People keep them under wraps, but fetishes and phobias can be crippling disorders that disrupt lives and even lead to crime
He was a bright 17-year-old who attended a prestigious school.
But the boy had a secret fetish for lingerie, which aroused him when he put it on.
He would then masturbate in the privacy of his room, says psychiatrist, Dr BL Lim, who declined to name his patient because of confidentiality.
A fetish refers to the usage of an inanimate object (or for some psychiatrists, a non-genital part of the body) for sexual arousal or fantasy.
Eventually, the boy's parents found out about his habit after his mother discovered the lingerie in his cupboard while cleaning his room.
"They got worried. So she and her husband installed a video camera in his room and discovered this tendency, and brought him to see me," says Dr Lim.
His patient's experience is similar to that of Defence Science and Technology Agency scholar Jonathan Peh, who was found with more than 200 bras in his home. When questioned by police, he was unable to say how he got them.
The 26-year-old research engineer was given a one-year mandatory treatment order for his underwear fetish, which he had developed since entering university.
He faced a total of 11 charges for crimes committed between May and November last year.
No defined cause
Psychiatrists The New Paper on Sunday spoke to say it is difficult to pinpoint a predominant cause leading to the development of a fetish, but it usually begins with associating an object with sexual release.
Dr Lim's patient had been exposed to online pornography since the age of 13, and also watched footage of deviant sexual practices.
"He experimented with these practices and found himself sexually aroused when he wore bras and underwear.
"He found it hard to talk about sex to others as this was a taboo subject, and he had not realised such practices were unusual," the doctor explains.
While it is normal to be aroused by certain types of clothing such as fishnet stockings or provocative lingerie, it becomes a problem when the object is the preferred or sole manner in achieving sexual satisfaction, says Dr Brian Yeo, consultant psychiatrist at Mount Elizabeth Medical Centre.
Not a crime
The practice of indulging in a fetish is not a crime.
But it can sometimes lead a person to break the law, such as when he has the urge to steal the objects he has a fetish for.
Referring to his patient, Dr Lim says: "He had initially bought the lingerie, but had been contemplating stealing the underwear belonging to neighbours as he felt that would arouse him more.
"We see male patients who are fixated with lingerie more commonly. They get in trouble with the law for stealing this."
The impact of a fetish on a person or his family becomes pronounced only when his habit is discovered, or when an arrest is made, say psychiatrists.
In such cases, arrests may shame the person with the fetish and his family, or affect his job, says Dr Yeo.
Fetishism, like many other atypical sexual interests, is not recognised as a mental disorder.
It crosses the line to become a psychiatric disorder when it harms the individual or others around him, says Dr Tan Hwee Sim, specialist in psychiatry at Raffles Counselling Centre.
Few seek help
Because fetishes are often expressed in private, most do not seek help unless the habit is exposed publicly, such as when the person is arrested, says Dr Yeo.
The Internet has also made it easy to buy items like soiled underwear, which some have a fetish for, he adds.
Due to the sensitive and covert nature of the subject, research or studies investigating it are limited, say psychiatrists, who were not able to provide exact numbers on the percentage of people here who suffer from the disorder.
He estimates that in the past 10 years, he has seen fewer than five patients who struggle with fetishism.
Treatment for a fetish can be divided into two levels: The first focuses on preventing the person from breaking the law because of the fetish.
At this level, adverse or negative consequences are linked with the object of sexual interest in order to deter theft, says Dr Yeo.
The second deals with modifying or converting the fetish into a healthier sexual habit, such as through incorporating the object into regular sex, as long as the person's partner does not mind.
To treat the root cause of the issue, the psychiatrist needs to explain to the patient how the link between the object and sexual release occurred, then seek to incorporate it into healthy sexual acts with his partner, adds Dr Yeo.
"If he has no partners, then the goal would be to encourage more adult-to-adult interaction and shift the focus away from the object," he says.
In some cases, medication is prescribed to lower preoccupation with the sexualised object and sexual arousal, says Dr Tan.
