Background

Psychopathology Of Fetishism And Body Integrity Dysphoria ( BID)

Uploaded 9/9/2020, approx. 30 minute read

As esteemed colleagues, it is my honor to accept the position of co-editor-in-chief of the academic journal Mental Health and Addiction Research.

Over the years, I have been appointed as editor-in-chief of the Journal of Psychology and Psychiatry Studies, editor-in-chief of Mental Health and Family Medicine, and editor-in-chief of Journal of Psychiatric Studies. I have also been appointed as editor-in well over 70 academic journals in our fields of psychology, psychiatry and neuroscience.

And yet, this particular appointment is dear to my heart, and is dear to my heart because it validates my recent work in the field of addiction studies, where I suggest that addiction is actually the normal state, the baseline, not an abnormal state, brain disorder or mental illness.

It's been a hard pill to swallow, and many members of the community had rejected and resented and criticized savagely sometimes my work in addiction and being appointed to this exalted position in the academic community as co-editor-in-chief restores a measure of inner peace.

My name is Sam Vaknin, I'm a professor of psychology in Southern Federal University in Vakhrushin-Siverski in Russia, and I'm a professor of finance and a professor of psychology in the outreach program of SIAS-CIAPS, Center for International Advanced and Professional Studies.


And today, I would like to discuss body integrity disorder, fetishism and other manifestations of irregular relationships between identity and personality in one's body.

And this, of course, leads to a serious debate. Are these merely sexual preferences or are they mental illnesses or mental disorders? We'll come to it as we proceed.

Body integrity dysphoria, BIID, also known as BIID, body integrity identity disorder, appears only in the 11th edition of the ICD, the International Classification of Diseases. It makes no appearance in the Diagnostic and Statistical Manual, Edition 5, 2013. And it makes no appearance there because the committee, the DSM committee, had rejected this as a diagnosis as a clinical entity.

Body integrity dysphoria is the overwhelming desire to be rendered disabled, usually by amputating a limb.

Similarly, when one is extremely uncomfortable with being able to-bodied, when there is extreme discomfiture with being full-bodied, full-fledged, that's also body integrity dysphoria.

Confusingly, body integrity dysphoria has several diametrically opposed clinical manifestations, the most prevalent being apotemnophilia. Apotemnophilia is the wish to be amputated.

And then there is acrotomophilia. It is being sexually aroused exclusively with a disabled partner, usually with an amputee.

The fact that the DSM committee had rejected the diagnosis and poo-pooed the clinical entity behind the suggested diagnosis gave rise to the idea that these are actually merely sexual preferences.

Actually, in reality, there are medical doctors who amputate such people. People with acrotomophilia and people with apotemnophilia claim that they cannot be sexually aroused unless they're amputated or unless they interact within sexual settings, within romantic settings, within erotic settings, with an amputee.

And so there are medical doctors who rush to the breach and amputate these people. And they amputate these people because the profession has legitimized it. The profession said this is not a mental illness.

And my approach, my attitude is that saying that this is not a mental illness has no leg to stand on, pardon the pun.

Acrotomophils enjoy dominating the amputee partner during sex. They are stimulated by the need to position the amputee partner, to take care of her needs because she can't do it herself. She's disabled.

BID should not be confused with other disorders, with similar manifestations or similar clinical presentation. So it should not be confused with somatoparaphonia.

Somatoparaphonia, these people call themselves trans-ables.

Somatoparaphonia is when the person denies ownership of a limb, usually the left arm, or the entire half of the body, typically the left half of the body.

Even when presented with overwhelming evidence to the contrary, somatoparaphoniacs refuse to acknowledge that the arm or the leg or the half body belongs to them.

And then there is asomatognosia, loss of recognition of one's limbs.

These people mistake their own limbs for other people's limbs. So they may say, well, this is not my arm, this is your arm. When they go to a doctor, when they go to a therapist, they attribute their limbs to the therapist or to the doctor.

But as opposed to somatoparaphoniacs with asomatognosia, when these people are confronted with proof of body integrity or body integralness, they usually accept ownership of their limbs.

And still, both these conditions are essentially neurological conditions. They are not psychological conditions.

BID is a psychological condition.

Body integrity dysphoria, as the name implies, is a form of dysphoria akin, for example, to gender dysphoria.

