How to Get Rid of a Fetish: Is It Even Possible?

Fetishes appear to be deeply embedded in the brain’s reward circuitry, and no treatment has been shown to reliably erase one. The more honest framing, and the one most clinicians now use, is whether the fetish is causing genuine harm or distress, because that distinction changes everything about what “getting rid of it” even means. For many people, the real problem is not the fetish itself but the shame surrounding it, and modern psychiatry has increasingly reflected that shift.

Why Sexual Arousal Patterns Resist Unlearning

Sexual arousal is not a simple on-off switch you can reprogram. Research suggests that once a pattern of sexual reward is established, the brain’s opioid and dopamine systems work together to lock it in. Opioid activation forms the basis of sexual reward, and that reward then sensitizes dopamine pathways that direct attention and motivation toward cues associated with it.¹ In plainer terms, your brain learns what arouses you and then builds a motivational highway toward those cues. That highway does not simply disappear because you want it to.

Laboratory experiments reinforce this picture. In one study, researchers conditioned sexual arousal responses in women by pairing a neutral image with physical stimulation. When they later tried to extinguish that learned arousal by repeatedly showing the image without stimulation, the conditioned response did not fade. The arousal pattern persisted even through repeated extinction trials.² This is a striking finding because extinction is the standard mechanism by which learned associations weaken in other domains, like fear conditioning. Sexual arousal seems unusually resistant to it.

This does not mean arousal patterns are totally fixed from the moment they form, but it does mean that the “just stop finding it arousing” approach has no support in the neuroscience. The brain does not offer a delete button for sexual preferences. What it sometimes allows is a shift in how much control a preference exerts over your behavior, which is a different goal entirely.

When a Fetish Counts as a Problem

The psychiatric world has moved substantially on this question. When the World Health Organization revised its International Classification of Diseases for the eleventh edition (ICD-11), an expert working group recommended removing fetishism, fetishistic transvestism, and sadomasochism from the list of disorders entirely. Under the new framework, a sexual interest only qualifies as a paraphilic disorder if it involves non-consenting people or causes substantial distress, functional impairment, or direct risk of injury or death.³ A foot fetish that you and your partner enjoy, or a latex interest you explore consensually, does not meet any of those criteria. It is not a disorder. It does not need treatment.

The distinction that matters most is between ego-syntonic and ego-dystonic experiences. If a fetish feels compatible with your identity and does not cause you distress, that is ego-syntonic. If it feels alien, shameful, or out of control, that is ego-dystonic. A cluster analysis of people with fetishistic interests found three distinct subgroups, and the ego-dystonic group, the people who were distressed about their fetish, showed significantly higher levels of depression compared to the other groups.⁴ This matters because it suggests the depression is linked to the person’s relationship with the fetish, not to the fetish itself. You can have the same sexual interest as someone else and be fine, while they are miserable, because of how each of you feels about having it.

This is why many therapists today will not try to eliminate a fetish that is consensual and harmless, even if the client asks them to. The more productive target is often the distress, guilt, or compulsive quality that surrounds the behavior, not the arousal pattern underneath it.

What Aversion Therapy Taught Us the Hard Way

For much of the twentieth century, the dominant approach to unwanted sexual interests was aversion therapy: pairing the arousing stimulus with something deeply unpleasant, like electric shocks or drugs that induced vomiting, in the hope that the brain would learn to associate the sexual cue with pain rather than pleasure. This was used not only for fetishes but extensively against gay and bisexual people.

The results were consistent and damning. One woman who was subjected to aversion therapy in England described being given injections to induce vomiting and electric shocks when shown pictures of women. She said the treatment made her feel terrible for months and put her off being near women, but it did not make her attracted to men.⁵ That outcome captures the fundamental problem with aversion therapy: it can suppress behavior through fear and avoidance, but it does not rewire the underlying arousal pattern. The person ends up traumatized and avoidant without any change in what actually attracts them.

Aversion therapy is now widely considered unethical for sexual orientation and has fallen out of favor for fetishes as well. Professional bodies in most Western countries have condemned its use for trying to change sexual orientation. Its history is relevant here because it represents the most aggressive attempt anyone has made to erase a sexual preference, and it failed. That failure is informative: if electric shocks and chemically induced nausea cannot overwrite a sexual response, gentler methods are unlikely to do so either. The question has to shift from “how do I delete this” to “how do I manage how it affects my life.”

