Sexual Aversion, Disgust, and Fear of Intimacy: A Comprehensive Case History Using a Multimodal Therapeutic Approach

This single-case study examines the psychotherapeutic journey of a 23-year-old woman experiencing a persistent and long-standing fear of emotional intimacy and aversion to physical intimacy, which led to the active avoidance of sexual encounters, psychological distress, and interpersonal difficulties. Over 26 one-hour sessions, an integrative therapeutic approach was employed, combining elements from psychodynamic, acceptance and commitment, cognitive-behavioral, and exposure therapies, with psychoeducation and sex education playing pivotal roles. The treatment resulted in significant improvements, as evidenced by both quantitative and qualitative assessments. Quantitative measures of emotional distress—specifically anxiety, depression, and fear of intimacy—initially increased during intentional exposure but showed significant improvements at 6-month and 1-year follow-ups. Qualitative data revealed enhancements in self-concept, increased self-compassion, and improved social functioning aligned with the individual’s life aspirations. This case study highlights effective therapeutic strategies for addressing sexual aversion in young adults and demonstrates the potential for alleviating symptoms and enriching quality of life through an integrative approach.