The rejection of one's sex is a form of rejection of one's body. I am not expressing any value judgment, nor am I expressing an opinion here. I'm just stating what I regard to be a fact.

It's a mental health disorder.

Now we can cope with mental health disorders by giving pills, psychopharmacology.

And there is no reason not to cope with mental health disorders via surgery.

So sex reassignment or sex change surgery operations. These might be acceptable ways of coping with the underlying mental illness, exactly like pills and exactly like talk therapy.

Talk therapy interferes with cerebral neuronal pathways and circuits. When we talk, we change the brain of our interlocutor. We rewire it. The brain is neuroplastic.

So talk therapy, pills, surgery, everything is legitimate in trying to cope with mental illness.

What is not legitimate is recasting mental illness as a preference, a choice. Nothing wrong with it. Nothing wrong with amputating your leg or your arm. Nothing wrong in gouging your eye out because some of these people, they want to become blind or they want to become deaf. This is the disability they seek in order to be sexually aroused.

Instinctively and intuitively, there's something wrong with it. But as we shall see when we proceed, there's something wrong with it on clinical grounds as well.

It's definitely a clinical entity and the DSM committee had committed a grave error by rejecting it.

This is one of the few cases where the non-American, non-American mental health authorities made better choices, more well-informed choices.

In general, single leg amputations with a stump are preferred by acrotomophiles and others. They are preferred to any other intervention. They also prefer to bilateral disability and they also prefer to deafness and blindness.

So people with BID prefer to amputate themselves, to amputate a single leg, usually the left leg, or to interact with someone whose left leg is amputated, but only one leg, not bilateral. And they much prefer this to any other form of disability. This is meaningful and we will come to it a bit later.

There is a general trend of aggrandizing, aggrandizing mental health issues, reframing them as advantages.

So you see narcissists online and offline claiming to be superior human beings, the next stage in evolution.

You see covert narcissists claiming to be empaths possessed of almost supernatural sense of empathy. And you see people with BID calling themselves devotees.

Devotee sounds like something religious, like some adherence to a cult, and at any rate removes the stigma, removes the stigma of amputating oneself or being attracted to deformed, partial, defective, problematic bodies. So they are devotees. That's how they call themselves online.

And they have forums, they have support groups and they're very proud of their alleged sexual preference. In other words, they're very proud of their mental illness.

There is a glorification of mental illness. Even in academe, we see scholars glorifying psychopaths. We see scholars publishing books advocating psychopathy and narcissism and teaching people how to become more accomplished psychopaths and narcissists, high functioning narcissists, high functioning psychopaths.

This is a very sick, worrying, worrisome, problematic trend and it had contaminated and penetrated academe.

Non-clinical labels such as empaths, sociopaths, shy borderline have been adopted by academics, scholars simply because there's money in it.

If you make videos about empaths, you can sell books to empaths, you can sell counseling services to self-styled empaths. There's a lot of money sloshing around and exactly like in politics, money had corrupted psychology. The science or at least the discipline of psychology had corrupted it to the core.

One of my main undertakings, one of my main pledges to you is not to allow such corruption to creep into the academic journals that I'm involved with as an editor, let alone as an editor in chief. I will not allow this.

Solvan wrote in 2007, devotees adhere to standard conceptions of attractiveness in all other matters outside of amputations.

So it seems that while they maintain traditional and standard concepts of aesthetics, what's beautiful, what's not, what's repulsive, what's acceptable, there's one blind spot and that is amputation.

They consider amputated people, amputees and their own amputation as an aesthetic experience.

BID patients present with a mismatch between the mental map of the body and its actual layout. Possibly it's an error in proprioception or kinesthesia. And this error could be mediated via damage to specific proprioceptors, the mechanosensory neurons that mediate proprioception. Or it could be a problem with the vestibular system. We don't know it.

There is a dearth, there's absolutely insufficient number of studies of BID. Sufferers of BID seek to remedy this incongruence, this mismatch between mental map of the body and the real body.

So they seek to remedy, they seek to merge the mental map with the real body by removing the redundant, the colonizing, the alien parts of their body, members, organs, parts, tissues of the body that don't fit into the mental map.

And so by removing these parts, by amputating themselves, they restore a sexually exciting, autoerotic, aesthetic, perceived wholeness, completeness via self-mutilation.

