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Description: Cognitive behavioral therapists teach clients to identify and avoid antecedents to fetishistic behavior, and substitute non-fetishistic fantasies for ones involving the fetish. Neurotic , stress -related and somatoform Adjustment Adjustment disorder with depressed mood. Gender binary Gender identity Men who have sex with men Sexual identity Sexual orientation Women who have sex with women. Sigmund Freud believed that sexual fetishism in men derived from the unconscious fear of the mother's genitals, from men's universal fear of castration, and from a man's fantasy that his mother had had a penis but that it had been cut off.