Case material is presented from two patients suffering from addictive
sexual behavior. The term addiction is used because of the intense, dr
iven quality of the behavior and because of its mood-elevating effects
. Psychodynamically, the patients' sexual acts helped to undo feelings
of rejection at the hands of their mothers and to enhance feelings of
lovability and of self-esteem. The behavior also helped to neutralize
powerful feelings of rage toward the mother. In one patient, the acts
also helped to ease inner turmoil related to an underlying attention
deficit disorder. I speculate that some adults with addictive sexual b
ehavior may have underlying attention deficit disorders. In both my pa
tients, the sexual behaviors served the self-regulatory function of al
leviating inner feelings of anhedonia and depression. When they decrea
sed their sexual activities during the course of the treatment, they r
equired adjunctive antidepressant medication. The underlying meaning o
f the medication and countertransference attitudes toward such patient
s are explored.