George, 20, came from a family who belonged to a strict religious sect. He was a shy student with little social life and no sexual involvement with women because this would have invoked disapproval from his parents. But his life changed when the family acquired an Austin Metro car - an object that he could safely love.
George, confused but happy, began to masturbate inside the car, or crouching down behind it next to the exhaust pipe. He was excited by the exhaust pipe especially if the engine was running and it was emitting fumes. He made great efforts to find deserted car parks and other places where he could be alone with the family Metro. He also liked the Vauxhall Nova, Vauxhall Astra, Fiat Uno and Ford Fiesta which, he said, resembled the Metro. The front of the Metro resembled a smiling child-like face George told his therapists, Padmal de Silva and Amanda Pernet at the Institute of Psychiatry, London. George found the rear of the car unpleasant, but deeply arousing even though he was afraid of being polluted by exhaust fumes.
'Elimination had formed a central theme in George's other sexual preferences,' the therapists write in the latest issue of Sexual and Marital Therapy. 'Before cars, his major preoccupation had been with children and adult women urinating. Before this, at the age of 10 or so, his interest had been in dogs urinating.'
He had relatively little interest in adult women. He had occasionally masturbated to pictures of women dressed in swimwear or scanty clothing but he was far more aroused by pictures of the family Austin Metro which he kept in his bedroom. George was treated by a technique known as orgasmic reconditioning. He was instructed to masturbate with his usual fantasy of cars until the final moment when, according to instructions, he would look at pictures of naked women obtained from magazines. Gradually he learnt to introduce the pictures of women earlier in the sequence. He was also taught to perform another mental exercise in which he imagined himself masturbating beside an Austin Metro. When the image was established in his mind he would conjure up the figure of his father or other people catching him in the act. It was an unpleasant and difficult exercise.
'These exercises were designed to change his sexual pre-occupation from cars to women and they were partially successful,' Dr de Silva said. 'George developed a greater interest in women which was helped by social skills training which we were able to give him. However, he retained a strong interest in Austin Metros which we have not yet been able to modify a great deal.'
Dr de Silva has found these methods, which are widely used, successful in modifying fetishistic interests, but the original fetish often remains and is difficult to overcome. One patient whose fetish was men's shorts and singlets was apparently cured until the Olympic Games when he found it impossible to avoid watching men in brief sportswear on television.
'Some men go through a phase where cars have a sexual significance. Horses may have a similar significance for young women at a certain stage in life. But only rarely does this become a total substitute for sexual activity as it did in George's case,' Dr de Silva said.