Most fetishes don’t need to be “gotten rid of,” and in many cases, completely eliminating one isn’t realistic. But if a fetish is causing you genuine distress, interfering with your relationships, or taking over your sex life in ways you don’t want, there are therapeutic approaches that can reduce its grip and help you regain a sense of control. The first step is understanding what you’re actually dealing with, because the answer to “how do I get rid of this?” depends heavily on why it bothers you.
When a Fetish Is a Problem (and When It Isn’t)
Modern psychiatry draws a clear line between an unusual sexual interest and a disorder. The DSM-5, the diagnostic manual used by mental health professionals, states plainly that most people with atypical sexual interests do not have a mental disorder. A person with an intense, persistent fetish, say for feet, would only be diagnosed with fetishistic disorder if that interest causes significant personal distress or interferes with daily functioning. The key word is personal: distress that comes purely from feeling ashamed because society disapproves doesn’t meet the clinical threshold on its own.
This distinction matters because it changes the treatment goal. If your fetish isn’t harming anyone and doesn’t consume your life, the most effective path may not be trying to erase it but rather addressing the shame or anxiety surrounding it. Many people who search for ways to eliminate a fetish are actually struggling with guilt, often rooted in cultural or religious expectations, rather than with the interest itself. A therapist experienced in sexual health can help you figure out which situation you’re in.
Could It Actually Be OCD?
Some people who believe they have a fetish are actually experiencing intrusive sexual thoughts, a well-documented form of obsessive-compulsive disorder. The two can look surprisingly similar on the surface, and misdiagnosis is common. The old rule of thumb that OCD thoughts are distressing while paraphilic thoughts are pleasurable turns out to be unreliable on its own, because people with genuine fetishes can also feel deeply distressed about them.
The difference lies in a cluster of factors that a clinician needs to evaluate together: whether the thoughts feel wanted or intrusive, whether they align with your broader pattern of arousal, whether you engage in compulsive checking or avoidance behaviors, and how you respond to the thoughts emotionally over time. If your unwanted sexual thoughts came on suddenly, feel alien to you, and trigger intense anxiety rather than arousal, OCD is worth exploring with a professional. The treatment for OCD (exposure and response prevention) is very different from treatment for a fetish, and getting the right diagnosis changes everything.
Cognitive Behavioral Therapy
For fetishes that genuinely cause distress or compulsive behavior, cognitive behavioral therapy (CBT) is the most studied psychological approach. CBT doesn’t aim to rewire your brain overnight. Instead, it works on the thought patterns and behavioral loops that keep a fetish feeling compulsive, helping you identify triggers, challenge distorted thinking, and build alternative responses.
A pilot study of internet-delivered CBT for men with compulsive sexual behavior, including those with paraphilic interests, found significant reductions in both compulsive sexual symptoms and paraphilic symptoms after a 12-week program. Improvements in psychiatric well-being were moderate, and the effects remained stable three months after treatment ended. Notably, there was a dose-response relationship: the more of the program participants completed, the greater the improvement. This suggests that consistency matters more than any single technique.
CBT for unwanted sexual interests typically involves several components. You’ll learn to recognize the chain of events leading to compulsive behavior, from initial trigger to the thought patterns that escalate arousal to the behavior itself. The therapist works with you to interrupt that chain at multiple points, building new habits and coping strategies. Over weeks, the goal isn’t necessarily to make the interest vanish but to reduce its intensity and its control over your behavior.
Reconditioning Techniques
Some behavioral approaches attempt to directly modify arousal patterns through masturbatory reconditioning. These techniques involve using masturbation in structured ways to shift what you find arousing, typically by pairing orgasm with non-fetishistic fantasies or by using the fetish fantasy only after climax (when arousal is lowest) to build an association with boredom rather than excitement.
Four main methods exist: thematic shift, fantasy alternation, directed masturbation, and satiation. The evidence behind them is limited. A review of the research found that most of the published literature consists of uncontrolled case reports rather than rigorous studies. The reviewers concluded there was little support for thematic shift or fantasy alternation, but “some hope” that directed masturbation and satiation may be effective. These techniques are sometimes used as part of a broader treatment plan, but they shouldn’t be relied on as a standalone solution.
Medication for Severe Cases
When a fetish becomes truly compulsive or is part of a broader pattern of hypersexuality, medication can help reduce the intensity of sexual urges. Certain antidepressants, particularly SSRIs, have a well-known side effect of dampening sexual drive, and clinicians sometimes use this therapeutically. These medications work by altering brain chemistry in ways that reduce the urgency and frequency of sexual thoughts.
For the most severe cases, where someone’s paraphilic interests pose a serious risk of harm, international treatment guidelines outline a stepped approach that escalates from psychotherapy alone to hormonal medications that dramatically reduce testosterone levels. These hormone-based treatments are reserved for situations involving risk to others, require extensive medical monitoring, and are always paired with ongoing therapy. They aren’t relevant for someone who simply wants to reduce an unwanted but harmless fetish.
The important takeaway: medication is a tool for managing intensity, not a cure. It works best in combination with therapy, and the effects typically last only as long as you’re taking the medication.
What Realistic Progress Looks Like
If you’re hoping for a clean switch where the fetish disappears entirely, you’ll likely be disappointed. Sexual interests, especially ones that developed early in life, tend to be deeply rooted. The more realistic and achievable goal is reducing the fetish’s power over your behavior and emotional life. For many people, that means the interest fades to a background thought rather than a consuming need.
In the 12-week CBT study mentioned earlier, participants saw meaningful improvement within three months, with gains holding steady at the follow-up assessment. That’s a reasonable minimum timeline to expect before seeing change from therapy. Some people need longer, particularly if the fetish is intertwined with anxiety, shame, or compulsive patterns that took years to develop.
Progress also isn’t always linear. Stress, loneliness, and boredom are common triggers for sexual compulsivity of all kinds, and a fetish may feel stronger during difficult periods even after significant improvement. Building a broader, more satisfying sex life and addressing underlying emotional needs often does more long-term good than focusing narrowly on eliminating the specific interest.
Finding the Right Therapist
Not every therapist is equipped to help with this. You want someone who specializes in sexual health or has specific training in treating paraphilic concerns. A good therapist will start by helping you clarify whether your fetish actually needs treatment or whether the real issue is shame, relationship conflict, or anxiety. They won’t judge you, and they won’t automatically pathologize an interest that isn’t causing harm.
Look for therapists certified in sex therapy through organizations like AASECT (the American Association of Sexuality Educators, Counselors and Therapists) or those with training in CBT for sexual behavior. Be direct in your initial consultation about what you’re dealing with. A therapist who seems uncomfortable discussing sexual topics in detail is not the right fit for this work.