignored any evidence that gives fuel to those who wrongfully stigmatise such behaviors, and decided to claim that fetishes can’t be eradicated.
All the studies which show fetishes can be changed may unintentionally be implying that they should be changed, which is not true; if someone is happy with their fetish, there’s no reason why they should be forced to change. Therefore, some people might automatically rebel against that assertion, and even try to claim a genetic cause or that fetishes are inflexible. This is well-meaning, but not scientifically accurate.
More likely, this information is simply just not part of the public knowledge. Most people with a fetish may automatically try to work out for themselves why they have their fetish, creating their own stories and justifications – which creates misleading and untested information to be spread by how many people ‘believe’ it might be true, rather than an evidence-based approach.
And sometimes, the voices that are the loudest are not the best informed. Google, for example, ranks search results by how many other places on the internet link to that page. If a particular page is widely shared and linked to in relevant places, it ranks higher, and gets seen by more people – no matter the scientific validity (that’s also why you should share this article and post a link to it in somewhere relevant!). Anyone claiming that fetishes are unchangeable might enthusiastically share any web page repeating that, regardless of its reliability. Then, that page gets seen, shared, and the arguments get spread without question. Whereas the majority of people who have more accurate viewpoints are less likely to talk about it, care about it, or even bother to argue – so those viewpoints don’t get shared and heard. (So, please share this page to correct the balance, and help make sure public knowledge is well-informed!)
In summary, yes, all the evidence suggests that many treatment approaches are effective, and fetishes can be removed, eradicated, and reduced until they are gone.
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Note: Strictly speaking, the term ‘fetish’ refers to an attraction to an object whereas ‘paraphilia’ refers to situations. However, in common language the term fetish is used as any attraction to anything specific, outside of normal sex, so that’s how I’ve used the term ‘fetish’.
Cuckold Psychology (recommended)