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Last week I met with a client I had not seen in about five years. He was filling me in on all that had gone on in his life: his work, his former obsession with playing a particular online game, the emptying out of the contents of his childhood home precipitated by his aging mother's move near her relatives, his rapid ejaculation, and about the women with whom he had been sexual. I heard about one partner who had an unusual requirement in order for her to reach her orgasm. She needed to be holding his penis with her hand. I realized instantly that she would not be part of the 30% of women who are able to have an orgasm during intercourse. (You can't hold it in your hand if it's already inside of you.) And then I tried to conjure up positions in which two people could arrange themselves that would permit this type of holding: various arrangements of oral stimulation of her by him and a handful of ones that would allow his manual stimulation of her. Vibrator use also came to mind. Then I realized that all sorts of sexual stimulation could work for her if the crucial ingredient was that she be able to hold his penis at the same time. So, what initially seemed like an impediment to a sexual relationship actually started in some ways to look like a benefit. It sounded like this "holding" added a lot - if I understood him correctly. If her hand was "happy," then her sexuality was "happy." It's that way with a fetish . Just one aspect of a sexual situation can carry the whole experience forward in an increasingly arousing direction. Fetishes are often the "holders" for a person's sexuality. They sometimes spring from people's discomfort with integrating the fact that they are sexual. Rather than weave an acceptance of sexuality throughout their definition of who they are, people with fetishes tend to keep it fairly compartmentalized. They take the "holder" out of the closet whenever they want to be sexual. Then, when they're done, they put it back. As I reflected on the possible background of this woman I'd never met, I thought about several things.