Now this is much less rare than we tend to believe.

This tendency to modify one's body in order to restore wholeness, inner peace, completeness, aesthetic self-perception, alluring and sexually arousing self-image, all these things are more common than we know, more common than we think.


Consider, for example, cancer patients. Cancer patients resent and reject their tumors. They seek to excise the tumors. Even if it means removing breasts, women who remove their breasts, they seek to excise the tumors. And by excising the tumors, they restore a sense of well-being, a sense of health.

In a way, people with BID, they regard their left leg as a growth, as a cancer, as a malignancy, as a metastatic tumor.

And they wanted gum. They wanted gum because the left leg is sick.

This is the locus of their sickness. This is the thing that stands between them and a sense of well-being and welfare and happiness.

It is like a repository of everything that's evil and dark and bad and peabo.

And with a simple single action, amputation, they can take care of this and they can restore a light-filled life.

Or maybe it's the same like pregnant women. Many pregnant women, about one-third of the body to study, feel whole again, complete again, restored, healthy, happy, and sexy only when the baby had been expelled from their bodies in childbirth.

As long as they're pregnant, they feel bad. It negates their sense of welfare and well-being, which would explain, of course, postpartum depression in about one-fifth to one-third of women.

The anger, the anger felt towards the superfluous body part inevitably gives rise to sexual excitation. Like sex, sex involves sublimated aggression in multiple ways.

So the more aggressive you are towards the part of you that you reject, the part of you that is alien, part of you that is hated, the more violently you want to tackle this part, the more sexually aroused you are likely to be.

BID may be reconceived as a body dysmorphia. BID patients resort to role play. For example, they use prosthesis or they use casts. In extremely rare cases, they self mutilate, they self harm.

The preference for the surgical removal of left-sided organs may indicate damage to the right parietal lobe. We do know that the line of desired amputation remains stable over the lifespan from childhood to old age. And we also know that skin conductance is markedly different above the hoped for, above the desired amputation line and under and below the line, strangely.

We can only speculate.

So this is the physiology of BID. We can only speculate as to the psychology of BID.

By the way, there are almost no studies. There are no studies with FMRI, functional magnetic resonance imaging. There are no brain studies with FMRI. There's been a few skin conductance studies and essentially that's more or less it. We know close to nothing about the physiology of this. And similarly, we can only speculate about the psychology of BID.

What do patients with BID want to do? They want to modify, to change, to alter their bodies. They want to sculpt themselves. They regard their bodies as raw material.

Modifying our bodies in order to attract mates, to attract other people. Modifying our bodies in order to keep our mates, our spouses, our boyfriend, girlfriend. Modifying our bodies in order to have an interpersonal, a stable interpersonal relationship and success in mate selection. And also in order to conform to social mores regarding body image.

This is common practice. What is makeup if not modifying one's face? What are diets? Diets are a form of self amputation and self mutilation.

Because when you diet, you shed, you shed parts of your body. Kilograms, five kilograms if you're lucky, ten kilograms. Whatever weight you shed, you shed. This weight used to be part of your body and you are getting rid of it.

The diet is a kind of a proverbial or abstract or symbolic or imaginary scalpel. Knife. What is plastic and cosmetic surgeries?

A proposed scalpel. All these are examples of body modification.

So the aforementioned restoration of a sense of corporeal completeness and wholeness. This may be an important reason. And this is a universal reason. We're all trying, we're all attempting to accomplish this goal of changing, sculpting, altering, playing with our bodies to, to feel better. Controlling a disabled and dependent partner in order to fend off anxiety. That's also pretty common. It stands to reason that people with BID, especially ichrotomophiliacs, has debilitating abandonment anxiety. And this is very akin to the psychodynamic borderline personality disorder and dependent personality disorder co-dependence.

So there's an abandonment anxiety. And by amputating the partner by or by selecting a partner who is already amputated or is already crippled or in invalid, dependent on you for the performance of daily bodily functions, this guarantees that there will be no abandonment. It reduces the risk of being discarded, humiliated, ignored.

Similarly, many men would choose an ugly woman or an obese woman as a life partner, because the chances of an ugly or obese woman to cheat, these chances are considered lower. It's sort of an insurance policy against being too committed, against being cheated, against being abandoned.

