Foreskin Fetishism and its Relation to Ego Pathology in a Male Homosexual1

In psycho-analytic literature the fetish has been discussed exclusively as an auxiliary object or device in the service of heterosexual gratification, and as a defence against perversions proper, particularly homosexuality. Freud (1927) had derived the aetiology of fetishism from castration anxiety relating to the phallic phase. He had established the psychic contents of the fetish as denial of castration and had stated: 'The fetish is a substitute for the woman's (mother's) penis that the boy once believed in and does not want to give up.' By his emphasis on the singular importance of the mechanisms of denial (disavowal) and splitting in the ego's attempt to deal with the castration threat Freud (1927), (1938) had also established the beginnings of researches into ego pathology and its relation to preversions which have since enlarged extensively the aetiology of fetishism to include: (a) primary preoedipal relation to the (breast) mother (Lorand, 1930); (Wulff, 1946); (Buxbaum, 1960); (b) internal objects and early ego development (Payne, 1939); (Gillespie, 1940), (1964); (Hunter, 1954); (c) transitional object phenomena and primitive mental functioning (Winnicott, 1953); (Lacan and Granoff, 1956); (Fraser, 1963); (d) separation anxiety and the dread of abandonment (Bak, 1953); (Weissman, 1957); (e) pathological body-ego development and threat of disintegration from disturbed mother-child relationship (Greenacre, 1953), (1960); (Mittelmann, 1955); (f) bisexual primary identifications with the mother and the wish to bear a child (Kronengold and Sterba, 1936); (Kestenberg, 1956); (van der Leeuw, 1958); (Socarides, 1960); (g) flight from incest (Romm, 1949); and (h) a defence against archaic anxiety affects which threaten the relation to reality with the accompanying dread of breakdown into psychotic states (Glover, 1932), (1933), (1949); (Socarides, 1959); (Katan, 1964).

In the literature, to my knowledge, there is only one case, reported by Bak (195