What Cognitive Behavioral Therapy Actually Targets

Modern therapy for problematic fetishes or paraphilic interests does not aim to erase the arousal pattern. Instead, cognitive behavioral therapy (CBT) targets the behaviors, thought patterns, and emotional responses that surround it. A CBT protocol for paraphilic disorders typically includes functional analysis of the behavior, restructuring of distorted beliefs, strategies for emotion regulation, mindfulness, and relapse prevention techniques for maintaining behavioral change over time.⁶

In practice, this means helping a person understand what triggers their compulsive engagement with the fetish, challenging any beliefs that make the behavior worse (like catastrophic thinking about being “broken”), building skills to tolerate urges without acting on them, and developing a broader behavioral repertoire so the fetish does not dominate their sexual life. The arousal pattern may still be there, but it no longer controls decision-making.

A pilot study of internet-delivered CBT for men with hypersexual disorder, some of whom also had paraphilias, found significant decreases in sexual compulsivity symptoms along with moderate improvements in paraphilic symptoms and psychiatric well-being. Those improvements held steady at a three-month follow-up.⁷ Notice the language: “improvements in paraphilic symptoms” does not mean the paraphilia vanished. It means the distress and compulsive behavior around it decreased. That is a meaningful and achievable outcome, even if it is not the clean erasure some people are looking for.

CBT is generally the first-line recommendation for someone whose fetish is causing them genuine problems, precisely because it does not require the impossible task of eliminating the arousal itself. It works with what the brain allows: better control, less distress, more flexibility.

Medication and What It Can and Cannot Do

For people whose paraphilic interests are more severe, particularly when behavior is compulsive or involves risk of harm to others, medication enters the picture. The pharmacological options fall into two broad categories: drugs that target brain chemistry and drugs that suppress testosterone.

Selective serotonin reuptake inhibitors (SSRIs), the same class of drugs used for depression and anxiety, have shown some promise in reducing paraphilic symptoms. The mechanism is thought to work through both serotonin’s role in impulse control and the well-known side effect of SSRIs: reduced sex drive. Case reports and open trials have documented efficacy in treating paraphilic behaviors, though no large-scale placebo-controlled trials have been completed.⁸ One case report described a man with compulsive sexual behavior successfully treated with fluoxetine, a common SSRI, with the goal of managing uncontrollable urges rather than eliminating the underlying interest.⁹

At the more aggressive end of the spectrum are androgen deprivation therapies, sometimes colloquially called “chemical castration.” These include steroidal antiandrogens and GnRH analogs, both of which dramatically lower testosterone. A study of men with paraphilias treated with the GnRH analog triptorelin found that deviant sexual fantasies dropped from an average of about 48 per week to zero during treatment, and incidents of abnormal sexual behavior dropped from about five per month to zero.¹⁰ Patients also reported feeling more relaxed and experiencing reductions in aggressive feelings alongside the drop in sexual fantasies.¹¹

These numbers look dramatic, but context matters. Androgen deprivation therapy has serious side effects, including weight gain, muscle cramps, migraines, edema, breast tissue growth, and bone loss from long-term use. GnRH analogs in particular frequently cause osteoporosis, requiring supplementation and monitoring.¹² These treatments are primarily reserved for cases involving serious risk of harm, most commonly in forensic settings with sex offenders. They are not prescribed for someone who is simply uncomfortable with a consensual foot fetish. And crucially, when treatment stops, the fantasies and behaviors tend to return, because the underlying arousal pattern was suppressed, not eliminated.

A systematic review of pharmacological interventions across 28 studies found that both SSRIs and androgen deprivation therapy reduced deviant fantasies and increased patients’ sense of self-control, with SSRIs generally producing fewer side effects.¹² But again, “reduced deviant fantasies” is the outcome, not “erased deviant fantasies.” Medication manages; it does not cure.

