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It is the thesis of this paper that sex therapy produces lasting symptomatic change only through first producing character change. Sustained symptomatic relief, meaning in this context good and on going sexual functioning with a chosen partner, cannot take place without a corresponding change in those character structures which have initiated and/or maintained the sexual dysfunction. Sometimes the causes of ongoing and well-established (in contrast to transient or situational) sexual problems still seem to be primarily nonconflictual and conscious factors alone, such as misinformation and inexperience, so that mere reeducation and practice are sufficient to produce dramatic and lasting improvement. However, in the majority of cases cumulative clinical experience has indicated (Levay and Kagle, 1977; Zilbergeld and Evans, 1980) that the impressive cure rates claimed by Masters and Johnson (1970) do not take into account the high rate of recidivism, which is often delayed. These “cures” appear to represent primarily the beneficial effects obtained by patients' temporarily borrowing their therapists' benign attitudes towards sex, towards themselves, or each other, and/or modeling their interactions on the therapists' collaborative treatment behavior. Additional factors bringing about such favorable changes may include transference cures, flights into health and even symptom substitution. However, when underlying conflicts are not touched upon and no attempt is made to work them through, the ego-superego “transplants” are sooner or later rejected, as are the temporarily erected behavioral solutions, when the need for resistance or psychic defense reasserts itself. Character structure does not change, and symptoms return.