A psychoanalytic framework for understanding the incest-spectrum group of disorders is outlined. Incest disorders are viewed as a group of perverse activities representing a dynamic solution to developmental conflict or, alternately, as compensatory enactments that serve the function of re-regulating a defective or fragmenting self-structure. While incest is typically thought of as behavioural in nature, it also involves particular psychodynamics that underpin the sexualized behavioural enactment. Incestuous activity employs sexualized, bodily engagements to restore self-regulation or to regulate intense adverse affective states. This perspective emphasizes the need to understand the developmental and psychostructural features of the incest patient. Case material is provided to illuminate aspects of this understanding.