Choosing a disabled partner is such an insurance policy and ameliorates, reduces anxiety and in this sense, it's an anxiolytic choice. Such a theology of course may indicate the existence of underlying narcissism.

Narcissists psychologically objectify their partners in any case. Narcissists regard their partners as objects to toy with, to manipulate spatially, temporally and psychologically. They reduce their partners to body parts or to fetishes. Narcissists are very big on fetishes. And narcissists are very big on the consumption of pornography. And pornography reduces people, especially women, to body parts.

Well over 40% of pornographic films, pornographic images, focus on body parts rather than the entirety of the individual. So pornography, objectification, narcissists seek to disable their life or intimate partner mentally in a variety of techniques and strategies.

And also they render their partners physically ill in due time. The complex post-traumatic stress disorder, which is very common in relationships with narcissists, very common with narcissistic abuse, CPTSD often comes with physiological and physical and medical manifestations. So narcissists disable their partners in a variety of ways, objectify them and reduce them to body parts.

It stands to reason that people with BID would have a high coefficient of narcissism. And narcissists of course, exactly like border lights, suffer from abandonment anxiety. So it all fits in very nicely.

Acrotomophilia has many variants and manifestations. I, for example, consider pedophilia to be a form of acrotomophilia, because children, exactly like amputees, exactly like disabled partners, children are not yet fully formed. Children are socially and functionally disabled. They are crippled by their own helplessness and dependence.

So to be attracted to a child is to be attracted to a helpless, disabled, partial person.

There is also the issue, of course, of apropopaedophilia. There's the issue of infantilization, the wish to be taken care of, the wish to avoid having to grow up, to be an adult with adult chores and responsibilities.

If you amputate yourself, you instantly become dependent. You instantly become helpless. You instantly regress to a phase of childhood.

In acrotomophilia, the reverse dynamic applies, parentify. The acrotomophilia is grandiose. If you were to visit forums of devotees, most of whom are actually acrotomophilia, they brag.

They say, I can see beyond the body. I can see into the soul. I am not stupidly and primitively addicted to appearances and to looks. I'm much beyond that. I'm much superior to that. I'm much more evolved. I see to the essence. I bond with the quiddity of my partner. I don't care how she looks. I don't think what I don't care and I don't mind the limbs that she misses. I have no problem with her disability because I love her. I don't love her leg. I don't love her boobs. I don't love her hand. I love her.

And they're very proud of it. It's a whole ideology constructed around the issue of amputation and disability.

And the acrotomophilia is grandiose and acts as a benevolent and caring parent to his disabled or deformed or amputated intimate partner. And this is, of course, parentifying the opposite of infantilization.

Perhaps it's an attempt to reenact or resolve early childhood conflicts with caregivers with a hoped for different outcome.

And finally, the ability and courage to modify the body. That's an autoerotic thing. You know, again, it's a grandiose statement. Look at me. I own my body. I'm free. And I have a freedom of choice. And I have self ownership. And no one will tell me what to do with my body. I can do anything I want with my body. And I'm strong and courageous enough and brave enough to amputate my leg or to have it amputated. That's how fearless I am. That's how brave I am.

It's a reassertion of self control. We have the same psychodynamic in eating disorders.

Also a form of reasserting control by self via self amputation.

Also a statement of freedom, demonstrable freedom, a protest showing society and humanity or one's parents and peers, the middle finger.

It's a private ritual. And it's very sexual. It's very autoerotic.

The body becomes one's libidinal object.

It's in this sense, regressive.

There's a transition from object relations to self relations and a kind of attempt to reconstitulate the self around a different body with a different body image and a different proprioceptive mental map of the body.

In other words, it's a way of reinventing oneself, of being one's own creator and one's own God.

And amputating a limb, separating it from the body, renders what remains a fetish, technically, clinically.

If I play with someone else's body or with my own body and mold it so differently, render it functionally and by shape, if I shapeshift the body, then we have a situation of a fetish.

Sigmund Freud wrote in 1905, in Three Contributions to the Theory of Sex, he wrote, the sexual fetish is like the fetish in which the savage sees the embodiment of his God.

As I mentioned before, it's a process of reinvention. It's becoming one's own creator, one's own God, very similar to narcissism, where the false self is God-like.

And these are private religions. There's a self-worship here, self-worship via aggrandizement in the case of narcissism and self-worship via grandiose self-mutilation or teaming up with a mutilated person, thereby elevating oneself to a higher moral ground and a higher intellectual and emotional ground.

