This paper illustrates the importance of the thing-presentation in clinical work by examining sexual thing-presentations. A modern ego psychological conceptualization of sensory emotional representations (thing-presentations) can enhance our understanding of conflicts around sexuality and intimacy and illuminate unconscious emotional dynamics underpinning sexual experience. I present two case vignettes that demonstrate how the identification and analysis of thing-presentations can deepen treatment for some patients who suffer from sexual inhibitions, difficulties with intimacy, and unsatisfactory object choices/relations. I also address the importance of locating thing-presentations within the context of a modern ego psychological framework.