How Much of the Problem Is Actually Shame

One of the most underappreciated aspects of this topic is how much of the distress people feel about a fetish comes not from the fetish itself but from the cultural context they live in. What counts as sexually normal varies enormously across societies. Definitions of normal and deviant sexual behavior are shaped by cultural factors including religion, legal systems, and local social norms, and these definitions shift over time within the same culture.¹³

A person with a bondage interest living in a community where kink is openly discussed and practiced might experience no distress at all. The same person in a conservative religious community might experience profound shame and a desperate wish to be “fixed.” The fetish is identical in both cases. The distress is entirely a product of the social environment. This is why the ego-dystonic fetishism group in the cluster analysis mentioned earlier showed elevated depression: their internal conflict about the fetish, not the fetish’s intrinsic properties, was driving their suffering.⁴

This does not mean that all fetish-related distress is “just” shame and therefore not real. The distress is genuine and can be severe. But it does mean that for many people, the most effective intervention is not trying to change the sexual interest but working through the shame, whether in therapy, through community, or through education about how common these interests actually are. If you could feel completely neutral about your fetish, would it still be a problem? For a lot of people, the honest answer is no.

When the Fetish Itself Is the Problem

There are situations where the fetish genuinely is the core issue, not just the feelings about it. If a fetish has become so consuming that you cannot become aroused without it, if it is interfering with your ability to maintain relationships or hold a job, or if it involves urges toward non-consenting people, then the interest itself needs clinical attention.

Compulsive sexual behavior is where the overlap between fetishes and clinical problems becomes clearest. Personality traits like high neuroticism and obsessive-compulsive tendencies have been studied as predictors of paraphilic intensity, suggesting that for some people, the problem is less about the specific content of the fetish and more about a broader pattern of compulsive thinking and behavior.¹⁴ In these cases, treating the compulsivity can be more productive than targeting the fetish content. When the obsessive quality diminishes, the fetish often settles back into a less dominant role in the person’s life without needing to be erased.

For interests that involve non-consenting targets, the situation is more serious and the clinical approach is correspondingly more aggressive. This is where the heavier pharmacological interventions, including antiandrogens, are used in conjunction with therapy. The goal is harm prevention, and clinicians treat it with the urgency that goal requires.

Fetishes and Neurodevelopmental Differences

An area that gets less public attention is the link between autism spectrum disorder and atypical sexual interests. Research has found that individuals with high-functioning autism seem to report more paraphilic fantasies and behaviors than general population surveys suggest, with the pattern driven primarily by males with ASD.¹⁵ The reasons are not fully understood, but hypotheses include differences in how autistic individuals process sensory information, a tendency toward intense focused interests that can extend into the sexual domain, and reduced sensitivity to social norms that might otherwise suppress or conceal atypical interests.

This is relevant because autistic individuals may be especially likely to feel distressed about a fetish without having the social framework to understand that many sexual interests are common and harmless. They may also be more vulnerable to rigid thinking patterns that make a fetish feel like an emergency rather than a manageable part of their sexuality. Clinicians working with autistic clients on these issues often need to adjust their approach, spending more time on psychoeducation about the range of human sexuality and less time assuming the client has absorbed cultural knowledge about what is and is not typical.

A Realistic Framework for Moving Forward

If you have landed on this topic because you are distressed about a fetish, the evidence points toward a few practical takeaways rather than a simple yes-or-no answer. First, assess honestly whether the fetish causes harm. If it involves consenting adults, does not dominate your life, and does not cause you persistent distress, the psychiatric consensus is that it is not a disorder and does not need treatment. If it does cause distress, the most accessible and evidence-supported option is CBT focused on managing the compulsive or shame-driven aspects, not on erasing the arousal itself. If the fetish involves compulsive behavior that is genuinely out of control, SSRIs may help with impulse management alongside therapy. And if the interest involves risk of harm to others, more intensive interventions including androgen suppression exist and can be effective at reducing fantasies and behaviors for as long as they are maintained.

What none of these options do is make the arousal pattern disappear as though it never existed. The brain does not work that way. The conditioned sexual response studies, the neurobiology of reward learning, and the long history of failed attempts at aversion therapy all converge on the same finding: sexual arousal patterns, once established, are remarkably persistent. The productive question is not “how do I get rid of this” but “what kind of relationship do I want to have with this part of myself, and what help do I need to get there?”

Finding a therapist who specializes in sexual health is worth the effort. General practitioners and even general-purpose therapists may lack the specific training to distinguish between a harmless interest and a clinical problem, and some may bring their own cultural biases to the conversation. A sex-positive therapist with training in paraphilic disorders can help you figure out whether you actually have a problem or whether you have been convinced by your environment that you do, and those are very different starting points for very different journeys.