Guilt, titillation, and anxious confusion about sexuality and sexual relations between therapist and patient pervade the psychoanalytic community. Review of state laws and regulations as well as professional ethics codes reveals a lack of certainty about what constitutes professional misconduct, especially posttermination. Comparing the training approaches of sex therapy and psychoanalysis, the author suggests that psychoanalysis will benefit from shifting its focus on extreme cases of egregious sexual boundary violations onto greater in-depth exploration of clinically universal experience of powerful erotic and negative transference and countertransference. Innovative and experiential educational formats that promote openness, acceptance, confidence, and skill with these dynamics are the best prevention.