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The main theoretical position on fetishism remains that outlined by Freud, the splitting of the ego and castration anxiety being central to the establishment of the fetish. The dangers and attractions of an oedipal resolution are outlined in the case of ‘Stanley’, an older adolescent whose nappy wearing, transvestism and obsession with pregnant mothers and their babies brought him to therapy. The paper demonstrates some of the technical difficulties in such work, the slow ego-structuring that is necessary, the patient's swift perception of danger at any failure of attunement by the therapist and subsequent flight to the perverse defence, and the impetus that acceptance of oedipal gain may bring to development.