I don't depend on the body for love. I love the essence. I'm beyond that.

Back to fetishes.

The propensity to regard and treat other people, caregivers, parents, as objects, propensity to objectify, significant others, is an inevitable phase of personal development and growth during the formative years, six months to three years.

As psychoanalysis and the Object Relations School of Psychology teach us, we outgrow this immature way of relating to our human environment.

We instead develop a sense of empathy.

And yet some of us remain fixated. We do not progress into full-fledged adulthood.

Arguably the most ostentatious manifestation of such retardation is the sexual paraphilia known as fetishism.


The first few ground rules, so to speak, a classification, a taxonomy.

There are three types of fetishes.

One, an inanimate object, a real object, a physical object, usually with a sexual connotation. So it could be a shoe or a bra or a panties.

The second type of fetish, a body part that is clearly still attached to a complete body, dead or alive, hair, feet, buttocks, breasts.

And the third type of fetish is a reified trait, usually a deformity or an idiosyncrasy, that implies disability, inferiority, helplessness, or dependence. For instance, a lame, amputated, grotesquely obese, hunchbacked person. All these are fetishes and technically FETISH is an extension and a form of fetishes.

Consequently, there are three categories of fetishism and three categories of fetish practices.

The first category is the objective fetishes, for whom the inanimate fetish, the object, the real object, stands for and symbolizes a desired role that is out of reach.

So a woman's shoe would stand in for the woman, would substitute for the woman. The woman is unattainable, inaccessible, merely desirable, but never touchable. So her shoe would do, her shoe would stand in for her.

Then there are somatic fetishes for whom the body part stands for and symbolizes a coveted human body and by extension a relationship that is again unattainable.

And finally, there are the abstract fetishes.

They latch on to a trait or characteristic as a means to indirectly interact with their defective bearer.

And in this way, they fulfill the fetishist grandiose fantasies of omnipotence and innate superiority. It's a form of morphological narcissism actually.

And we have in language as well, synagogue and other situations where a word represents an object, a trait represents a person, a part represents the whole.

Arguably, people who prefer autoerotic, partialist, necrophilic, coprophilic, urophilic, anonymous sex, a protomophilic, apotemnophilic, sex, they are also fetishes with the fetish being their own bodies or the organs and excretions of their sex partner or the absence of the organs of their sex partner.

Sexual fetishism is predicated on a pathological sexual attachment to a fetish.

The fetishist climaxes only in the presence of the fetish. He cannot reach orgasm otherwise.

In the absence of their fetish, most fetishes are sexually dysfunctional. For instance, they suffer from erectile dysfunction or they are sexually hyperactive or asexual.

Some forms of fetishism involve sadomasochistic and domination submission fantasies with fetishes such as feet or boots and shoes. The circumstances surrounding the sexual encounter are usually immaterial to the fetishes, as is his environment.

And so a fetishist who is fixated on, I don't know, bra, bras, shoes, feet is unlikely to mind the physical characteristics of the proprietress of the bra or the owner of the feet. Everything around the feet or the bra or the shoes or the panties or whatever it is or the amputation, the stump, everything around is immaterial.

The focus is on the fetish. It's like tunnel vision, like laser instead of diffused light.

The fetishist makes love.

Caffex's emotionally invests in the fetish.

And the person with whom brings the fetish to play, that's merely a courier and a carrier.

It's like when you order pizza, you focus on the pizza, not on the pizza delivery guy, unless he looks really good.

This tunnel vision is common to other mental health disorders, such as, for example, autistic spectrum disorders, schizophrenia disorders and somatoform disorders. And so it may indicate the existence of underlying mental health problems or traumas that either give rise to fetishism or exacerbate it.

Fetishism can be confined to recurrent and intense fantasies and urges, or it can be acted upon.

So there are passive fetishes and active fetishes. It invariably involves masturbation.

The fetishist interacts with his fetish in five ways by watching it.

So there's an element of voyeurism or exhibitionism. So he can watch the fetish worn by a sex partner, his sex partner wearing the fetish, or as an isolated item, by holding it, by rubbing it, or rubbing against it, by smelling it, and by vividly fantasizing about it.

The fetishes have very, very rich fantasy life. What's the etiology of fetishism?

