This chapter describes the heterogeneity found in psychodynamic perspectives particularly as applied to understanding and treating sex offenders. Classical and contemporary psychodynamic perspectives are described in terms of their philosophical differences as is the impact of specific psychodynamic perspectives on the therapeutic relationship. The case of a serial child sex offender is examined through the lens of various psychoanalytic theories to demonstrate how different perspectives bring about multiple alternative understandings of the sex offender as a unique person. As demonstrated in this case example, psychodynamic perspectives contribute to a holistic approach to the rehabilitation of sex offenders that can assist in and augment the benefits achieved by time-limited, reductionistic, manualized treatment programs. A ‘both-and’ rather than ‘either-or’ attitude to the treatment of sex offenders is proposed that seeks to maintain a balance in recognizing the priority of recidivism risk reduction according to empirical research findings while appreciating the complexity of the sex offender’s psychopathology which gives rise to their criminal behavior.