Occasionally the imagination is tempted to try the same ideas in an inverted rôle. There may even be realization of this inversion. Such attempts in imagination and in acts, however, are usually soon abandoned as inadequate for the original inclination.

Masochism and sadism also occur in combination with contrary sexual instinct, and, too, in association with all forms and degrees of this perversion. The individual of contrary sexuality may be a sadist as well as masochist (comp. Cases 48 and 49 and numerous cases in the following series of cases of contrary sexual instinct).

Wherever a sexual perversion has developed on the basis of a neuropathic individuality, sexual hyperæsthesia, which may always be assumed to be present, may induce the phenomena of masochism and sadism—now of the one, now of both combined, one arising from the other. Thus masochism and sadism appear as the fundamental forms of psycho-sexual perversion, which may make their appearance at any point in the domain of sexual aberration.[[86]]

3. The Association of Lust with the Idea of Certain Portions of the Female Person, or with Certain Articles of Female Attire—Fetichism.—In the considerations concerning the psychology of the normal sexual life in the introduction to this work (vide p. 17), it was shown that, within physiological limits, the pronounced preference for a certain portion of the body of persons of the opposite sex, particularly for a certain form of this part, may attain great psycho-sexual importance. Indeed, the especial power of attraction possessed by certain forms and peculiarities for many men—in fact, the majority—may be regarded as the real principle of individualization in love.

This preference for certain particular physical characteristics in persons of the opposite sex,—by the side of which, likewise, a marked preference for certain psychical characteristics may be demonstrated,—following Binet (“du Fetischisme dans l’amour,” Revue philosophique, 1887) and Lombroso (Introduction to the Italian edition of the second edition of this work), I have called “fetichism”; because this enthusiasm for certain portions of the body (or even articles of attire) and the worship of them, in obedience to sexual impulses, frequently call to mind the reverence for relics, holy objects, etc., in religious cults. This physiological fetichism has already been described in detail on page 17 et seq.

By the side of this physiological fetichism, however, there is, in the psycho-sexual sphere, an undoubted pathological, erotic fetichism, of which there is already a numerous series of cases presenting phenomena having great clinical and psychiatric interest, and, under certain circumstances, forensic importance. This pathological fetichism does not confine itself to certain parts of the body alone, but it is even extended to inanimate objects, which, however, are almost always articles of female wearing-apparel, and thus stand in close relation with the female person.

This pathological fetichism is connected, through gradual transitions, with physiological fetichism; so that (at least in body-fetichism) it is almost impossible to sharply define the beginning of the perversion. Moreover, the whole field of body-fetichism does not really extend beyond the limits of things which normally stimulate the sexual instinct. Here the abnormality consists only in the fact that the whole sexual interest is concentrated on the impression made by a part of the person of the opposite sex, so that all other impressions fade and become more or less indifferent. Therefore, the body-fetichist is not to be regarded as a monstrum per excessum, like the sadist or masochist, but rather as a monstrum per defectum. What stimulates him is not abnormal, but rather what does not affect him,—the limitation of sexual interest that has taken place in him. Of course, this limited sexual interest, within its narrower limits, is usually expressed with a correspondingly greater and abnormal intensity.

It would seem reasonable to assume, as the distinguishing mark of pathological fetichism, the necessity for the presence of the fetich as a conditio sine qua non for the possibility of performance of coitus. But when the facts are more carefully studied, it is seen that this limitation is really only indefinite. There are numerous cases in which, even in the absence of the fetich, coitus is possible, but it is incomplete and forced (often with the help of fancies relating to the fetich), and particularly unsatisfying and exhausting; and, too, closer study of the distinctive subjective psychical conditions in these cases shows that there are transitional states, passing, on the one hand, to mere physiological preferences, and, on the other, to psychical impotence in the absence of the fetich. It is therefore better, perhaps, to seek the pathological criterion of body-fetichism in purely subjective psychical states. The concentration of the sexual interest on a certain portion of the body that has no direct relation to sex (as have the mammæ and external genitals)—a peculiarity to be emphasized—often leads body-fetichists to such a condition that they do not regard coitus as the real means of sexual gratification, but rather some form of manipulation of that portion of the body that is effectual as a fetich. This perverse instinct of body-fetichists may be taken as the pathological criterion, no matter whether actual coitus is also possible or not.

Fetichism of inanimate objects or articles of dress, however, in all cases, may well be regarded as a pathological phenomenon; since its objects fall without the circle of normal sexual stimuli. But even here, in the phenomena, there is a certain outward correspondence with processes of the normal psychical vita sexualis; the inner connection and meaning of pathological fetichism, however, are entirely different. In the ecstatic love of a man mentally normal, a handkerchief or shoe, a glove or letter, the flower “she gave,” or a lock of hair, etc., may become the object of worship, but only because they represent a mnemonic symbol of the beloved person—absent or dead—whose whole personality is reproduced by them. The pathological fetichist has no such relations. The fetich constitutes the entire content of his idea. When he is possessed by it, sexual excitement occurs, and the fetich makes itself felt.[[87]]

According to all observations thus far made, pathological fetichism seems to arise only on the basis of a psychopathic constitution that is for the most part hereditary, or on the basis of existent mental disease.