I have had fetishes for feet and tickling since I was a teenager, but have never been confident in opening up about it before. I told my current girlfriend and, happily, she did not reject me. However, she will not take part. When it comes to me wanting to worship her feet, she declines because she believes they are inherently unhygienic. I don’t want these fantasies to be the only part of our sex life, but I would like them to play some part.

While it is important that all sexual practices between two people are consensual, it’s also reasonable to introduce something unusual or fetishistic to a partner cautiously and incrementally. Instead of rushing to propose something that might seem radical or even bizarre, help her to get used to the idea by gradually suggesting something more palatable. It is often best to start with something that would not be generally considered weird. So, rather than requesting a full menu of foot worshipping – and knowing that her discomfort is partly related to her notion of hygiene – perhaps you might initiate love-making in a bath, shower, swimming pool or the sea. Make this session 95% “vanilla”, including her favorite sensual stroking or oral pleasuring to fully arouse her, then switch to something such as oral toe-pleasuring. If she enjoys this, you can repeat and extend it until it becomes a regular aspect of your love-making. Eventually, you can introduce something slightly more advanced, but it must always be very gradual.

• Pamela Stephenson Connolly is a US-based psychotherapist specialising in sexual disorders.

• If you would like advice from Pamela Stephenson Connolly on sexual matters, send us a brief description of your concerns to private.lives@theguardian.com (please don’t send attachments). Each week, Pamela chooses one problem to answer, which will be published online and in print. She regrets that she cannot enter into personal correspondence.