Underlying Dissociative Adjustment in a Case of Same-Sex Sexual Compulsivity

This case study describes the psychotherapeutic process of one man, Francesco, whose compulsive same-sex sexual behavior was found to be driven by an underlying dissociative state. Francesco's therapy experience draws attention to the psychodynamics and intersectional oppressions that may influence outcomes related to the experiences of childhood trauma, subsequent dissociation, traditional religion, and same-sex sexuality. Although treatment trajectories are unique to each person, Francesco's psychotherapy experience suggests the contribution of dissociation to sexual compulsivity can be reduced by bolstering new affect regulation strategies, attending to locus of control dynamics, and promoting a more secure attachment base both intrapsychically and, initially, within the therapy relationship.