As originally published on Understanding Infantilism
A common question asked of ABDLs is "why?" Strong stigmas against diapers are common, so it is hard to imagine why people who aren't incontinent would want to wear them. This simple question is actually quite difficult to answer.
There are, of course, many theories on what causes paraphilic infantilism and diaper fetishes, some dating back to 1905 [1]. While there is an abundance of theories, the theories are largely untested. ABDLs are rare and varied, so significant empirical studies are difficult. They are also generally well-adjusted, and so seldom seek medical help [2,3]. Many reported cases actually sought help for something more severe, and this other factor might have dominated their condition [4, 5, 6, 7]. In addition, law enforcement records provide little information on ABDLs, since the they are generally law-abiding. Finally, many ABDLs live reasonably happy and successful lives, so they are not given a high priority for research. As a result, there hasn't been much research into the causes of paraphilic infantilism and diaper fetishes.
The best-tested theory for the cause of fetishism is behavioral conditioning. It holds that items can become erotic if they become associated with sex. Experiments have exposed college students to pictures of neutral objects, such as shoes or coins, intermixed with heterosexually erotic pictures [ 8, 9]. These experiments were able to eroticise the neutral objects, but did not report developing of a compulsive fetish. This may be because the students were sexually somewhat mature or did not reinforce the connection over long periods of time. There are some anecdotal accounts of people becoming diaper lovers after erotic incidents that involved diapers. The reliability of these accounts is unknown.
The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders categorizes infantilism loosely as a masochism [10]. No attempts to experimentally induce masochism are known. However, it has been observed that masochism is unique to the modern Western culture, unlike transsexualism and other paraphilias [11]. This implies that masochism is environmentally enabled, possibly by differences in how identity, guilt, or emotional trauma are handled. Emotional stress or trauma that isn't resolved directly needs to be redirected. Mental mechanisms are a subconscious way of deflecting those pressures. These were documented by Sigmund Freud around the turn of the century, and are summarized at ChangingMinds.org.
For example, consider a schoolchild who is under pressure to be more mature. To protect his self-esteem, his subconscious might use a defense mechanism. One mechanism is "substitution." Instead of suffering the mental damage of not having what he wants, he changes his wants. He subconsciously substitutes one desire for another desire. Instead of an urging to be mature beyond his years, his subconscious urges him to be infantile. Substitution is only one of a list of mechanisms. Another example of mechanisms driving infantilism can be found in Three Things to do with a Wet Knee Brace.
Genetics, and possibly the prenatal environment, have been shown to influence homosexuality, while not causing it deterministically [12]. It is possible that these factors might also influence the development of paraphilic infantilism or diaper fetishes.
Another reason why there is so little research is because so few are demanding it. Many ABDLs have come to accept their interests, and so no longer need to know why. However, there are others who may be struggling desperately to control their urges, and are seeking a cure. There is no known cure. It is possible that the urges will fade in later life [13]. The author has corresponded with one man who claims to have "outgrown" his infantilism at 53. Behavioral and chemical therapies have uncertain results. One new case of infantilism actually developed after treatment with Depo-provera [14].
While there is no magic cure, there may be ways to moderate the effects of infantilism or fetishism. The first step is to look back into one's history for traces of trauma or abuse. There might not be any, but if there is, addressing it now has two benefits. It will make the infantilism or fetishism easier to control, and it may also address other unnoticed effects of the historic event. The second step is to carefully evaluate the acceptability of one's infantilism or fetish in light of their situation and beliefs. Much time and suffering is caused by perceptions. Since these years (or decades) of struggle cannot be replaced, it is important to be certain that the struggle is necessary.
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