A case of fetishism is presented with the support of etiopathogenetic and therapeutic hypotheses. Some non-clinical aspects are emphasized that are often important for a global vision of a patient for which clinical answers are not possible.
We examine the nosographic and clinical characteristics of the paraphilia. The case is described in a dimensional manner.
Therapy is problematic as the subject does not suffer from his behaviour: his greatest interest is to satisfy his compulsions, and sees no need for treatment. However, the patient’s behaviour provokes pain in the family and causes social impairment.
The case demonstrates that is insufficient to assert that treatment in this type of disturbance is necessary only when there is a violation of social rules. There are important ethical and clinical problems that must however be examined through analysis of a larger patient cohort.