The fetish has to be exactly right in smell, texture, appearance, everything. If it's not exactly right, it loses all its sexual potency.

Fetishes often go to incredible lengths to make sure that their fetish is just the way it should be exactly. It would seem that fetishes are triggers, akin to objects that provoke flashbacks and panic attacks in post-traumatic stress disorder.

It stands to reason, therefore, that the same mental mechanism gives rise to both, a mechanism known as association of learning.

So it seems that trauma and fetishism have a common etiology, association of learning.

Memory has been proven to be state-dependent. Information learned in specific mental, physical, or emotional states is most easily recalled in similar states.

Conversely, in a process known as red integration, mental and emotional states are completely invoked and restored when only a single element is encountered and experienced.

You know, the famous, the longest book ever written, a remembrance of things passed by Marcel Proust.

It starts with aa smell. The protagonist passes next to a house and there's a wafting smell of a specific type of cookies called Maudlin. And so he smells the Maudlin and it starts a whole train of memories and he remembers his entire life.

And so red integration is when emotions, memories, identity fragments or elements, mental imagery, they're all invoked, restored, provoked, evoked, and take over.

When a single sensory element is experienced, the smell, the taste, the sight, fetishism does this. It works through the process of red integration.

The fetishist describes his experience with the fetish as full-fledged sex.

In 1877, the French psychologist Alfred Binet, 1857, 1911, suggested that fetishism is the outcome of a repeated co-occurrence of an object, the fetish, and sexual arousal.

He said every time the fetishist was sexually aroused, there was an object there, the same object, and gradually the brain of the fetishist learned to associate sexual excitatory states with the object.

The more frequent the association, the more entrenched, the more persistent and enhanced it becomes. The stronger the allure of the fetish, the more secure is the exclusivity of the fetish, is a modus of sexual expression, the more it is associated with memories of good sex.

Behaviourist psychologists largely agree with Binet, though they prefer to use the term conditioning rather than association, and others like Wilson in 1981 suggested that fetishism is nothing but faulty imprinting.

Yet imprinting has never been demonstrated in humans.

You could ask Lawrence and his geese, but so it works in geese. It's never been shown to work in humans, and fetishes, whatever we may think of their predilections, are usually humans, human beings.

Fetishes gain in strength when other avenues of sexual gratification are not available, owing to extreme shyness, social anxiety, fear of sex, physiological dysfunction, socio-cultural inhibitions, or disability, coming back full circle to B.I.D.

And so fetishism could be more prevalent in sexually repressive cultures and societies. We find it more among women, homosexuals, and other sexual minorities.

At least that's a theory, a theory that is if fetishism replaces normative ways of expressing sex. And this theory had predominated for a few decades until we discovered that it's wrong.

Fetishism is noted mostly among men, actually, not among women. And it's noted among both homosexual and heterosexual.

There's no preference. It's not like it's overrepresented among homosexuals. So it has nothing to do with sexual repression or repression of normative sexual expression.

Even more, it's very probable, very possible, that fetishism may be underreported in these groups.

And still, women are shy. And honestly, they lie, owing to social strictures and norms. So we don't know. We're not quite sure about the prevalence and incidence of fetishism among women. Still, it's mainly a male phenomenon.

There's no question about it. Studies conducted among sex workers confirmed this. It's a main thing.


And before I come to that, I think it's a main thing because males in today's world are encouraged to objectify their sex partners, especially via pornography.

Western society encourages what the sexologist Magnus Hirschfeld called partial attractiveness. Women are taught to emphasize certain organs, certain limbs, certain areas of their body.

Particular fashion accessories and clothing items do that. There are gender-specific traits that emphasize body parts. And these serve as healthy and socially acceptable fetishism.

And males, men, respond to this. Other explanations of fetishism are a bit more convoluted. Actually, they're so convoluted that they either defy reason or cannot be regarded as science by any stretch of the word.

Freud himself suggested in the standard edition, volume 21, pages 147, 150, published in 1927. So Freud suggested that fetishism is the outcome of an unresolved castration anxiety in childhood.

The fetishist attempts to ward off the lingering stress by maintaining unconsciously that women are really possessed of an occult penis and are thus made whole.

Fetishes, in other words, are symbolic representations of the fall of a penis.

