Despite a very striking shift in our culture over the last several years towards more acceptance of diversity, I hear from many individuals every month that continue to struggle with discomfort around their sexual interests.  Often this anxiety stems from fantasies that these folks may find jarring, disturbing, or simply they are trying to make sense of. For previous articles on sexual fantasies, you can click here and here. As readers of this site well know, I always approach these situations from a nonjudgmental, collaborative, and humanistic perspective. While some fantasies or desires can be accounted for by some psychological need, many desires appear to be hard-wired and while we just don’t have enough strong scientific data to definitively assess whether kinks and fetishes are genetic, as I detailed in my book Modern Sexuality, new research appears to support that, in some people they may have an innate basis.

At any rate, etiology, while interesting, often provides little of value in the way of eliminating or suppressing that desire. This is because, regardless of etiology, much of our sexual desires have become hard-wired, either through a genetic component, or through endless repetition, or a mixture of both. Even if the content of the fantasies or desires seems to shift over time, the overarching theme stays omnipresent while the specifics may change. For example, someone who craves an experience of humiliation may imagine being verbally thrashed, but then those fantasies can shift towards elements containing bondage or physical impact. While the content seems to shift, the underlying motivation fueling the fantasy remains the same. (Note: there are many reasons someone may engage in the activities described in the prior sentence, humiliation is but just one example.)

Anyway, one of my first priorities is to provide my clients with accurate psychoeducation. Often, people may feel alone in their desires and feel like “freaks” or “outsiders” because they experience their desires as so rare or deviant. However, recent research, such as this one by researchers in Quebec, in which over 1500 Quebecois were asked whether or not they had experienced 55 different fantasies listed on a questionnaire. found that very few fantasies are indeed rare. For example, fantasies which included themes of dominance and age discrepancies were found to be quite common, and even fantasies of urination and wearing clothes of the opposite gender were not rare. Certainly, many fantasies are only meant as fantasies, and only a certain percentage of these fantasies were acted out. Interestingly, men and women were roughly about equally likely to experience some of these fantasies (men scored higher on some while women scored higher on others), but men were much more likely to act on them, perhaps due to a socialization aspect, but that is a discussion for another time. For those interested in learning more about this study, I’ve covered it in greater depth for Psychology Today.

Now that we’ve established that these desires are probably not as deviant or uncommon as once suspected, next we often delve into the difference between thoughts, fantasies, and behaviors. As the above research demonstrates, there is often a large gulf between desiring something in one’s mind and acting on it, and this is an important distinction to understand since often individuals may be frightened of their fantasies and experience them as if they’ve already happened, even though they’ve only been imagined. Another point of distinction here is that not all desires are created equal. The DSM III identified three categories of paraphilias (fetishes): optional, preferred, and exclusive. While those who experience their desires as optional may find it easy to take them or leave them, those whose experience is preferred crave them intensely, and those for whom it is exclusive absolutely need to experience them in order to become aroused.

These are important nuances to understand, since those who have exclusive fetishes may incorrectly self-diagnose themselves as “addicted” and seek sex addiction treatment, even though they inevitably set themselves up for failure since abstinence will not cure them of their hard-wired exclusive fetish. This is just one difficulty with the whole sex addiction concept, but I go further into these quibbles in other articles on this blog.

Throughout this psychoeducation and exploration process, my aim is to accomplish the following– reduce shame, put things in their proper context, understand one’s relationship to one’s sexuality without harsh judgment, determine (if applicable) what deeper psychological meaning this desire holds, and understand in which category the individual experiences their desire. That’s a lot to accomplish and sometimes that may take some time. But these are initial steps. From there, we can collaborate on forging a way forward in determining what the individual does with their desires. Sometimes we realize the desire is best set aside as a fantasy which can be enjoyed now and then, and this can be a fun place that the individual can go to in the comfort of their own privacy, but without acting on it. Other times, we may realize that this desire is of significant importance and the individual may experience great benefit in exploring it further. Or the individual may already be engaging a certain behavior, but feels it is harmful and detrimental, yet still feels compelled to act, in which case we will look at harm reduction alternatives. Most importantly, I tailor my interventions to the specific needs of the individual. No cookie cutter or one size fits all system or ideology can possibly accommodate the specific needs of everyone. Sexuality is way too complex and personal for that.