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Fetishism is the result of a rather definite combination of genetic influences in disturbances of pregenitality. These consist of (i) disturbances in the early months of life, producing instability in the formation of the body image. (These include early physical disturbances causing marked sudden fluctuations in body image or subjective feelings of this nature; disturbances of mother-child relationship, which affect the sense of the infant's own body and leave an imprint on the early emerging ego; and finally the effect of early primary identification.) (ii) Complementary disturbances of the phallic phase which produce an exaggeration of the castration complex. The genital area of the body image is in any circumstances less certain in the early months of life than other parts of the body except the face. Under normal developmental conditions, the genital area of the body image becomes consolidated during the phallic phase, owing to the increase of the spontaneous endogenous sensations then arising. Under the disturbed conditions of pregenitality described, the overlying strong castration anxiety is combined with body-disintegration anxiety from the early phase and depletes rather than reinforces the genital outlines of the body. These conditions also contribute to increased bisexuality and to a corresponding split in the ego.
Owing to the marked pathology of the first months, there is a persistence of the unusually strong primary identification (which in many cases has played a part also in confusing the genital part of the body image). This persistent tendency to primary identification, especially through vision, again influences the attempts at intercourse. Then the sight of the penislessness of the partner brings into focus the underlying feminine identification and makes genital performance impossible unless special support is offered.
The support is attained through the use of the fetish. It offsets the effect of the identification with the partner, an