Fetishism: A Brother's Struggle with Mental Health in the Military - Psychiatry

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Understanding fetishism, particularly in the context of mental health, can be complex and sensitive, especially when it involves a family member. Your brother's behavior of taking and wearing your underwear suggests a condition known as fetishism, which is classified under paraphilic disorders in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition). This condition is characterized by intense sexual arousal from non-living objects or a specific focus on a non-genital body part. While it may seem disturbing or "perverted" to some, it is essential to approach this situation with empathy and understanding.

1. Is this behavior considered a sexual psychological disorder?
Yes, your brother's actions can be classified as a paraphilic disorder, specifically fetishism. However, it is crucial to differentiate between having a fetish and engaging in harmful or non-consensual behavior. If his actions are not causing harm to others and are consensual, it may not necessarily warrant a diagnosis of a mental disorder. Nonetheless, if this behavior is causing distress to him or others, it may be beneficial for him to seek professional help.

2. Will seeking treatment lead to military discharge?
The concern about being discharged from the military due to seeking treatment is valid, especially in a military context where mental health issues can carry stigma. However, mental health treatment is essential for overall well-being. In many cases, military personnel are encouraged to seek help for mental health issues without fear of punitive action. It is crucial to emphasize to your brother that seeking help is a sign of strength, not weakness. If he is worried about confidentiality, he should inquire about the privacy policies of military mental health services. Many professionals are bound by confidentiality laws, and his treatment details may not be disclosed without his consent.

3. Should his commanding officer be informed about his treatment?
Generally, it is not necessary to inform his commanding officer about his treatment unless there are safety concerns or if he poses a risk to himself or others. The focus should be on getting him the help he needs without adding to his stress or fear of repercussions. Encouraging him to speak to a mental health professional within the military can provide him with the support he needs while maintaining his privacy.

4. Should you inform his girlfriend or parents?
This is a delicate matter. Sharing information about his mental health struggles should be approached with caution and respect for his privacy. If he is open to it, discussing his situation with trusted family members or his girlfriend may provide him with additional support. However, if he is not comfortable with this, it is essential to respect his wishes. You can offer to support him in seeking help without disclosing his situation to others.

In conclusion, your brother's behavior indicates a need for professional evaluation and support. Encouraging him to seek help from a mental health professional who understands fetishism and its implications can be a significant step toward addressing his struggles. It is essential to create a supportive environment where he feels safe to express himself and seek the help he needs without fear of judgment or repercussions. Remember, mental health issues are common, and seeking help is a proactive step toward recovery.