The evolution of a shoe fetish.

This paper deals with clinical material gathered from the long-term, psychoanalytically-oriented treatment of a patient with a shoe fetish. Genetic and dynamic aspects of this problem are emphasized. The combination of a dominating mother and a passive and absent father, the sharing of a bed with an older sister until age eleven, and the receipt of frequent enemas contributed directly to the development of the fetish, the most crucial determinant being the commulative traumatic effect of the enemas. During adolescence, the patient also resorted to transvestism to deal with the intensification of castration fears. Becoming a husband and father threatened to disrupt his tenuous defenses and forced him to seek therapy for two years, during which he was able to gain sufficient insight to forego the fetish and to engage in heterosexual activity in reasonably conflict-free manner. Previous theorectical contributions on the subject are included and theorectical issues are dealt with, particularly the role of the core fantasy of the phallic woman in the perversions.