AbstractThe single most significant cause of injury to women in the United States is battery by someone with whom they have had an intimate relationship. In many cases, substance-related disorders are at play. But the relationship of substance abuse and violent behavior is not simply one of cause and effect. Addictive sexual disorders are also associated with domestic violence, which may start as pressure to submit to unwanted sexual play. Sex may deteriorate into hostile or repressive activity, with abused partners participating to avoid physical violence. A common barrier to treatment of sexual addiction is the perpetrator's fear of exposure. Another complicating factor is the clinician's counter transference. Helping professionals would do well to develop clinical plans for approaching both victims and perpetrators. This should include taking a thorough history, having literature on hand about available resources, obtaining informed consent, documenting the trauma, and considering the consequences of whatever actions are taken.