While it is possible for most who struggle with fetishes to recover, many are not motivated to change their behaviour, says Dr Lim.
"The patient I saw was better but defaulted treatment after some time.
"He continued to have significant fetishistic urges, especially during periods of stress in school," he says.
Says Dr Tan: "Fetishism is not a problem if an individual is comfortable with it.
"They will need to seek help if it is causing them distress or guilt, or if it is causing harm to themselves or others."
Turned in for turn-ons
These fetishes got people into trouble with the law:
Wallets/smell of leather (2013)
A serial thief with a fetish for sniffing women's leather wallets was jailed for 13 months after a judge decided he had already been given enough chances to mend his ways.
The 48-year-old also took upskirt pictures of a woman bending over in a toy store.
The man, who becomes sexually aroused by the smell of leather, has been in and out of jail since 1986, spending a total of 16 years behind bars.
He was spared prison in May 2011 when he was placed on probation due to his psychiatric disorder.
But he breached the order repeatedly, stealing and insulting a woman's modesty.
Urine and faeces (2011)
A sales representative, 31, walked by two kindergartens and feeling sexually aroused, entered the premises.
There, he wrote down on a whiteboard his fantasies involving girls, urine and faeces.
A few months later, he went into a child care centre and headed for the toilet, expecting to find improperly disposed diapers, with which he would fantasise and masturbate.
He found several used diapers, which he took with him, smearing their contents on the walls of the childcare centre.
The man had previous convictions for committing obscene acts, outraging the modesty of a five-year-old girl and criminal trespass.
Taking into account two other charges, the judge sentenced him to six months' jail and fined him $2,500.
A 48-year-old, who gets sexual pleasure from riding motorbikes belonging to others, was caught stealing an $8,700 bike at Marina Bay Sands.
He was diagnosed with the fetish more than 20 years ago, and it has landed him in jail at least three times.
He was again arrested after a bike owner's brother spotted the motorcycle in a carpark on Seah Im Road.
A psychiatrist from the Institute of Mental Health found he was suffering from depression and paraphilia, a condition characterised by abnormal sexual desires involving extreme or dangerous activities.
The problem started in his teens when he experienced sexual pleasure riding his uncle's bicycle.
He bought his own bicycle but reported getting more gratification by riding someone else's.
Later in his teens, his fetish moved on to motorcycles. He would usually take someone else's for a ride and then put it back.
He had been in and out of jail since 1996 for stealing offences, and had attempted suicide several times.
Smell of women's armpits (2008)
A man, 36, was fixated with wanting to smell women's armpits.
Over 15 months, he molested 23 women - from girls as young as nine to women in their 50s.
Apart from his tendency to sniff his victims' armpits, he also touched a 13-year-old's breasts, placed his hand up her skirt and exposed himself to a 53-year-old cleaner.
The man stalked his victims and followed them into lifts.
He would strike inside the lifts, at staircase landings and even at their homes.
The man, who is mildly retarded, was sentenced to 14 years of preventive detention, a jail term for hardcore prisoners with no chance of parole.
He was also sentenced to 18 strokes of the cane.
Women's underwear (2008)
A Singaporean professor teaching at the Electronic Science and Technology University in China was placed on probation for 12 months after he was caught stealing women's underwear, which aroused him sexually.
The 39-year-old, who is married, was caught at a Nanyang Technological University hostel, where he had returned to during his leave from work.
The underwear he had stolen had been left on railings outside hostel rooms.
His lawyer said he had been sexually aroused by undergarments since he was 14.
Smelly shoes (1999)
A 43-year-old caught twice with dozens of used shoes explained to the court that he was addicted to their smell.
Comparing his urge to smell old shoes to that experienced by drug addicts, the lorry driver said he typically took shoes that had been left outside flats.
The man kept the shoes until the smell ran out.
Then he either gave them to the Salvation Army or tried to return them.
The judge, who took into account two other similar charges against him, sentenced him to a total of 25 weeks' jail.