According to Freud, in his article, splitting off the ego in the process of defense, again, standard edition, volume 23, pages 275, 278, in this article, Freud offered yet another mechanism of fetishism.

He postulated that the fetishist's ego harbors two co-existent, fully functional, and hermetically sealed attitudes towards external reality.

One attitude is taking the world into account. The other attitude is ignoring and rejecting the world.

That's Freud.

With no, of course, experimental proof whatsoever, adherents of the Object Relations School of Psychodynamics, such as Donald Winnicott, consider fetishes to be transitional objects, today we call them comfort objects, that outgrew their usefulness.

The fetish originally allowed the child to derive comfort and to compensate for the withdrawal of the primary object.

In other words, when the mother became absent, even for a short period of time, or the caregiver walked out of the room and object constancy was threatened, the child used an object to replace or to substitute for the missing primary object.

Child used a physical object, like a teddy bear, to stand in for mother in her absence.

He bonded with and attached with the teddy bear. He projected things onto the teddy bear. He emotionally invested, affected the teddy bear, so that the teddy bear can serve as a bridge between the two presences of mommy, mother one, mother two, and there's a gap, an absence in between, and the comfort object, or the transitory object, transitional object, replaced the mother in this period.

Winnicott II, Winnicott II believes that the fetish amounts to an anxiety-ameliorating substitute for the missing maternal phallus.

To put these literary contraptions aside, I think there are several themes, common themes.

Anxiety reduction, grandiosity, and anxiety connected to abandonment, so abandonment anxiety, amelioration of abandonment anxiety, grandiosity, and objectifying sexuality.

Sexuality that is focused on objectifying department, rendering department non-human and partial reductionist sexuality.

Now these are all maps of pathological narcissism, and perhaps all these are actually merely sexual overt manifestations and expression of the underlying pathology of narcissism or even psychopathic narcissism.

It's the thesis that I would like to study and promote in this presentation and in my future work.

I thank you for your patience, I thank you for the appointment, I promise to do my best to include only quality content, publish only quality material, based on evidence-based, and to not succumb to popular trends, especially as expressed online, as unfortunately a big part of academe is beginning to do.

We must fight, we must buck the trend, we must fight this tidal wave and tsunami of contaminating the academic environment. We must remain, we must remain detached to some extent. We must observe, we must structure, we must classify, we must speculate, we must study and test conduct experiments.

In other words, we must adhere to the scientific method and we must not confuse and conflate and confute language with substance, as many many are doing today.


Perhaps it's the role, the remaining role of academic journals via the peer review mechanism in other ways, the editorial control, the remaining role to safeguard the purity and function of science, as it had been envisioned during the enlightenment period in the 17th and 18th and 19th centuries.

Something has gone awry and it's our job to restore what's been, you know, destroyed.

Thank you again.

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Professor Sam Vaknin discusses the love life, sexual fantasies, and relationships of borderline women, as well as the connection between borderline personality disorder and promiscuity. He delves into the origins and manifestations of the disorder, including its link to childhood trauma and heredity. Vaknin also explores the impact of these dynamics on relationships and the potential for resonance or exacerbation of pathologies in such pairings.


Betrayal, Trauma, Dissociation: Roots of Cluster B Personality Disorders (Compilation)

The text discusses the theory of structural dissociation, which posits that trauma can cause the personality to divide into an apparently normal part (ANP) and an emotional part (EP). The ANP attempts to function in daily life and avoid trauma-related memories, while the EP contains the traumatic memories and associated emotions. This division can lead to various dissociative symptoms and disorders, including PTSD, CPTSD, and dissociative identity disorder (DID). The theory also suggests that different parts of the personality can have varying degrees of autonomy, memory access, and sense of self. Treatment involves integrating these dissociated parts to achieve a more cohesive sense of self and improved functioning.


Therapy Session with Vince(nt) van Gogh (Estrangement Technique)

Professor Sam Vaknin uses a technique called estrangement in his therapy sessions, where he addresses his patient with the name of someone significant in their life to elicit an outsider's point of view and provoke the patient. In this session, he speaks with Vincent Van Gogh and suggests that Van Gogh has borderline personality disorder. Vaknin encourages Van Gogh to seek help, take a break from his current life, and gain perspective on his relationships and emotional investment in his painting.


