The Clinical and Forensic Psychiatric Issues of Retifism

Abstract

The literature on the etiological theories, clinical manifestations and treatment of retifism (foot fetishism) and fetishisms in general are briefly reviewed. The case of a 27 year old married male foot-fetishist is presented with emphasis on the psychosexual development leading to the specific sexual deviation. The specific behavioural treatment consisted of covert aversive conditioning using self-reports of sexual urges and psychophysiological monitoring as objective measures of therapeutic change. The theoretical basis for the therapeutic response is discussed.

Correlates of Inserted Object-Assisted Sexual Behaviors in Men: A Model for Development of Paraphilic and Non-Paraphilic Urges

“…If, for example, a feeling is present immediately before sexual arousal occurs, the feeling (e.g., loneliness) becomes the conditioned stimulus for sexual arousal (Adams & Robinson, 2001). Furthermore, as a result of the conditioning, the conditioned individuals experience compelling urges to engage in the behavior and similar related behaviors that can either be acted on with ease or resisted with difficulty (French, 1991;Goodman, 2001;Krueger & Kaplan, 2002;Kunjukrishanan, Pawlak, & Varan, 1988;McConaghy, Blaszczynski, Armstrong, & Kidson, 1989). The net result of all of these factors is that the conditioned behavior tends to be repeated frequently, resulting in further augmentation of the conditioning unless the individual successfully (and with difficulty) resists the urges over a long period of time.…”