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Five points are emphasized in the development of fetishism. (1) Weakness of the ego structure which may be inherent or occur secondarily through physiological dysfunctions or through disturbance of the mother-child relationship. (2) Fixation in pregenital phases, especially anal erotism. (3) The symbolic significance of the fetish corresponds to pregenital phases and may thus represent separately or in condensation: breast-skin, buttocks-faeces, and female phallus. (4) Simultaneous and alternating identification with the phallic and penisless mother, corresponding to the 'split of the ego' (Freud). (5) The identification with the penisless mother leads to the wish to give up the penis and to marked intrastructural conflict. Historically, the pregenital identification with the phallic mother cannot be given up in the phallic phase in spite of the new reality (penisless) because separation from the mother is experienced as a danger equal to, if not greater than, the loss of the penis. Both phases of danger, i.e. of separation and castration, are defended by the fetishistic compromise.
Two case histories are described.