Borderline Girl, Interrupted (Rebecca Ray's "Pure")

Professor Sam Vaknin discusses the book "A Certain Age" by Rebecca Ray, praising it as a masterpiece that provides insight into the formation of borderline personality disorder in adolescence. He reads excerpts from the book and comments on them, highlighting the pathogenesis of borderline personality disorder, precocious sexuality, dissociation, and the internal struggles of individuals with this disorder. He emphasizes the transactional mindset, external locus of control, and the use of fantasy as a defense mechanism. The discussion also touches on self-harming behaviors, lying, and the need for external validation in individuals with borderline personality disorder.


Signs of SWITCHING in Narcissists and Borderlines (Read PINNED comment)

Professor Sam Vaknin discusses the phenomenon of switching in dissociative identity disorder, borderline personality disorder, and narcissistic personality disorder. He explains that switching is a common regulatory mechanism in these disorders and is triggered by stress, anxiety, and environmental cues. Vaknin describes the signs of switching, including emotional dysregulation, changes in body posture, and dramatic shifts in identity and behavior. He also emphasizes the impact of switching on relationships and the need for partners to adapt to the changing identities of individuals with these disorders.


Borderline Woman: Partner Devaluation, Self-harm, Alcoholism

In summary, Professor Sam Vaknin discusses the psychology of borderline women, focusing on splitting, self-destructive behaviors, and substance abuse. Splitting is an infantile defense mechanism that leads to idealization and devaluation of others. Self-destructive behaviors can include risky sexual encounters, reckless behavior, and defiance. Substance abuse, particularly alcohol, can serve as a coping mechanism for negative emotions, restore self-confidence, lower inhibitions, and allow for the accomplishment of goals that would not be considered when sober.


Mental Health Dictionary - Letter B

Sam Vaknin discusses the letter B in his Mental Health Dictionary series. He covers topics such as blocking, borderline personality disorder, and the Borderline Personality Organization Scale. He provides detailed descriptions of the symptoms and behaviors associated with BPD, including unstable relationships, impulsive behavior, and mood swings. Vaknin also mentions his plans to continue the series with the letter C.


Tips: Survive Your Borderline Enchantress

Professor Sam Vaknin discusses coping with borderline personality disorder, including abandonment anxiety and object constancy. He suggests establishing rituals and procedures of presence, permanence, stability, and predictability, involving the borderline in activities that can be misinterpreted as forms of abandonment, and introducing object constancy into the relationship through mementos, programmed reminders, and shared sentences. He also discusses decompensation, acting out, and mood lability in individuals with borderline personality disorder. Finally, he offers advice on how to deal with a partner who has borderline personality disorder, including restoring reality testing, preventing suicide, and countering transient paranoid ideation.


4 Paths of Trauma Release and Reactance (International Summit on Depression, Anxiety and Stress Management)

Professor Sam Vaknin discusses the connection between trauma, including external shocks such as the pandemic, and reactants, or disproportional reactions to daily triggers. He reconceives personality disorders as post-traumatic conditions, with all personality disorders in cluster B starting as trauma and abuse in early childhood. Trauma imprinting is the core of post-traumatic stress disorder and complex trauma, and triggers are places, people, smells, sounds, circumstances, dates, and objects that are reminiscent of the same classes of stressors involved in the original trauma. The pandemic has touched upon every dimension of existence, making it difficult to recover from, and there is a risk of a secondary pandemic of mental health, with millions of people developing personality disorders.


CPTSD or Personality Disorder? (Compilation)

Sam Vaknin discusses the concept of late-onset trauma and its potential to cause enduring personality changes that could be classified as personality disorders. He explains that while early childhood trauma is often linked to the development of personality disorders, catastrophic events experienced in adulthood can also lead to significant and lasting changes in personality. Vaknin argues that the diagnosis of Enduring Personality Changes After Catastrophic Experience (EPCACE), which was included in the ICD-10 but removed in the ICD-11, should be restored as it captures the unique and severe impact of adult trauma on personality. He emphasizes that EPCACE is distinct from PTSD and CPTSD, as it involves stable changes in personality resulting from extreme events such as torture, life threats, or prolonged captivity. Vaknin also critiques the current diagnostic approach that lumps various trauma-related disorders into a single category, suggesting that this leads to a lack of specificity and fails to account for the diverse ways individuals react to trauma.

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