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Fetishism is traditionally regarded as a disorder of males, a perversion in which the ability to perform the sexual act is dependent on the concomitant awareness of an accessory and specific inanimate object. This object, the fetish, clearly represents the penis and is necessary to ward off the intense and incapacitating castration panic which the patient would otherwise suffer (Freud, 1927), (1938). To be sure, it has a bisexual meaning, too, but it is the phallic significance which is serviceable in permitting intercourse, or, in some instances, masturbation. According to my view of the situation, the fetishist not only endows his partner with the removable and adaptable penis, but in doing this he can incorporate the penis himself through vision, touch, and smell, and thereby bolster his uncertain genitality. The disorder is one which has at its base a faulty body-image and body-ego development, with consequent disturbances of the senses of reality and of identity, and of object relationship (Greenacre, 1953), (1955).
The fetish of the adult has something in common with the transitional object of infancy, which normally plays its part in the establishment of reality and of object relationship (Stevenson, 1954); (Winnicott, 1953); (Wulff, 1946). But the persistence of the fetish into adult life indicating the need for so prolonged a bridge bespeaks the chronic fault in the somatopsychic structure. The transitional object, on the other hand, is ordinarily given up with the rise of genitality, except in those cases where it merges into the adult fetish because of the severity of the underlying disturbance. The transitional object is not sex limited and seems to be derived more from the relationship to the mother's breast and soft body and is not especially focused on the genital.