PICTURES: 15 Most Shocking Sexual Fetishes

(CBS) You've heard of foot fetishes, leather fetishes, handcuffs.

But we dug around a bit and found some fetishes so strange that it's hard to believe they actually exist.

But they do.

But what distinguishes a fetish from say, a preference or a turn-on? 

Dr. Ian Kerner, a New York sex therapist and frequent contributor to the CBS News's "The Early Show," says  fetishes are only a problem if the person experiencing them reports distress.

Yet few people report distress. Kerner says that could be because many people with fetishes are comfortable with them. They  may also be under-reported due to embarrassment.

Yet there is a battle waging within the psychological community as to whether a fetish is something that can be healthily integrated into a person's life, or whether a fetish is, by nature, psychologically debilitating.

Dr. Barry McCarthy, a therapist in Washington, D.C., says that the argument against fetishes is that they "inhibit a person's sexual desire for intimate, interactive sex," because a fetish is a "narrow, controlling thing in terms of sexual response."

PICTURES: 15 Most Shocking Sexual Fetishes

1) Psychoanalysis, in which the therapist attempts to trace the fetish to a childhood trauma or unresolved parental issues.

2) Cognitive behavioral therapy, where the therapist works with the patient as he/she navigates his/her life, using behavior reinforcement tools to break the fetish.

3) Drug therapy to reduce arousal and bring the fetish under control.